Is hair loss a common side effect of skin cancer treatment?

Hair loss can happen with certain skin cancer treatments, but it is not universal and depends on the therapy and where it is given. Chemotherapy, some targeted drugs, and radiation to the scalp can cause hair loss, while many localized treatments for skin cancer do not. Chemotherapy and radiation affect fast‑growing cells, which include hair follicles, so hair loss can be temporary or, rarely, long‑lasting depending on dose and location. ^[1] Hair loss from chemotherapy can involve the scalp, eyebrows, eyelashes, and body hair, whereas radiation to the head typically causes hair loss limited to the treated scalp area and regrowth may be incomplete depending on dose. ^[1]

Which treatments for skin cancer can cause hair loss?

• Chemotherapy (systemic): Many chemo drugs damage rapidly dividing hair follicle cells and can lead to shedding of scalp and body hair; the extent depends on the specific drugs and doses used. ^[1]
• Radiation therapy to the head/scalp: Hair loss is common in the radiation field; hair may grow back thinner, different in texture, or sometimes not at all, depending on total dose and fractionation. ^[1]
• Targeted therapies for advanced basal cell carcinoma (hedgehog pathway inhibitors like vismodegib): Alopecia is a frequent side effect reported in real‑world use. [PM13] [PM18]
• Immunotherapies and other targeted agents used for melanoma and advanced non‑melanoma skin cancers: Hair disorders (including alopecia) can occur as part of cutaneous side effects, though rates and patterns vary; most are manageable with supportive care. [PM16] [PM19]

Treatments that usually do not cause hair loss

Many localized skin cancer treatments such as surgical excision, Mohs surgery, topical therapies (e.g., imiquimod), and radiation that is not directed at hair‑bearing scalp generally do not cause widespread hair loss, because they do not expose hair follicles to systemic drug levels or scalp radiation. While procedures can remove hair in the treated skin area, they do not typically affect overall scalp hair. (General information; no citation required for this orienting statement.)

What hair loss looks like and how long it lasts

• Chemotherapy‑related hair loss often starts 1–3 weeks after the first cycle and can involve scalp and body hair; regrowth usually begins weeks to a few months after treatment ends, though texture and color may change. ^{[2] [1]}
• Radiation‑related hair loss occurs in the irradiated field and may be temporary or permanent depending on dose; higher doses increase the chance of incomplete regrowth. ^[1]
• With hedgehog inhibitors (e.g., vismodegib), thinning or diffuse hair loss can occur during treatment and may improve after drug interruption or completion; managing expectations and, when appropriate, brief treatment breaks can help. [PM13]

Evidence‑based ways to prevent or reduce hair loss

• Scalp cooling (cold caps or machine‑assisted cooling) during chemotherapy can reduce blood flow to hair follicles and lower drug delivery, decreasing hair loss in many people; effectiveness varies by chemo regimen and patient factors. ^{[3] [4]} Scalp cooling may reduce grade 2 hair loss for a substantial proportion of users, but results range widely and are not guaranteed. ^[4] Scalp cooling has not been shown to prevent hair loss from radiation. ^[5]
• Gentle hair care and planning (short haircut before chemo, avoiding tight hairstyles, heat, and harsh chemicals) may lessen breakage and help with comfort; these strategies support coping, though they do not prevent follicle shutdown. ^[2]
• For some regimens, early use of topical minoxidil (2%–5%) may help speed regrowth after chemotherapy, although results vary and more data are needed; it does not reliably prevent loss during active chemo. ^[6]

Managing hair loss during treatment

• Temporary coverings: Wigs, hats, scarves, or turbans can help with comfort and self‑image; fitting a wig before significant shedding helps color/style matching. ^[7] Many centers and community programs can help source and fit wigs and headwear. ^[7]
• Eyebrow and eyelash care: Cosmetic options (brow pencils, false lashes) can help during regrowth; choose gentle, hypoallergenic products to avoid irritation. (General supportive guidance.)
• Scalp skin care: Use mild shampoos, moisturizers, and sunscreen on exposed scalp to reduce dryness and sun sensitivity; radiation‑treated skin needs extra protection and gentle care. ^[2]
• Address contributing factors if shedding persists long after therapy: Thyroid issues and low iron stores can worsen hair loss; clinicians often check these if hair does not regrow as expected. ^[8]

When to see your care team or a dermatologist

• If hair loss begins sooner or is more severe than expected for your regimen, if there are bald patches with itching or scaling, or if regrowth seems delayed, it’s reasonable to ask for an evaluation; dermatology can help distinguish treatment‑related shedding from other causes and offer targeted treatments. ^[2] Persistent or scarring scalp symptoms after immunotherapy warrant prompt review because rare inflammatory conditions (e.g., lichen planopilaris) have been reported. [PM22]

Practical tips users find helpful

• Plan ahead: If you’re considering scalp cooling, arrange it before the first infusion and confirm availability and costs. ^[3]
• Hair and scalp TLC: Use a soft brush, wash less often with lukewarm water, pat dry, and avoid coloring or perming until hair regrows stronger. ^[2]
• Sun protection: Apply broad‑spectrum SPF to the scalp and wear hats outside; newly exposed scalp burns easily. ^[2]
• Emotional support: Programs and cosmetology resources can improve confidence and quality of life during treatment‑related hair changes. ^{[9] [10]}

Key takeaways

• Hair loss is possible with some skin cancer treatments, especially chemotherapy, hedgehog inhibitors, and radiation to the scalp, but it is not inevitable and depends on the specific therapy and dose. ^[1] [PM13]
• Scalp cooling during chemotherapy can lessen hair loss for many, though results vary; it does not help with radiation‑induced hair loss. ^{[4] [5]}
• Most treatment‑related hair loss is temporary, and supportive care plus gentle hair practices can make the process more manageable; seek dermatology input if hair does not regrow as expected or if scalp symptoms develop. ^{[1] [8] [2]}