In this article:

• Why does radiation cause hair loss?
• Does all radiation cause hair loss?
• Is hair loss from radiation permanent?
• How to prepare for expected hair loss with radiation

Radiation is a specific targeted therapy that is used to destroy cells. This therapy uses high-energy particles or waves to destroy and damage cancer cells. All cells must divide to replicate themselves. However, cancer cells grow and divide much quicker than most other healthy cells in your body. Thus, radiation targets those rapidly dividing cells and works by causing small breaks in their DNA to cause them to die before replicating themselves.

Unfortunately, many healthy cells can be targeted by radiation as well, which is why this treatment can come with some complex side effects. However, what makes radiation stand out from other forms of cancer treatment like chemotherapy is that doctors can use it locally instead of traveling your entire body and affecting cells everywhere.

One of the side effects that concerns many people is the potential of hair loss. Radiation can cause hair loss because hair cells are some of the most rapidly dividing cells in your body. Thus, radiation is likely to snag onto those cells and killing them along with cancer cells. As a result, radiation can cause your hair to thin and may even lead to complete hair loss.

Not all types of radiation will cause hair loss. Because radiation is localized, for the most part, many people can expect to lose hair in the area they are getting treatment (if there is hair growth there). For example, if your doctor treated your leg with radiation, you may lose your leg hair, but the hair on your head would not fall out.

Generally speaking, the degree of hair loss you can experience will depend on many factors, such as the size of the area you are treating and the total dose you are receiving. However, if a radiation beam exits the body, it may cause hair loss at the point of exit as well.  

Hair loss from radiation therapy may be temporary or permanent. Usually, if a person receives a lower dose, it is temporary, but it may be permanent if it is at a higher dose. Hair loss can be challenging to bear, both physically and emotionally. If you are concerned about hair loss, speak with your oncologist about what dosing they intend to give you and what amount of hair loss you can expect.

How you handle your specific case of hair loss will differ from the next person. Some people will be more affected than others, and there is no right or wrong way to feel and handle it. And, how you plan to prepare for potential hair loss depends entirely on what makes you most comfortable and what feels suitable for you.

Some people prefer to cut their hair, especially if it is long, so the impact of hair loss doesn’t seem so great when you do start shedding. Others prefer to shave their heads entirely ahead of time if they expect to lose their hair, which usually happens with chemotherapy.

If you don’t plan to make any major changes, be sure to use a gentle shampoo that is ph-balancing and try a soft-bristled brush when combing your hair. Also, avoid dying and bleaching your hair, or using hot irons and curlers, as it may cause your hair to fall out more quickly. Finally, you may want to use a different fabric on your pillowcases, such as satin or silk, to minimize friction while you sleep.

Some people who do expect hair loss may wish to look for a wig ahead of time while they still have their hair. If you have one made for yourself, your wig stylist should be able to match your hair color, texture, and length, so it is similar to your natural hair.

For more information on hair loss with radiation therapy, connect with your oncologist and explore the resources for hair loss at the National Cancer Institute.