All you need to know about hair growth after chemotherapy

You have just finished chemotherapy and you are wondering when is your hair going to come back, and if it is going to grow at the same speed as it did before. The answer is it all depends on each specific case; on the type of treatment you have received, on your genetics, your age, and your general health condition. Besides that, you must take something else into account: if your immune system is busy defending your body from external attacks or receiving adjuvant Cancer treatment, not enough nutrients will get to your follicles, and therefore, your hair won’t grow as fast as it normally would. But if you allow me a piece of advice, according to my experience, there is nothing worse than comparing your case with other people’s. Your hair will grow when it is ready to grow, and that is the quick answer. 

The Cancer treatment you receive (the drugs they have given you) will have a great impact on your hair’s growth speed. For example, if your tumour is triple negative and you receive chemo combos like FEC or AC, and your hair comes back straight (this happens very rarely), one year after finishing chemo you might have a full head of hair that almost reaches your jaw. However, many people will see this, and will stress out thinking: “How come my hair is still this short?” Well, you probably have had a different chemo combo (like Taxotere/Docetaxel, which is very tough on hair).

After receiving this treatment, the hair growth is going to be slower, and if your tumour is triple positive, and you are receiving Herceptin (and maybe even Perjeta) for a complete year, then your hair won’t be growing as fast as it would normally grow, unfortunately, because your body is still receiving some type of treatment (targeted therapy, in this case). Targeted therapy isn’t as strong as chemotherapy, but it is still quite harsh on your body. Many people also report hair thinning with Tamoxifen, the hormonal therapy that people with estrogen-positive tumours have to take for five to ten years. But don’t despair! You will get there.

When will my hair grow back after chemotherapy?

As said above, each pearson is different. But I would say that, after my last chemotherapy infusion (with FEC), it took one month and 22 days for my hair to start growing. It is true that while on FEC chemotherapy your hair won’t grow, but while on Taxotere/Docetaxel, many people experience some hair coming back (I did); however, this is usually baby hair and your real hair won’t appear until around two months after finishing your chemotherapy treatment.

Even after finishing Taxotere, some of those new hairs might fall again, which can be certainly distressing. Why did they start growing if they were going to fall all over again? Who knows? Taxotere works and affects each person in different and complex ways we cannot dream understanding. 

In my case, around 20% of the new hair it grew fell again just after finishing chemo, but around seven weeks after finishing completely, it stopped falling, and I didn’t have a single hair falling from my head until a year later, when I would have one or two hairs falling from time to time. 

But to understand better hair growth, let’s see the phases which hair goes through.

1. Anagen – Growing Phase

The anagen phase is when the hair is growing, and it lasts for around 6 years, although this depends on each person’s genetics.

The longer the anagen phase is the longer the length of hair – this varies from person to person. In some people, this phase is shorter, resulting in shorter hair lengths, and in some people, of course, it can be longer.

An average hair will grow at a rate of around 1 cm per month. However, the rate of new hair growth after cancer treatments is often slower at the beginning. After a while, it will catch up, though.

2. Catogen – Transitional Phase

At the end of the anagen phase the hair enters the catogen phase, where the hair prepares to rest and eventually fall out. On average, this phase lasts approximately ten to fourteen days. During this phase the hair is still held in place in the follicle, but it stops growing. The follicle, then, prepares to release the hair.

3. Telogen – Shedding Phase

Finally, the telogen phase is when the hair falls out of the hair follicle. As part of this phase the follicle then remains inactive for approximately three months and the entire process is repeated, starting again at the anagen phase.

Approximately 90% of our scalp hair is in the anagen phase at one time (thank God! If this wasn’t the case, we would be bald for a while at some point…)

Why does hair fall out after receiving some chemo drugs?

Chemotherapy targets the quickest growing cells in the body. This is because their aim is to destroy cancer cells, which are rapidly dividing cells. However, these drugs cannot distinguish between the cancer and other quick growing cells, and that is why it will affect the cells in your hair follicles, depriving these from oxygen and nutrients and temporarily destroy the cell matrix. This forces the hair to go from the anagen (growing phase) into the catogen (transitional phase), where the hair prepares to rest and eventually fall out. That is why the hair will start falling between 10 and 30 days after the first chemotherapy infusion.

After FEC, hair regrows much faster than after receiving Docetaxel/Taxotere. Taxotere is really harsh and there is a 15% chance that your hair won’t ever come back (this was one of the scariest information I received during my cancer journey). In the past, oncologists would not even let patients know about this (it wasn’t even written anywhere in small print!), but after many women sued the Taxotere manufacturers, they started stating this side effect at least in small print (read more about the Taxotere Lawsuit here: https://www.acaseforwomen.com/taxotere-lawsuit/#contactform).

If I lived in the US and I had to pay for my treatments, then I would definitely have chosen Taxol instead of Taxotere, to make sure that my hair was going to come back. In Spain they usually give weekly Taxol as well, as Taxotere is really strong (in words of Spanish oncologist Dr Hornedo) and can cause permanent hair loss. But in the UK, unfortunately, I didn’t have a choice. If you receive Perjeta (brand name for Pertuzumab) and Herceptin (brand name for Trastuzumab) in the UK you need to get Taxotere (brand name for the chemo drug Docetaxel), and this is something to do with “license’s issues”, as explained by one oncologist at my cancer center. Obviously, if you cannot tolerate Taxotere you will receive, then, Taxol.

As I said, my hair started growing right after “lovely” FEC went out of my system. I finished my last FEC on the 4^th of January, and one month and 22 days after that, hair started to show, even though I was receiving the horrendous Docetaxel/Taxotere. 

How will it start coming back?

The hair is usually going to appear first in the sides of your head. The top will take longer. For me the growth was quite uniform, although the temples took slightly longer.

How can I make my hair grow faster? 

Can we really make our hair grow faster with external help? Well, this we will never know. And whoever tells you the opposite is just being hopeful, because how can that person know that this thing or this other remedy is working wonders for them? Unless they go back in time and decide not to use that very same thing they are using (so they can, then, compare), they cannot know!

But it never hurt anyone to be optimistic, and I do also belive placebo can be a very efficient treatment, if you believe it’s a medicine. So check this article to read about all possible tricks to accelerate hair growth, but understand that your hair will grow slowly while your body is still in treatment (radiotherapy, targeted therapy or even hormonal therapy). 

 What to do when new hairs are coming out after a harsh treatment like chemotherapy (baby hairs)

-Get a softer hair comb; it will gently massage your scalp without hurting your skin.

-Start taking Biotin in capsules (but make sure it is a pure Biotin. There are many cheap Biotin around and those won’t do anything for you). 

-Use a gentle shampoo.

Myths about hair growth after chemo

“Hair will come stronger after chemo”

This is not true at all. Your hair is exactly the same as before, but because it is short and curly/wavy it will seem like thicker. Actually, when it starts growing it starts very brittle, and perhaps because you are comparing to that baby hair, you believe that the hair is stronger than before. But it is not; it is exactly the same, as before your Cancer journey started. Sometimes, it will be worse than before (due to Docetaxel), but it will never be better.

Another reason people might think it is stronger than before is because you have been using a wig for months or years and these have a worst quality hair than your own, so many people, perhaps even yourself, will be comparing this hair to the wigs, because the reality is that nobody remembers your hair before starting your cancer journey.

“You need to have several haircuts to make it strong”

This is the biggest nonsense anyone can tell you. Cutting your hair won’t make it stronger. Moreover, many women after having chemo won’t want to even think of cutting it. I was one of them; I just wanted it to grow non stop. Therefore, I didn’t cut mine until a year and a half after chemo. It will come curly in 99% of people, so you don’t need to be cutting it all the time to equal the strands, because it won´t be visible to the eye. It is true that the hair will grow before in your temples and in the back, so you might need to cut a little bit the sides and the back till the top catches up, but if you keep on cutting it, hair will take longer to grow.

“Your hair will grow in no time. 1cm per month, so within a year, expect to have a bob!”

I used to hate when people told me this, because I was seeing myself in the mirror daily and my hair was not growing 1cm per month. As explained before, your hair won’t grow as fast as usual in the first months after chemotherapy. You have received like a nuclear bomb in your cells, so these will take a while to repair themselves and let any hair grow out of them.

Another annoying observation from people was: “After a year, that is 12 cm; your hair will be touching your shoulder! I don’t know what kind of physics this people believe in, but that is just not possible. Hair has to grow upwards from the root, and then, slowly, it starts curving, but even 7 cm of growth will look like 3 cm of length. You must realise that your hair is growing from scratch; it is not the same as if a person shaves their head and, yes, in such case their hair will grow 1cm per month, but that is not your case. 

My advice is try not to obsess with this (easier said than done, I know), but don’t despair; if the hair has come back, then it will eventually grow. 

One day you will stop worrying about it. For me it was on my month 16^th, when I had my first haircut but not because of this reason, but because my hairdresser, who is fabulous, straightened my hair and it suddenly looked longer, despite he had cut it. He also did a keratin treatment at this stage and this changed my life. I passed from being a man (short hair doesn´t suit me at all) to being a woman and to feel like a human being again.

Thanks to not being obsessed to make it equal while it started growing, after two years, my hair is quite long. At this time, the top part of your hair will be touching your jaw; but, because I didn’t cut my hair, optically, it is so much longer, and it passes my shoulders. Of course, the hair has about 4 layers, but if you have tons of hair, it won´t be ugly.

Check out my hair evolution! https://youtu.be/PhtSm1WA520

And now, some curious facts about hair

• 95% of the total skin area of humans is covered in hair.
• For the average person, it will take about 7 years to grow your hair to your waist and 3 years to grow it to your shoulders (or two if you leave it in layers, like mine!)
• Scalp hair has the ability to grow longer than eyebrows, lashes and other body hair.
• We lose 50-100 hairs every day. 
• The average scalp has over 100 000 hairs. 

Do you want to share your experience with hair growth after chemo? How long did it take for your hair to grow?