Hair loss, skin and nail health

Hair loss 

Drugs that damage or destroy cancer cells also affect normal cells. Rapidly dividing cells, such as hair follicle cells, are the most affected. This is why hair loss (alopecia) is a common side effect of chemotherapy. Hair loss can range from thinning to baldness. It may be sudden or slow. You may also lose hair from other areas of your body such as eyelashes and eyebrows.  

Hair usually grows back after treatment ends. The thickness, texture, or color of hair may be different when it grows back.  

Side effects do not always happen and can be different for each patient, depending on the drug(s), amount of drug, length of treatment, how each patient reacts, and the presence of other health problems. 

Ways to cope

• Wash your hair and scalp every two to four days using a mild, moisturizing shampoo and/or conditioner
• Continue to comb or brush your hair. Not combing or washing your hair will not prevent hair loss.
• If you have long hair, consider getting a short haircut or shaving your head before hair loss begins. Some patients find that this makes it easier to cope with hair loss. Avoid perms, chemical relaxers, permanent hair dyes, and bleach, which can damage the hair and irritate the scalp.
• Avoid using straighteners, curling irons, or other hot tools, which can damage your hair
• Avoid styling hair in tight braids or ponytails, which can cause breakage
• If you're planning to buy a wig, save some locks of your hair so your natural color and texture can be matched more easily
• Wear a bandanna, hat, or scarf to keep your head warm if you choose not to wear a wig
• Apply mineral oil to your scalp to ease dryness
• Use a makeup pencil to draw on eyebrows, if desired 

Skin health 

Skin-related side effects from cancer treatment include: 

• Dry skin
• Redness
• Itchiness
• Skin lesions 

Tell your doctor about any changes to your skin. Your doctor can recommend or prescribe appropriate treatment, including topical solutions (creams, lotions, or gels) to soothe your skin or relieve itching. 

Tell your doctor immediately if you notice: 

• Sudden or severe itching, rash, and/or hives. These may be signs of an allergic reaction.
• Red, swollen, or tender skin and/or discharge from skin, especially around a wound, sore, rash, or IV catheter site. These may be signs of infection.  

Care for your skin in these ways: 

• Keep skin moisturized by using a gentle, unscented lotion
• Avoid activities that put you at risk for cuts, injuries, or burns
• Wear a broad-spectrum sunscreen with SPF 30 or higher and reapply every two hours  

Nail health 

Chemotherapy can affect the color and texture of your fingernails and toenails: 

• Nails may darken, crack, or become brittle
• White ridges or bands of discoloration may appear along the nails
• Nail beds may darken
• A small percentage of patients lose all or part of their fingernails and toenails 

Except in rare cases, nails will grow back or return to normal after chemotherapy ends. 

Tell your doctor about any changes to your nails, especially pain, redness, discoloration, odor, or discharge from under the nail. These could be signs of infection.  

Keep your fingernails and toenails clean, dry, and relatively short.