Hair Loss and Prostate Cancer Treatment: How Common Is It and What Helps

Hair loss (alopecia) is not typically common with standard hormone therapy for prostate cancer, but it can happen with certain treatments like chemotherapy or radiation to the head. ^[1] Hair changes, including thinning and reduced body hair, may occur with androgen deprivation therapy (ADT), though complete scalp hair loss is uncommon with ADT alone. [PM26]

What causes hair loss in prostate cancer care?

• Hormone therapy (ADT): ADT lowers testosterone, which can lead to less body hair and sometimes scalp hair thinning rather than full baldness. ^[1] Hair changes have been reported among the broader side‑effect spectrum of ADT. [PM26]

• Chemotherapy (e.g., taxanes like docetaxel or cabazitaxel): Many chemo drugs can cause temporary scalp hair loss because they affect rapidly dividing hair follicle cells. ^[2] Hair usually starts thinning or falling out 1–4 weeks after the first chemo session and often regrows after treatment ends. ^[3]

• Radiation therapy: Radiation aimed at the head causes hair loss in the treated area; this is less relevant for prostate radiation unless the scalp is within the field. ^[4] Regrowth after head radiation depends on dose; hair may return differently or, at higher doses, may not fully regrow. ^[3]

In summary, ADT may cause hair thinning and reduced body hair, while chemotherapy is more likely to cause noticeable scalp hair loss. ^{[1] [2]}

How common is it?

• Chemotherapy-induced alopecia: Across cancer care, chemotherapy causes hair loss in a large share of people, though exact rates depend on the drug regimen. ^[5] With taxane regimens used in prostate cancer, alopecia is a recognized and often expected side effect. ^[2]

• Hormone therapy: Loss of body hair and “feminizing” changes (such as gynecomastia) are known ADT effects; scalp hair loss is usually milder, manifesting as thinning rather than complete alopecia. ^[1] Hair changes are listed among ADT’s physiologic side effects. [PM26]

What does hair loss look like and when does it start?

• Chemo timing and pattern: Hair may begin thinning or falling out within 1–4 weeks after starting chemo, often progressing to more noticeable loss over subsequent cycles; eyebrows, eyelashes, and body hair can also be affected. ^[3] Hair typically regrows a few months after chemo ends, sometimes with a different texture or color at first. ^[2]

• Radiation to scalp: Hair loss occurs in the irradiated area; regrowth depends on dose and may be incomplete at higher doses. ^[3]

• ADT pattern: More often a gradual thinning of scalp hair and reduction of body hair rather than sudden or complete scalp hair loss. ^[1] Hair changes can be part of the broader physiologic effects of ADT over time. [PM26]

Practical management strategies

Before and during treatment

• Discuss expectations early: Ask which drugs are planned and their hair-loss risk so you can prepare with coping measures. ^[2]
• Gentle hair care: Use mild shampoos, avoid harsh chemicals and heat styling, and brush gently to reduce breakage. ^[2]
• Cut or trim hair: Shorter cuts can make thinning less noticeable and easier to manage during shedding. ^[2]

Scalp cooling (cold caps)

• Consider scalp cooling during chemotherapy: Cooling the scalp before, during, and after chemo infusions can lower drug delivery to hair follicles and may prevent or reduce hair loss for many regimens. ^[6] Scalp cooling has prevented moderate-to-severe hair loss in about half or more of people in studies, though success varies by the specific chemo drugs used. ^[6]

Topical and medical options

• Topical minoxidil (5%): After chemo, minoxidil can support faster regrowth; for endocrine‑related (hormonal) alopecia patterns, minoxidil has shown moderate to significant improvement in a majority of cases in clinical observations. ^[7] It is generally applied once or twice daily to the scalp; discuss timing with your care team to fit your treatment plan. ^[2]
• Manage hot flashes and other ADT effects: Addressing ADT side effects (hot flashes, mood, sleep) can indirectly help you cope better with hair changes; options include certain hormones or non‑hormonal medicines when appropriate. [PM26]

Cosmetic and supportive measures

• Camouflage products: Hair fibers and concealers can reduce the appearance of thinning patches; choose shades matching your hair. ^[4]
• Head coverings: Hats, scarves, and wigs can provide comfort and confidence during periods of loss. ^[2]
• Emotional support: Persistent or noticeable hair changes can affect mood and self‑image; counseling and peer support can be helpful. ^[8]

After treatment

• Expect regrowth with chemo: Hair usually starts to grow back a few weeks to months after chemotherapy, initially fine and possibly a different texture. ^[2] Gentle care and patience are key as follicles recover. ^[2]

When to contact your care team

• Sudden or patchy hair loss, scalp pain, itching, or signs of infection should be discussed promptly to rule out other causes and get targeted help. ^[2]
• If hair loss feels distressing, ask about scalp cooling programs, minoxidil use, or referrals to supportive care and dermatology services familiar with cancer‑related alopecia. ^{[6] [7]}

Key takeaways

• ADT commonly reduces body hair and may thin scalp hair, while chemotherapy is the main driver of temporary scalp hair loss in prostate cancer treatment. ^{[1] [2]}
• Scalp cooling is the best‑studied preventive tool during chemo, and topical minoxidil is a practical option to support regrowth or manage hormonal alopecia patterns. ^{[6] [7]}
• Gentle hair care, cosmetic aids, and emotional support can make a meaningful difference during and after treatment. ^{[2] [8]}