Everything You Need To Know About Hair Restoration After Chemotherapy

For patients undergoing cancer care, side effects like hair thinning and loss can be a disheartening reminder that lingers long after treatment has ended or the illness has passed. Studies show that chemotherapy-induced hair loss affects body image and increases the risk of depression in cancer patients.

Chemotherapy-induced alopecia (CIA) doesn’t happen to everyone undergoing infusion therapy; it’s dependent on a combination of the patient and the type of chemotherapy drug. But it is something that many patients experience. Here, we break down everything you need to know about what causes chemotherapy-induced alopecia and the many professional and at-home hair restoration solutions that exist to treat it.

Why Does Chemotherapy Cause Hair Loss?

Chemotherapy targets rapidly-dividing cells — not just dangerous cancer cells but also healthy ones, including skin and hair cells. This causes damage to the hair follicles, often resulting in:

• Scalp sensitivity
• Hair thinning
• Hair loss

For some, the patchiness, thinning, and even bald spots are permanent. The chances of developing long-term chemotherapy-induced alopecia are greater following infusions that affect hormones — like docetaxel for breast cancer. While CIA is most noticeable on the head, eyebrows, and eyelashes, but it can impact body hair, such as underarms and pubic hair, as well.

When Does Hair Grow Back After Chemotherapy?

Every patient’s situation is unique, but regrowth after chemotherapy typically begins within several weeks of the treatment ending. “Fortunately, most of the time hair loss from chemotherapy is temporary,” says Craig Ziering, DO, a board certified dermatologist and hair restoration specialist. Even so, it may not be noticeable right away. “Usually this patient population can expect to regrow their hair in three to six months after treatment ends, though the hair might grow back differently,” he explains. “This can be temporary or permanent.”

Some of the most common characteristics of post-chemotherapy hair changes include:

• Thinner hair
• Decreased amount of hair
• Varying growth rates
• Patchy or bald spots
• Texture changes (i.e. ‘chemo curls’)
• Color variations (often graying)

Experts recommend that, while hair is growing back, patients avoid things like hair dye, perms, or bleach. Using gentle hair care products and applying sunscreen to the scalp will also help protect the delicate skin and strands.

The Best Post-Chemotherapy Hair Restoration Treatments

During this period of hair loss and regrowth, patients historically had few options beyond wearing head coverings (like hats, turbans, and scarves) or donning a wig or hairpiece. Today, patients experiencing both temporary and permanent chemotherapy-induced hair loss may benefit from a variety of professional and at-home hair restoration modalities.

Dr. Ziering emphasizes that it’s important to consult with a specialist who is well versed in post-chemotherapy hair restoration because of the many variables unique to cancer patients. Depending on the patient’s cancer type, treatment plan, and hair loss pattern, a hair restoration expert can tailor the regimen. Some patients may be eligible for pre-treatment modalities, while others should wait until their new hair has substantially regrown.

Interestingly, many of these treatments have been discovered by accident. During experiments and studies, researchers find hair growth to be a side effect of a given drug or therapeutic technology. Below, we’re rounding up many of the best hair restoration options available.

1. Micropigmentation

According to Dr. Ziering, “scalp micropigmentation (SMP) is a type of tattooing technique in which microparticles of metabolically inert pigment granules are implanted below the epidermis with a specific, artistic technique of strokes to appear similar to a closely shaved scalp.” It can also be used to fill in sparse areas to give the illusion of more hair.

The Skinny:

• Mechanism: Tattooing needle
• Classification: Semi-permanent makeup
• FDA Status: Not regulated
• Timing: 3 to 6 months after treatment
• Best For: Smaller bald/sparse spots like temples, hairline, or crown; mimicking a closely shaved head
• Result Duration: Semi-permanent (pigments remain indefinitely but require maintenance)
• Side Effects: Risk of infection, granuloma, color inconsistencies, scarring

2. Microblading

Sometimes called eyebrow feathering, microblading is a popular solution to thinning or sparse brows, including those that have been changed by chemotherapy. While some patients opt to undergo the procedure prior to cancer treatment, many experts agree that waiting until after chemotherapy is completed is best. Hair regrowth is unpredictable and many cancer treatments disrupt hormone balance, which can affect the appearance of the micro pigments used in semi-permanent makeup. You can learn more in our comprehensive guide to permanent makeup after chemotherapy.

The Skinny:

• Mechanism: Specially designed blade
• Classification: Semi-permanent makeup
• FDA Status: Not regulated
• Timing: Before or after treatment (not during)
• Best For: Maintaining the look of brows during treatment; filling in sparse post-treatment brows
• Result Duration: Semi-permanent (pigments remain indefinitely but require maintenance)
• Side Effects: Risk of infection, granuloma, color inconsistencies, scarring

3. Cooling Caps

Also known as scalp hypothermia treatment, scalp cooling caps work by chilling the blood vessels in the scalp. Doing so is believed to minimize the amount of chemotherapy drugs that can reach the hair follicles. Treatment occurs concurrently with medication infusions and, depending on the device and drugs used, has been shown to help the majority of women retain some of their hair (about 50 percent) during chemotherapy.

The Skinny:

• Mechanism: Cap-like device worn on the head
• Classification: Cold gel-/liquid-filled medical device
• FDA Status: Approved (depending on device)
• Timing: During treatment (before, during, and shortly after chemotherapy infusions)
• Best For: Preventing chemotherapy-induced hair loss
• Result Duration: Permanent
• Side Effects: Neck & shoulder discomfort, scalp pain, forehead pain, dizziness, nausea

4. Photobiomodulation Therapy (PBMT)

Also known as low level laser light therapy (LLLT), this relatively new technology consists of a device (like Capillus® or Kiierr) worn on the head that emits mild laser or LED energy to reduce inflammation and stimulate tissue regeneration. The technology was accidentally discovered in 1967 by Endre Mester, a researcher experimenting with the newly-invented ruby laser. He realized that using the laser to treat tumors in mice promoted hair growth and wound healing. Clinical trials for treating CIA are currently underway.

The Skinny:

• Mechanism: Cap-like device worn on the head
• Classification: Low level laser (LLLT) or light-emitting diode (LED) medical devices
• FDA Status: Off-label for CIA (approved for male & female pattern baldness)
• Timing: After treatment (possibly during)
• Best For: Stimulating hair growth in areas left patchy after chemotherapy
• Result Duration: Permanent
• Side Effects: None, though should be used cautiously with other hair restoration treatments

5. Regulated Drugs

There are many drugs on the market that are being used (often off-label) to treat hair loss in both men and women — including minoxidil, spironolactone, and finasteride. The vast majority of clinical data focuses on male (sometimes female) pattern baldness, rather than trauma or medication-induced hair loss. With that said, here are three drugs that have shown promise for post-chemo patients:

Minoxidil

Perhaps the most well known anti-hair loss medication, minoxidil (a.k.a. Rogaine) has been clinically proven to increase hair growth in patients with a variety of conditions, though results depend on what’s causing the alopecia. One clinical trial demonstrated faster hair regrowth in female breast cancer patients.

The Skinny:

• Mechanism: Topical drug applied to scalp
• Classification: Vasodilator (relaxes vessels to promote blood flow)
• FDA Status: Approved
• Timing: After treatment
• Best For: Decreasing the duration of alopecia
• Result Duration: Temporary (must continue use to maintain results)
• Side Effects: Scalp dryness, itching, stinging, scaling, flaking, redness

Finasteride

Most commonly known by its brand names, Propecia or Proscar, finasteride is an oral medication that’s widely used to reduce androgenetic alopecia (a.k.a. male pattern baldness). It may also help women with post-chemotherapy hair loss, however, it is not recommended for premenopausal patients because of its endocrine effects and possible risk to fetal development.

The Skinny:

• Mechanism: Oral drug
• Classification: 5-alpha-reductase inhibitor (blocks dihydrotestosterone, a hormone believed to promote hair loss)
• FDA Status: Off-label for women (approved for male pattern baldness only)
• Timing: After treatment
• Best For: Decreasing the duration of alopecia (one trial showed faster hair regrowth)
• Result Duration: Temporary (must continue use to maintain results)
• Side Effects: Decreased libido, dry skin, mild acne

Bimatoprost

Best known by its brand name, Latisse®, this glaucoma drug was discovered to also affect the hair growth cycle. Subsequent clinical studies have proven its effectiveness for the treatment of chemotherapy-induced eyelash loss (a.k.a. hypotrichosis).

The Skinny:

• Mechanism: Topical drug applied to lash line
• Classification: Prostaglandin analog (increases hair growth and hair cycle duration)
• FDA Status: Approved
• Timing: During & after treatment
• Best For: Promoting eyelash regrowth; promoting eyebrow growth (off-label)
• Result Duration: Temporary (must continue use to maintain results)
• Side Effects: Some patients experience mild eye irritation, eyelid darkening

6. Platelet-Rich Plasma (PRP)

Made famous on social media because of the so-called vampire facial, platelet-rich plasma (PRP) is actually widely used in many types of healing treatments — including hair loss. Plasma is harvested from the patient's own blood and then injected into the scalp to deliver nutrients (including growth factors) directly to the hair follicles.

While there is evidence that PRP injections do not prevent chemotherapy-related hair loss, the treatment is currently under clinical trial in patients with endocrine therapy-induced alopecia (EIA) for breast cancer to see if it can help hair regrow faster and healthier.

7. Supplements

There are quite a few hair supplements on the market that are aimed at bolstering growth — some of which have even been tested in clinical trials. Some of these, like Nutrafol and Viviscal, contain marine-derived ingredients. Though opinions vary, most experts agree that a combination of the following is essential for healthy hair growth:

• Amino acids
• Biotin & other B vitamins
• Iron
• Omega-3 & Omega-6 fatty acids
• Vitamins A, C, D, E
• Zinc

In addition, scientists speculate that adequate protein is crucial for healthy hair because hair is about 95 percent keratin, which — you guessed it — is a protein.

8. Surgery

Although chemotherapy-induced alopecia is typically temporary, there are a host of therapy drugs that can induce some degree of permanent hair loss. For patients with more significant loss, surgical hair restoration may be the best solution for both the scalp and the eyebrows. Options include:

• Follicular Unit Transplant (FUT): Involves taking a strip of skin with hair follicles from a donor site, typically the back of the head where hair is naturally fuller and less prone to balding, and transplanting it to the desired area.
• Follicular Unit Extraction (FUE): Unlike the strip that is extracted during FUT, this technique collects individual hair follicles from the donor site and inserts them into small incisions made in the recipient site.

It’s worth noting that eyebrow restoration is not as simple as just transplanting scalp hairs. Because natural brow hair grows in very specific ways, transplanted hair needs to follow the pattern of growth. Additionally, it will need to be trimmed regularly, which may leave a blunt end that is somewhat noticeable.

The Takeaway

Even though chemotherapy-induced alopecia is often temporary, the self-confidence boost that comes with hair restoration therapy can be extremely valuable for patients on their cancer journey. Be sure to talk to your oncology team before undergoing any hair restoration procedures and consult with a specialist who is an expert in post-chemo hair growth to develop the best treatment protocol for your case.

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