Immunotherapy and hair loss: what to know

Immune treatment can affect the skin and hair follicles, sometimes causing gradual thinning, patchy loss, scalp irritation or a change in hair texture. Hair changes may happen during treatment or after other treatment has been added, so the timing matters. A new rash, scaling, pain or inflammation on the scalp can provide useful clues. Hair loss does not by itself show whether immunotherapy is helping or harming the cancer. The underlying cancer type may also shape the treatment plan, including melanoma, lung cancer, lymphoma or other cancers.

Use a gentle shampoo, lukewarm water and a soft brush. Avoid tight hairstyles, harsh chemicals, frequent heat styling and scratching an irritated scalp. Ask before using hair-growth products, supplements, dyes or cooling devices because some options may irritate skin or conflict with treatment. Protect exposed scalp from strong sun and cold. Photograph changes if helpful and tell the oncology team when they began, whether loss is patchy and whether the scalp is painful or itchy. A nurse or dermatologist can suggest practical support, including head coverings.

Tell the treatment team promptly about sudden or extensive hair loss, a painful or blistered scalp, pus, fever, facial swelling, breathing difficulty or a rapidly spreading rash. Seek urgent help for swelling of the face or throat, severe breathing trouble, fainting or widespread blistering. Hair loss accompanied by marked tiredness, feeling unusually cold, weight change or changes in bowel habits may need assessment of hormone or other organ function.

Ask whether immunotherapy, another medicine or the cancer is the likeliest contributor, whether the change is expected to improve, and how the scalp should be treated. Ask if a dermatologist or cancer-support service can help and which hair products are suitable during treatment.