Causes and Preparation For Hair Loss
Many people will lose either some or all of their hair as a result of treatment for breast cancer. For some, hair loss can be one of the most distressing side effects of treatment. You may feel that your hair is an important part of how you feel about yourself and losing it may affect your confidence and self-esteem. Some people find that being prepared for hair loss before it occurs helps them cope better when it happens.

The experience of hair loss, scalp and hair care, and hair regrowth will be different for everyone. There are also differences according to hair type. Speak to your treatment team for individual advice and support. 


Hair loss is a visible side effect of treatment and can change how you view yourself. For many of us, the way we feel about ourselves is closely linked to the way we look, and losing your hair can be devastating. You may feel anxious at the thought of losing your hair, or angry and unhappy that this has happened in addition to your cancer diagnosis and treatment.

Hair loss may also make you feel vulnerable and exposed. You may see it as a constant reminder of your treatment, labeling you as a ‘cancer patient’ or feel that hair loss has prevented you from keeping your diagnosis private. Some people feel guilty about being upset when they lose their hair as they feel there are other, more important things to worry about.

There’s no right or wrong way to feel and, whether you lose some or all of your hair, the experience can be very distressing.

Some people describe hair loss as the most difficult side effect to deal with. Others find that losing their hair isn’t as upsetting as they thought it would be. While some people adjust quickly to hair loss, others find that it takes longer, or is more difficult to accept and adapt to than they imagined.
In some cultures and religions, hair has a particular significance. If the hair has a special significance for you, losing it may affect your cultural or religious identity as well as your body image and self-esteem. This can make it even more difficult to come to terms with. If you are finding these feelings overwhelming you may wish to speak to your treatment team or find further counseling and support.

If there’s a chance that you will lose your hair, your treatment team will talk to you about what might happen before treatment starts. This should include information about any risk of permanent hair thinning or hair loss that could happen due to the treatment. As well as talking about practical issues such as caring for your scalp or wearing a wig, you can also discuss your feelings about losing your hair and what support might be available to help you adjust to it.

Each person will find their own way of dealing with hair loss, but it can be helpful to talk to others who have been through the same experience.


You may feel that losing your hair means you will need to tell people about your diagnosis when you would prefer not to. However, it’s up to you who you tell.

Some people tell just their family and close friends, while others are happy to let everyone know.

People will respond to you losing your hair in different ways, and you may find some reactions difficult to understand.

A change in appearance may make you feel less confident about socializing with friends and family. However, withdrawing from your social life may make you feel more isolated or that your diagnosis is preventing you from doing the things you enjoy. Many people find continuing to meet up with others is a useful distraction and helps to keep some normality.
Cancer affects a family in many ways. Every family member’s experience is unique and different, often making it hard to know how to provide support to one another. There are changes in day-to-day routines and more responsibilities to be managed. Feelings of anger, sadness, helplessness, regret and fear may touch different family members at different times, making life unpredictable for everyone.

When someone in the family has cancer, it is normal to focus attention on that person’s medical treatment, and their well-being. Many parents try to protect their children by not sharing information about the situation. We don’t often realize that even if they are not told about cancer, children of all ages can feel the impact of an illness on a family.


Chemotherapy destroys cancer cells by interfering with their ability to divide and grow. It can affect healthy cells throughout the body such as the cells in hair follicles, which is why chemotherapy can make your hair fall out. As well as the hair on your head, this can also affect your body hair including eyebrows, eyelashes, nasal and pubic hair, and chest hair for men.

Not all chemotherapy will make your hair fall out. Some drugs don’t cause any hair loss and some will cause hair to thin. However, others make hair fall out completely. The most commonly used chemotherapy drugs to treat breast cancer will cause some hair loss.

How much hair you lose will depend on the type of drugs you are given and the dose. Drugs that are given in smaller doses on a weekly basis or are taken by mouth are less likely to cause hair loss.
If you are receiving a combination of chemotherapy drugs you are more likely to have hair loss. Your treatment team or chemotherapy nurse will talk to you about your treatment and how likely you are to lose your hair.

When your hair will fall out or start to thin depends on the type of drugs used, the dose, and how often you have chemotherapy. If you have chemotherapy every two to three weeks, hair loss will usually start two to three weeks after your first treatment. If you have chemotherapy every week, the hair loss may happen more slowly. If you are going to use scalp cooling the timing of any hair loss may be different.

Your hair will usually start to grow back around three to six months after your chemotherapy has finished. Some people find that it starts to grow back before they have completed all their chemotherapy.
Hair loss from breast cancer treatment is almost always temporary, but in some cases, it can be long-lasting or permanent. 
Targeted (Biological) Therapy
Targeted (biological) therapies are treatments that block the growth and spread of cancer.

Some targeted therapies may cause hair loss or hair thinning. These include trastuzumab deruxtecan (Enhertu), trastuzumab emtansine (Kadcyla), abemaciclib, palbociclib and ribociclib.

How much hair you lose will depend on the drug and whether you are given it alongside other drug treatments like chemotherapy or hormone (endocrine) therapy. Your treatment team will tell you about the treatment they recommend and how likely you are to lose your hair.

Your hair will usually grow back after your treatment has finished. However, people with secondary breast cancer may have treatment for a longer period. This is because treatment is given for as long as your treatment team feels you’re benefitting from it. This means hair loss or thinning may be long-term.
Immunotherapy rarely causes hair loss. However, a small number of people may experience hair thinning or hair loss with the immunotherapy drug atezolizumab. Hair loss may be more likely if you have atezolizumab and nab-paclitaxel.
Radiotherapy uses high-energy x-rays to destroy cancer cells.

Like chemotherapy, it affects healthy cells as well as cancer cells so can cause hair loss, but only in the specific area being treated. This means that you will only lose hair from that area.

If you’re having radiotherapy to the lymph nodes in your armpit as well as your breast you’ll lose underarm hair in the area that has been treated. Men may also lose chest hair from the part of their chest that has been treated.

If you are being given radiotherapy to treat breast cancer that has spread to the brain, you may experience hair loss on your head. If you’re having stereotactic radiotherapy (a very precise radiation treatment given to targeted areas), this will just be in the area being treated. If you’re having radiotherapy to the whole brain, this will usually cause complete hair loss on the head. The radiographer (a person trained to give radiotherapy) or specialist nurse will talk to you about the likelihood of you losing your hair before treatment starts.

Hair loss usually starts two to three weeks after your first radiotherapy treatment.

Any hair you lose will usually start to grow back once you have finished radiotherapy treatment, although it can take several months. It may not grow back completely and might be patchy. For some people, hair loss may be permanent.
Hormone (endocrine) therapy
Taking hormone therapy such as tamoxifen, anastrozole (Arimidex), exemestane (Aromasin), or letrozole (Femara) can cause hair thinning. This is usually mild and might only occur for a short time. However, in some cases, it can continue until treatment ends, which can be many years. People don’t always tell their treatment team or GP about hair thinning when they’re having hormone therapy so it’s difficult to say how common this is.

Hair loss may be more likely if you have hormone therapy and other drug treatments such as chemotherapy or targeted (biological) therapy.
You can ask your treatment team or local cancer information center for more information about services available in your area.
Hair loss caused by chemotherapy is almost always temporary.

However, there is evidence that some chemotherapy drugs may result in long-lasting or permanent hair loss. Permanent hair loss is described as incomplete regrowth of hair six months or more after completing treatment.

Although uncommon, taxane drugs such as docetaxel may cause long-lasting or permanent hair loss. There is some limited evidence to suggest that paclitaxel may also cause long-lasting hair loss.

Hair loss is common in both people with cancer and in the general population. This can make it difficult to be sure whether problems with hair regrowth are due to treatment, genetics or other factors such as extreme stress or medical conditions. It could be down to a combination of these things.

After radiotherapy, any hair that you have lost from the treated area will usually grow back. However, the hair may grow back thinner, patchy, or may not grow back at all. This will depend on the dose of radiotherapy and the number of treatments you’ve had. Your treatment team will be able to let you know how likely this is to happen.

Some people continue taking hormone therapy for up to ten years, which may cause hair loss and hair thinning. Once you finish this treatment your hair should return to how it was before treatment. However, this may take time and for some people hair may not fully return to the same thickness.

It’s important to talk through any concerns you may have about hair loss with your treatment team when making decisions about treatment.