Hair loss and body image

Radiotherapy and certain chemotherapy drugs can damage hair, making it fall out. The amount of hair loss varies between individuals and depends on the dose of the drugs or the area targeted by the radiotherapy. Some people’s hair only thins while others lose it all. Hair may be lost from the head or from the whole body. Not all chemotherapy drugs cause hair loss. Most people taking oral chemotherapy lost no hair; but Jean said that hers had thinned.

Some people had expected their hair to fall out immediately after starting treatment, but in reality it happened several weeks later. Aley kept pulling his to see if it would come out. Some people's hair thinned gradually before all coming out. Many were alarmed and upset by hair loss. Dianne had been amazed at how much hair was strewn about her room. Ann had been advised to wear a hair net at night to catch it.

Many people cut their hair short or shaved it off before it fell out; some said this gave them a sense of control. Several had a hairdresser friend or relative who did this for them. Kerry shaved hers off because she didn’t want to watch it fall out. Doing this didn’t necessarily avoid the upset though; Frances had been proud of her hair, which had been long, thick and shiny with grey streaks, and cried for a day. Neil’s hairdresser had a bit of fun by shaving his hair into a Mohican style and photographing it before removing the rest of it. Dianne shaved off a few tufts that were left after the rest of her hair came out.

Hair loss, combined with other visible effects of treatments, such as weight loss, changed people's appearance, which could be difficult to come to terms with and undermined self-confidence. Some people realised how much their eyebrows had defined their face. Aley said he looked horrific with no hair, pale skin and lifeless eyes. Frances said the combination of a purple rash, a round face and a small patch of hair in the centre of her head made her look like a red onion. She felt ugly and uncomfortable about being hugged by her partner (see ‘Self-image, sex and relationships’). Several people said they no longer recognised themselves in a mirror. John, aged 52, said in the mirror he saw “this old man with a grey face and skinny and looking rather worn out and weary.” He thought, “Well, that’s how I look after I’ve had chemotherapy as I’ve got leukaemia. That’s the look of a man with those things. That’s okay.” Brian felt that losing body and facial hair was odd for a man, whereas Jim's feeling of his masculinity was unchanged as his girlfriend thought he looked cute without hair.

Hair loss was a visible sign of the illness so going out in public could be difficult to cope with. Claire felt that people were staring at her. Others preferred to hide themselves away at home. Some people said that their hair loss upset people around them more than themselves, and they wanted to hide their hair loss from loved ones at first. Claire's youngest child didn’t like to see her bald. By contrast, Joanna hadn’t minded her husband’s loss of facial hair as she had never liked it.

The NHS can supply wigs but some people were reluctant to have one. Julie said a nurse tried to encourage her by wearing a variety of different wigs herself on the ward each day. Some people didn’t like their NHS wig; Thelma said she hadn’t taken the trouble to make sure hers fitted properly. Ann found it difficult to position her wig since she had no hairline, and found it hot to wear – she fainted one day while out shopping.

Men often wore a hat rather than have a wig, and lots of women said they preferred wearing a scarf, bandana or beanie, to wigs. Most people chose when to cover their baldness. They often stayed bald at home but would put on a wig or hat to answer the door bell. Most covered their heads in public but several didn’t bother when attending hospital appointments as others there were in the same situation. Meeting other people who had lost their hair through treatment helped Claire to have confidence in her changed appearance. Dianne said she went bald with pride. A nurse had complimented Frances on her bald head. Neil had a Spiderman head painted on his bald head for a laugh while running a tombola at a local fair.

Some people took a positive view, saying that baldness avoided the need to shave or to brush their hair. Jim hadn’t minded losing the unsightly hairs that grew out of his numerous moles. Some people's loss of hair hadn’t bothered them, either because they accepted the way they now looked or, for men, because bald heads were fashionable at the time. Some found hair loss was a small price to pay for having their life saved.

Hair often grew back thicker and curlier, or a different colour to how it had been before. Some people lost their hair two or three times. Ann’s hair had fallen out gradually the first two times, but fell out all at once the third time. Claire said that losing her hair a second time had upset her more than the first time.

Last reviewed: December 2018.

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