For many children with cancer, hair loss can be important and traumatic — yet for others, especially very young children, it can be relatively unimportant.

For teenagers with cancer, hair loss can be devastating, and you will need to do everything you can to help your teen find a satisfactory way to cope with this problem. Your child will need to know if hair loss is likely to occur because of his or her treatment, and you will need to make plans to cope with this in ways that make your child most comfortable. The good news is that there are a number of options your child can consider when it comes to covering his or her head.

Not all chemotherapy medications cause the loss or thinning of hair, so first ask the health care team about the recommended treatment and whether hair loss is expected. Some chemotherapy drugs will cause hair loss because they are made to kill fast-growing cancer cells. Certain normal cells, like hair cells, are also fast-growing; chemotherapy affects these cells, too.

For almost everyone with cancer, hair begins to grow back several months after chemotherapy ends. While the hair may initially be of a different texture and even a somewhat different color than your child’s original hair, this difference is usually temporary

If your child must have radiation to the head, hair will probably fall out in the area that is treated. In many cases, hair may not grow back here. Talk with your health care team for more information and what is likely to happen in your child’s case.

Hair loss usually begins several weeks after the first or second chemotherapy treatment, although this varies from individual to individual. Your child’s hair may begin thinning gradually before falling out faster and in larger quantities. If your child has radiation, hair loss occurs only when the treatment is concentrated on the scalp itself.

How to Prepare for Hair Loss

Once you and your child know that hair loss is expected with cancer treatment, you can plan ahead.

Have your child’s picture taken with his or her hair as it is usually worn, so if your child wants a wig, the hair stylist will have a picture to help shape the wig. Also, keep a snippet of your child’s hair, to help match color and texture.

• Have your child get his or her hair cut short. Once the hair is short and your child thinks she or he may want to cover the hair once it begins falling out, experiment with different hats (and scarves, for girls) to see which please your child. Feeling good about appearance is very important to most children undergoing cancer treatment, so take the time needed with this step to make this process as enjoyable and relaxing as possible.
• If your child is interested in wearing a wig, first get a “prescription” from your physician for insurance company purposes. Many health insurers cover the cost of wigs (called a “hair prosthesis” in insurance language) if a physician prescribes these. Locate a wig shop or hair salon that can help with a wig for a young person; your hospital social worker can usually make recommendations.
• Understand that most people should not plan to wear wigs “out of the box.” To fit comfortably and look good, wigs usually need some styling, trimming, and other adjustments by hair care professionals. Also, wigs need to be the right size for your child to be comfortable. Talk with your wig expert to discuss whether to use natural (human) or synthetic hair for your child’s wig.Generally, synthetic hair keeps it shape and requires less care than human hair, and is less expensive as well. Both kinds of hair come in a variety of colors and textures and you should be able to approximate your child’s natural hair if you choose to do so.
• If you lack insurance or your insurance doesn’t cover the cost of a wig, there are organizations that can help supply wigs at low or no cost. See Resources for information about these organizations. Also, contact your local chapter of the American Cancer Society for assistance in obtaining a free wig.
• It may help for you and your child to talk with other children who have been through the experience of cancer treatment and hair loss, and learn what worked and didn’t work for them. Your hospital social worker can help you find children or young adults with cancer to share their views.

This article was published in www.webmd.com on 1 March 2010.