Hair loss, also known as alopecia, is a common side effect of chemotherapy and cancer treatments. Many cancer treatments, including these, damage and attack rapidly growing cells. Hair growth occurs under the surface of skin. Each strand of hair goes through steps of a cycle, from active growth to shedding. Because cells of the hair follicle divide and grow rapidly, chemotherapy will also damage the hair follicles causing hair to rapidly fall out and be prevented from growing.
Chemotherapy affects everyone differently depending on the type of medicine and chemotherapy treatment they go through. For many patients, hair loss from cancer will begin 2-4 weeks after the start of treatment. Hair may fall out gradually or in larger clumps. Once the treatment subsides, it is possible for the hair to gradually grow back after 2-3 months. When hair does start to grow back, it may be a different texture or look to it. Some patients have seen their hair grow back curlier than before.
Hair loss can be extremely upsetting for cancer patients, especially children. Children and teens feel the need to fit in with their peers and be normal so when they are faced with a huge change in physical appearance, it can really affect their quality of life. It is important to encourage children to be themselves and not let appearance keep them from playing with their friends or doing other things they enjoy. Talking to your child about what would help them to feel supported and beautiful/handsome is the best method to support them.
Cancer hair loss can be sudden or gradual, depending on the patient. It is crucial to ask your healthcare professional what you should expect with the type of treatment and relay the information to your child. Hair can fall out at any time, so having a plan for what your child will do when that begins to happen is helpful. You can bring these topics up beforehand and answer any questions your child may have.
You can talk to your child about what they want to do when their hair starts to fall out. They may want to shave their head, cut their hair short, dye it a different color or choose a wig. This can be an opportunity to introduce creativity and allow the child to think about positive options.
Help children think about how they might respond to questions, looks, and bullying. In a lot of cases, friends and classmates are just curious. If the child has thought and created good responses to questions and interactions, then it is less stressful and awkward when it happens. As a parent, it is helpful to have a good understanding of chemotherapy and hair loss with cancer treatment in order to answer these difficult questions.
Families are surprised that for many, hair loss from pediatric cancer starts weeks after chemotherapy begins, not right away. People report that when they are losing hair it is itchy and their scalp or skin on their arms/legs can hurt. When the scalp begins to hurt, often children find relief when they shave their remaining hair. During MAP chemotherapy most warriors lose every bit of hair on their bodies including eyelashes and eyebrows. This can make their eyes sensitive and prone to irritation from debris. Having some eye rewetting drops to relieve dryness and help flush debris can be helpful.
Some children love when their friends and family shave with them, and others do not. If your child is attending school, some schools do an event where kids can shave to support their classmate or loosen the “no hat policy” to honor your child. If you are interested there are many wonderful organizations that help with wigs, hats or other items to help with hairloss. Crowns of Courage, makes halo-wigs that are worn under a hat, is one such organization. If you child has not yet lost their own hair, you can have it cut and send to make a halo-wig of their own hair with Crowns of Courage.
Hair loss with pediatric cancer is one of the more difficult side effects for some children and families. Finding the good in it can help you to accept it. Hair cells are fast-growing cells just like cancer cells. Perspective is everything. Hair cells are just like cancer cells so hair loss can be the first visible sign that chemo is killing cells! Plus, chemo can make you tired... so having no hair is one less thing to take care of when you are feeling crummy. Helping children develop this perspective can encourage them and build up their esteem.
*No two osteosarcoma patients are the same, therefore there is no substitute for the expert care of your medical team. This is not meant to replace the guidance of your oncology team. It is meant to share resources, information and support.