Radiotherapy commonly asked Q&A

Hair loss on the scalp and head area due to external beam radiotherapy treatment.

Radiotherapy treatment hair loss,external beam radiotherapy treatment

When preparing for treatment of cancer you may have many concerns on your mind. Hair loss is associated with many cancer treatments and is a natural concern for most people. We are here to help you look good and feel able to cope, should you be affected. Your cancer nurse specialist or radiographer will tell you more about your treatment and what to expect in terms of possible hair loss and how to best care for your scalp.

Additionally, take a look at our sections below to find answers to commonly asked questions about radiotherapy that affects the hair on your scalp.

Radiotherapy commonly asked Q&A

The following Q&A is for the subject of hair loss on the scalp and head area due to external beam radiotherapy treatment.

• How will I know if external beam radiotherapy will cause hair loss on my scalp or head area?
• What sort of questions do I need to ask my medical team so I can be clear about how much hair I might loose?
• Radiotherapy treatment to the head area – questions for your medical team
• Radiotherapy – will my hair grow back and what should I expect in terms of new hair growth?
• Will I be offered an NHS wig or hair piece prescription?
• How should I look after my hair and scalp during radiotherapy treatment to the scalp area?
• How long will it take for new hair growth to appear?

How will I know if external beam radiotherapy will cause hair loss on my scalp or head area?

Radiotherapy will only cause hair loss in the part of the body being treated. Hair loss can happen where the radiation beam enters and leaves the body. This means that hair loss will be isolated to areas where the external radiotherapy beam enters and leaves the head area.

For example:

Head area – if you have external beam radiotherapy to the top of your head you will probably lose some hairs on your scalp. The amount of hair lost will depend upon the size of the area being treated.

If you are having treatment for breast cancer and radiotherapy includes your armpit you may lose some under arm hair. But you will not loose hair on your head (scalp).

If you are being treated in the neck area and have facial hair e.g. a beard, you may find that you lose hairs from your beard.

Ask your cancer nurse specialist or radiographer to show you exactly where your hair is likely to fall out. Take a look at our helpful list of questions for your medical team.

What sort of questions do I need to ask my medical team so I can be clear about how much hair I might loose?

Initially your radiotherapy doctor (clinical oncologist), cancer nurse specialist or radiographer are the best people to ask about hair loss concerns. Once you have a clear picture of what to expect you can make plans for managing any hair loss.

Talking to your medical team about hair concerns may be something totally new to you, but most cancer doctors and nurses understand that hair loss can be a very emotional, physical and practical concern for you. So don’t feel uncomfortable about discussing your concerns about how you will look with your medical team because they are used to it and talk to people about their hair concerns every day.

We share this with you because people often tell us that they feel embarrassed to bother their busy medical team. Having clear facts about your treatment will help you to better prepare and avoid confusion.

Below are some suggested questions for your cancer nurse specialist or radiographer. It may be a good idea to write down any questions for your medical team on a note pad. You can then make a note of their response so that you are clear about hair loss. Please remember that if you are having more than one treatment, such as chemotherapy, you will need to ask questions related to that treatment as well.

Radiotherapy treatment to the head area – questions for your medical team

Can you give me an indication of the size and location of possible hair loss – for example larger than a 10p piece? You may wish to ask them to draw a diagram to be really clear.

Should I prepare myself for total hair loss across my scalp? At what stage in my treatment do you think this will occur and will my hair grow back?

Will my eyebrows, eyelashes (or beard – men’s facial hair) be affected?

Is there anything that you can suggest to help minimise hair loss?

If necessary, will I be offered a referral letter for an NHS hair piece or wig

If hair loss is upsetting me can you make any other suggestions to help me?

Hopefully your medical team will provide you with the answers you need. You can then read the advice topics that are most helpful to your specific needs.

Radiotherapy – will my hair grow back and what should I expect in terms of new hair growth?

Your cancer nurse specialist or radiographer need to offer you advice which is directly related to your dosage and radiotherapy treatment type. This is because sometimes hair does grow back and other times you may be left with areas of thinning or baldness. Should this happen to you we will offer you lots of help and ideas on looking good.

If you are told that your hair is likely to, or will, grow back then it can take a little while. In most cases the new growth is slower then following chemotherapy treatment. But most hair will start to grow back between three to six months post treatment, when the skin has healed and the Hair growth cycle can rejuvenate.

In other words re-growth is likely to start after treatment is complete and the skin and surrounding area has healed.

Take a look in our section Radiotherapy new hair growth for in-depth information.

Will I be offered an NHS wig or hair piece prescription?

If you are being treated in an NHS hospital you should be offered a referral to a wig supplier.

NHS referral for a wig or hair piece

Whilst it is normally your oncologist that will initially tell you that hair loss will be a side effect of your cancer treatment e.g. external beam radiotherapy to the scalp area, it is usually your cancer nurse who will talk to you in more detail about preparing for hair loss and action your referral for a wig supplied through the NHS system.

Take a look in our section Visiting your local NHS wig supplier for in-depth information.

We also have a dedicated radiotherapy section in our wig guide. Take a look at Radiotherapy – wigs and options.

How should I look after my hair and scalp during radiotherapy treatment to the scalp area?

If you are having radiotherapy directly to or around the scalp you will need to take individual guidance from your medical team about how to care for your hair and scalp. Your cancer nurse specialist or radiographer will tell you how to care for your hair and scalp and what products are suitable.

It may be that you have talked to your medical team and they have advised you that you need to use specialist creams and lotions. However, if they have said you are free to take care of your scalp as you wish then our guide to Scalp care may offer you some ideas and insights.

“When it comes to hair care, some people find that the area of hair loss is a patch or small area. You may be advised to use special lotions around the sensitive treatment area but you may also be told that you can continue to use your regular shampoo and hair products. In the case of treatment to the scalp area you are best advised to ask your cancer nurse specialist or radiographer.”