Chemo scalp care: protecting sensitive skin and new hair

Hair loss can leave the scalp dry, tender or more exposed. A simple routine using lukewarm water, mild fragrance-free products and careful drying can reduce irritation.

Some chemotherapy medicines affect rapidly dividing hair-root cells, so hair may thin or shed. The timing and amount vary with the medicines, dose and schedule. Skin can also become drier or more sensitive, while uncovered areas lose the shade and insulation that hair provided.

Mild tightness, flaking or tenderness can occur around shedding. However, broken skin, pus, rapidly increasing redness or a hot swollen area may point to infection or another reaction that needs assessment.

Wash only as often as needed with lukewarm water and a mild, fragrance-free shampoo. Use your fingertips rather than scratching with nails, rinse well, and pat dry with a soft towel. A plain fragrance-free moisturiser may help dryness; check unfamiliar products with your cancer team before applying them to irritated or broken skin.

Avoid close shaving over sore areas, harsh dyes, chemical straighteners and high heat from dryers. Outdoors, use a soft, breathable head covering and sun protection recommended by your care team. Wash hats, scarves, pillowcases and clipper guards regularly, and do not share razors.

If scalp cooling is offered, ask how to prepare your hair, which products to avoid and how the cap should fit. Scalp cooling is not suitable for every treatment or cancer type, and your oncology team can explain whether it fits your plan.

Contact your oncology team promptly for a fever or chills, pus, blisters, rapidly spreading redness, increasing warmth or swelling, severe pain, or a rash affecting the face or eyes. Follow the team's emergency temperature instructions even if the scalp looks normal, because chemotherapy can weaken infection defences.

Seek urgent help for trouble breathing, facial or throat swelling, faintness, or a widespread blistering or peeling rash. For ongoing itch, scaling or small spots without urgent features, tell the team before using medicated dandruff products, steroid creams or antiseptics.

Ask whether your medicines are expected to affect scalp hair, whether scalp cooling is appropriate, which cleanser and moisturiser suit your skin, and what temperature or skin changes should trigger the emergency number. You can also ask when colouring, shaving or other hair treatments may be resumed.