Hair loss, skin and nail health in children and teens

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. Your child may also lose hair from other areas of their 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 everyone, depending on the drug(s), amount of drug, length of treatment, how each person reacts, and the existence of other health problems. 

Ways to cope with hair loss 

• Wash your child’s hair and scalp every two to four days, using a mild, moisturizing shampoo and/or conditioner
• Continue to comb or brush your child’s hair. Not combing or washing their hair will not prevent hair loss.
• If your child has long hair, consider getting them a short haircut or shaving their head before hair loss begins. Some people 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 hair
• Avoid styling hair in tight braids or ponytails, which can cause breakage
• If you're planning to buy a wig for your child, save some locks of their hair so their natural color and texture can be matched more easily
• Let them wear a bandanna, hat, or scarf to keep their head warm if they don’t want to wear a wig
• Apply mineral oil to their scalp to ease dryness
• Use a makeup pencil to draw on eyebrows, if desired

Skin

Tell your doctor about any changes to your child’s skin. Your doctor can recommend or prescribe appropriate treatment, including topical solutions (creams, lotions, or gels) to soothe 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 child’s skin in these ways:

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

Nails 

Chemotherapy can affect the color and texture of your child’s 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 child’s nails, especially pain, redness, discoloration, odor, or discharge from under the nail. These could be signs of infection.

Keep your child’s fingernails and toenails clean, dry, and relatively short.