Chemo Related Hair Loss and the Proactivity Paradox

Per information published on the Mayo Clinic Web Site, chemotherapy may cause hair loss all over your body. In addition to hair loss on the scalp, sometimes eyelashes, eyebrows and other body hair also falls out. Some chemotherapy drugs are more likely than others to cause hair loss, and different doses can cause anything from a mere thinning to complete baldness. Hair is lost when chemotherapy drugs damage hair follicles, making hair fall out. According to the American Cancer Society, “it can be hard to predict which patients will lose their hair and which ones won’t, even when they take the same drugs.”

There are many Non-Oncology (Non-Cancer Related) conditions that can be treated by Chemotherapy including some Autoimmune Diseases and Inflammatory Conditions. Despite the severity and power of these drugs they often are prescribed in pediatric treatment regimen for childhood disease that can be treated effectively with Chemotherapy.  The symptoms are the similar to that which you will see in adults undergoing Chemotherapy including: Nausea, vomiting, and abdominal pain, muscle achiness, decreased appetite, decrease in blood cell counts, dizziness, darkened skin coloration, ringing in ears and hearing loss, kidney damage, rash and increased breathing effort, diarrhea or constipation, abdominal cramping, weakness, loss of reflexes and several other difficult symptoms. As you would imagine the difficulty of navigating these symptoms in children is, in many ways, more difficult than doing so with an adult patient.

Adding to the stress related to treatment is the impact of post treatment immunosuppression.  This occurs in chemotherapy patients and it makes them very susceptible to other ailments including colds, influenza, bronchitis and many others. Despite all of these complications, one of the least physically painful side effects, hair loss, can be among the most challenging to cope with.

In A Guide for Parents, Published by National Cancer Institute, it is suggested that it could be beneficial to take proactive steps to prepare for hair loss. Furthermore, if treatment is expected to cause a child’s hair to fall out, it may be helpful to let child pick out a fun cap, scarf, and/or wig ahead of time. Some have reported that it is best to pick out a wig before the hair falls out, so you can match it to their hair color. Sometimes cutting your child’s hair short before treatment helps make hair loss a bit less upsetting, in part because they have some control over the process and it happens all at once instead of falling out over a drawn out progression throughout the post treatment phase.

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For many patients undergoing treatment who experience hair loss, it is difficult to shake the cultural and personal attachment to their hair. However, in some cases it has been reported that the loss of hair, when dealt with in a positive, proactive manner can be an empowering event that buoys the patient’s spirit and conviction toward progress on the journey of care. In some cases the event can bolster a patient’s self-esteem by helping them realize the beauty they possess beyond the physical vessel of their body and all of its parts. Often the attachment we give to individual physical traits such as “beautiful flowing hair” can actually limit us and our self-image by depending too heavily on that one physical trait to bolster self-esteem. When such a gift is taken from us it can trigger a mourning period and even depression. Alternatively when given or shed proactively we can receive positive energy as a result of controlling an otherwise uncontrollable situation.

Tom Nieman is a Founder and President of The LIV Foundation and a financial services industry veteran. The best place to reach Tom is on LinkedIn at or email at

If you want to learn more, need help or know someone who needs help check out the following resources:

The Children’s Hospital of Philadelphia Department of Social Work and Spiritual Care:

The LIV Foundation:

A Guide for Parents – National Cancer Institute:


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