Believe it or not, hair loss (alopecia) due to chemotherapy is one of the most distressing side effects of chemo treatments.

Hair loss happens because the chemotherapy affects all cells in the body, not just the cancer cells. The lining of the mouth, stomach, and the hair follicles are especially sensitive because those cells multiply rapidly just like the cancer cells. The difference is that the normal cells will repair themselves, making these side effects temporary.

Hair loss does not occur with all chemotherapy. Whether or not your hair remains as it is, thins or falls out, depends on the drugs and dosages. Hair loss may occur as early as the second or third week after the first cycle of chemotherapy, although it may not happen until after the second cycle of chemotherapy. Hair loss can be sudden or slow. You may lose all of your hair or just some of it. Often it comes out in clumps rather than an even pattern. It is common for hair loss to include hair that grows anywhere including eyelashes, eyebrows, and even pubic hair.

In almost all cases of chemotherapy-induced hair loss, your hair will resume growth after treatments.

It may take from three to six months after therapy is completed or it may start growing back while you are still receiving chemotherapy. Be prepared for your "new" hair to possibly have a slightly different color, texture, or curl.

Currently, there is no known prevention for hair loss due to chemotherapy. Through the years, attempts have been made to reduce hair loss by using tight bands or ice caps. These techniques were thought to reduce the blood flow to the hair follicles, thus limiting the chemotherapy exposure. Unfortunately, these techniques did little more than cause headaches and have been abandoned in most settings.

Given that hair loss cannot be prevented, management focuses on your own comfort, or discomfort with baldness and on keeping your head warm if you live in a cool climate. The following are options to consider, the best option is the one that is most comfortable for you:

• Short hair - Cut your hair short if you are expecting hair loss during chemotherapy. Since hair often does not fall out evenly, some find losing short hair is less distressing. Some people shave their heads once the hair begins to fall out.
• Wigs - If you are interested in purchasing a wig, the best time to do this is before you lose any hair. This helps the stylist create the best match. Many insurance companies will pay for a wig, so be sure you have it written as a prescription from your doctor (usually written as "cranial prosthesis"). There are wig stylists who specialize in wigs for alopecia (hair loss). 
• Caps and Scarves - Some people find that the easiest, and most comfortable options are caps and scarves. These range from those you may already own to custom items made expressly for people who are undergoing chemotherapy.

You might check with your local chapter of the American Cancer Society. They sponsor a program called "Look Good, Feel Better." This program addresses ways to tie scarves and ways to make you look and feel better while experiencing hair loss during and after chemotherapy.