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Hair loss and cancer treatment

Hair loss is one of the most well known side effects of cancer treatment. It is a common side effect of chemotherapy.

Hormone therapy and biological therapies sometimes cause hair loss, but this is less common.

Radiotherapy makes the hair fall out in the treatment area. Hair in other parts of the body is not affected.

Cancer drugs

Some chemotherapy, biological therapy and hormone therapy drugs cause hair loss.  Some drugs thin your hair. But other drugs may cause complete hair loss.

Complete hair loss can happen gradually. Or hair may fall out fairly quickly, in clumps. You may also have thinning or loss of eyelashes, eyebrows and other body hair, including pubic hair.

If cancer drug treatment makes your hair fall out, it almost always grows back once your treatment has finished. This may take several months. Your hair will probably grow at the rate that is normal for you. By 4 to 6 months after chemotherapy it should have grown back fully. When it grows back, your hair may look the same as it was or may be thicker or thinner. Sometimes it can be a different colour, or curlier than it was before.

Radiotherapy

Radiotherapy to the head always causes some hair loss. Your hair will fall out in where the radiotherapy beams enter your head. You can also lose some hair on the opposite side, where the radiotherapy beams pass through.

After radiotherapy it may take more than 6 months for your hair to grow back. Hair re-growth may be patchy at first. For most people, hair usually grows back completely in time. But for some people it does not grow back completely and may stay patchy.

 

Tips on coping with hair loss

You may find that it helps to cut your hair very short before your treatment starts. This can help you to get used to seeing yourself with less hair or without hair. Having very short hair means that when it does start to come out, the change is not so dramatic. And you see less hair on your pillow and in the shower.

If all, or some, of your hair has fallen out you may decide to cover your head with a soft hat or scarf. This helps to protect your scalp from the sun and keeps your head warm in cold weather. You may need to wear a soft hat in bed to keep your head warm.

Other people prefer to wear a wig until their hair grows back. These days, wigs are very natural looking. Most people can’t tell that you are wearing one.

 

Your feelings about hair loss

Hair loss and hair thinning can be very stressful. Some people find it the hardest part of having cancer and its treatment. This is understandable because our appearance is closely linked to our feelings of self esteem. Trying to accept sudden changes in your looks can be very hard. It’s not unusual for people who have lost their hair to feel angry and depressed. You may feel worried about how your friends and family see you. And you may think that you are no longer as physically attractive to your partner.

If you are trying to cope with a change in your appearance, social activities can be more of a struggle. If you have children or grandchildren you may worry about how they feel about seeing you without hair. And you may worry about how their friends will see you, and how this may affect your children. It’s natural to worry about these things.

The important thing to remember is that the people closest to you will not see you any differently as a person. They will want to support you as much as they can, so it is important to tell them how you’re feeling. Talking things through can help you to feel less isolated and more able to cope.

 

Types of wigs

Before you make a decision about buying your wig, it’s important to understand the differences between the types of wigs that are available. Wigs are made from either

You can also get wigs that are made of both.

Man made (synthetic) wigs

Synthetic wigs are a lot cheaper than real hair wigs. They can cost anywhere between £50 and £200. Most synthetic wigs come ready to wear in a wide variety of styles, lengths and colours. You don’t have to style them and they won’t get damaged in the rain. You can usually get your wig quite quickly after having your fitting.

If all your hair has fallen out you can get sticky (adhesive) pads with your wig to stop it slipping. Some people say wearing these pads makes the wig feel more secure and helps them feel more confident. Acrylic wigs can be washed and they usually last between 6 and 9 months. This is usually plenty of time to allow your hair to grow back, although it may not be as long as it was before your treatment.

Synthetic wigs should not be exposed to direct heat. It can melt the fibres and make the hair frizz. So don’t use a hair dryer or curling wand. And you’ll need to wash your wig in cold water.

Real hair wigs

Real hair wigs are much more expensive than synthetic ones. The exact cost depends on where you buy the wig and its style and length. Prices range anywhere from £200 to £2000 for a top of the range, custom made wig. Despite the cost, some people prefer to have a real hair wig.

Real hair wigs last much longer than synthetic ones – between 3 and 4 years. If you decide to have a real hair wig you need to have a fitting before, or soon after your treatment begins. It should then be ready when your hair begins to fall out.

Some real hair wigs need to be styled and set by a hairdresser. If your wig needs to be cleaned professionally you may need to buy two, so you always have one to wear. Your wig stylist can tell you if your wig can be washed at home.

 

Getting a wig on the NHS

Wigs are free of charge on the NHS if you have one or more of the following

  • You have your treatment as an inpatient (meaning you stay in hospital overnight)
  • You are under 16 years old, or between 16 and 19 years old and in full time education
  • You or your partner are getting Universal Credit, Income Support, Income based Jobseeker’s Allowance or the guarantee credit of Pension Credit
  • You have an NHS tax credit exemption certificate
  • You are named on a valid ‘help with health costs’ (HC2) certificate 

If you are entitled to a free wig the NHS will provide you with a new one every 6 months if necessary. There is no national limit on the number of wigs the NHS can supply you with. But individual hospitals may set their own limits.

If you are on a low income, but don’t qualify for a free wig, you may still be able to get some help towards the cost. This is explained in the Department of Health leaflet called Are you entitled to help with health costs? (HC11). The leaflet is available at post offices or from your hospital. You apply for this help on form HC1. If you are entitled to help you will receive either a full help certificate (HC2) or a limited help certificate (HC3).

  • Certificate HC2 means that you don’t need to pay for your wig
  • Certificate HC3 means that you may get some help with the cost

If you are an outpatient and don’t otherwise qualify for a free wig, you will have to pay for one. Being an outpatient means you attend hospital but don’t stay in overnight. Buying an acrylic wig on the NHS costs anywhere between £50 and £200 depending on the type of wig you want. The Department of Health leaflet called Charges and optical voucher values (HC12) has details about how much NHS wigs cost.

You can see the HC11 and HC12 forms on the Help with health costs page of the NHS Choices website

You may decide to buy a wig privately instead. Human hair wigs are not prescribed on the NHS unless you are allergic to acrylic wigs or have a skin condition that will be made worse by an acrylic wig.

If you are still not sure what you are entitled to, speak to your hospital social worker or clinical nurse specialist. They can make sure that you’re getting all the help you are entitled to.

 

Buying a wig privately

If you decide to buy your wig privately there are several options. You can buy it

  • From a wig supplier such as a department store
  • Directly from a wig manufacturer
  • From a specialist wig store

Many places have a private room where you can have your fitting. But if not, don’t be afraid to ask for one. Some companies will come to your home to fit wigs. The cost of fitting and styling the wig is usually included in the price of the wig but it is always best to check. If you have a wig made for you, this may take longer and need 2 or 3 fittings.

You don’t have to pay VAT (Value Added Tax) on wigs that are bought for hair loss caused by cancer treatment. But you must fill in a VAT form at the time you buy your wig. Be sure to ask the supplier for this form, because you can’t claim the VAT back later. There is a list of places to buy a wig from on the next page.

 

Choosing and fitting your wig

If you’re staying in hospital (an inpatient) and having a wig provided on the NHS, the nurses will organise a wig fitter to come and visit you on the ward. Many hospitals will also organise this if you are an outpatient, but it may not happen everywhere.

Your wig fitter will help you decide on a style and colour that you are happy with.

Seeing the wig fitter can be upsetting for some people. It may be the first time that you really have to face the fact that you are going to lose your hair. Wig specialists will be very sensitive to this and will try to make the fitting as easy as possible for you.

The most important thing is that you don’t rush things and you get a wig that you feel suits you.

You may want to choose your wig before your hair begins to fall out. That way it is much easier for the wig specialist to match your real hair style and colour. It also gives you a bit of time to get used to the idea of wearing a wig. If you do this you will need to get a smaller size once you have lost your hair. Or you can choose a wig that adjusts to head size. Many people find it helps to bring along a relative or good friend to their wig fitting. They can support you through this tough time as well as helping you choose a wig that suits you best.

The following tips may help you choose a wig

  • Choose a wig that is most like your original hair colour and style
  • Your hairdresser or wig specialist can cut or style a particular wig to suit you
  • Always check that you have the wig on the right way around – it is surprisingly easy to put them on backwards
  • Buying an expensive wig doesn’t guarantee it will look more real. Some less expensive ones can look very real
 

Tips for wearing a wig

For the first few days or weeks it may feel very strange to wear a wig. Some people never get used to it and feel more comfortable without it. Others say that they forget they have their wig on. You won’t know until you try it.

Whoever supplies your wig should give you instructions about how to wear it and care for it. Follow these instructions carefully.

 

When can I stop wearing my wig?

This is really up to you. It can take a bit of time for you to feel confident enough to go out without your wig. But you may feel ready to stop wearing it before your hair gets back to your pre treatment length. A shorter look may really suit you and give you a new image.

Some people say it is a relief to get rid of the wig and feel like themselves again. Others may need more time. Just be kind to yourself and don’t expect too much. You have been through a lot in the past few months and had to deal with many changes in your life. So go at your own pace.

 

Other ways to cover your head

Some people don’t want to wear a wig, or may not want to wear one all the time.

The video below shows you different types of hats and scarves you can wear instead


 

View a transcript of the video showing the different types of hats and scarves you can wear when you have hair loss (opens in new window).

There are lots of alternatives, including hats, scarves, beanies, turbans, stretchy tubes and caps. You can buy these in high street shops or on the internet. There is also a list of suppliers on the next page. You can find the stretchy headwear shown in the video at Buffwear.

 

Other body hair

Some treatments cause other body hair to thin or to completely fall out. This includes your eyelashes and eyebrows. You can use make up to disguise these effects. In this section you can find tips and advice about skin care and using make-up during your cancer treatment.

 

More information about hair loss

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Updated: 28 March 2014