What You Need To Know About 'Chemo Curls'

Medically reviewed by William Truswell, MD

While chemotherapy can be effective for treating certain cancers, it can also affect your healthy cells, particularly those in your hair.

In fact, one of the most visible side effects of chemotherapy is hair loss and changes in hair texture. This is sometimes known as "chemo curls." Chemo curls occur when a cancer patient's hair grows back after chemotherapy in a different texture, thickness or pattern than before.

Although the exact cause of chemo curls is not known, research points to how the drugs used in chemotherapy can affect the hair follicles and alter growth patterns.

If you’re one of the many people experiencing these changes in hair after cancer treatment, here’s what you need to know about living with—and caring for—your chemo curls.

Why Do Chemo Curls Happen?

During and after chemotherapy, your hair may be finer, more prone to breakage and have a different texture. For many people, new hair growth becomes curlier than it used to be, even if your hair has never been curly before. A survey shows that 63% of cancer patients reported that their hair had become wavy or wavier when it began to grow back.

Although there are not yet clear answers on why chemotherapy causes many people’s hair to grow back in wavy, curly or more textured than before, it is clear that hair follicle cells are very much affected by various cancer drugs.

Chemotherapy drugs—which are also known as cytotoxic and cytostatic treatments—affect all cells. Cytotoxic drugs kill cancer cells while cytostatic drugs disrupt the way cancer cells multiply to help stop the cancer from spreading. These medications cannot tell the differences between cancer cells and healthy cells. Therefore, they tend to damage hair follicle cells because these cells continually (and rapidly) divide in the roots of the hair, which is what causes hair to grow. When these cells are exposed to chemo, both the function and the cycle of the hair follicle is impaired, causing hair to break off under the skin or near the surface.

Hair follicles can continue to behave differently even after chemotherapy drugs leave your system and your hair begins to grow back in. Typically, regrowth will begin three to six months after treatment ends. The changes you might see in your hair depend on which kind of cancer drug (or drugs) you received, how big or small of dose you received, how the drugs were administered, how long the treatment stays in your system and which other treatments you were given.

But for many people, these hair changes are only temporary. Research shows that 25% didn’t notice any changes in hair texture, 32% did not experience any changes in hair thickness after regrowth, and 62% didn’t say that their hair had become grayer or whiter as a result of treatment.

Do Certain chemotherapy Medications Affect Hair More?

Different chemotherapy treatments affect hair differently and not everyone who takes chemotherapy drugs experiences hair changes.

For people who receive chemotherapy, 65% notice changes in hair texture, structure and color during and after treatment. Only 30% of those who receive targeted therapies like monoclonal antibodies and 2% of people who are treated with immunotherapies noticed these changes.

Different categories of chemotherapy drugs affect hair differently as well. When it comes to hair loss in general, research shows that ​anti-microtubule chemotherapy causes hair loss for 80 percent of people, topoisomerase inhibitors cause hair loss for more than 60 percent of those treated and anti-metabolites cause hair loss in 10 to 50 percent of cases.

Research also shows that using multiple drugs at once are more likely to cause hair loss than using just one type of treatment.

Related: 13 Reasons Your Hair Is Falling Out

How to Care for Your Chemo Curls

During and after chemotherapy, your hair and scalp may be more sensitive than they were before you began your treatment. As your hair grows back, the new growth may look different than your previous hair, and likely be more delicate. This means that you’ll need to treat your hair more gently than before.

To avoid damaging your chemo curls be sure to:

• Use a wide tooth comb or a hairbrush with soft bristles when brushing your hair

• Wash hair gently with mild shampoo and pat dry

• Avoid harsh products like gels or sprays that can irritate the scalp

• Protect your scalp by wearing sunscreen when outside and using conditioner to soothe itchy or tender spots

To help stimulate your hair follicles, you might also gently massage your scalp. When in doubt, always opt for being as gentle as possible as your hair continues to regrow.

Related: How to Take Care of Your Scalp and Why It Matters

Tips for Styling Chemo Curls

Styling your hair after chemotherapy can be a challenge even if you haven’t experienced significant changes in its texture and fullness, since your scalp may still feel sensitive post-treatment.

To maintain optimal hair and scalp health, don’t overdo it on styling. Keeping your hair short so that it’s easy to style can be a good option. This way, you aren’t tempted to cause damage by using hot tools (curling iron or flat iron, in particular), or by pulling your hair into a tight ponytail or braid.

Even if you don’t love the color or texture of your hair as it’s growing back, try to avoid professional salon treatments like perms, chemical straightening or dyes. All of these can lead to breakage, which can impede the new growth process and prolong getting your hair back to normal. Plus, these treatments can be harsh on your scalp as well.

How Else Can Chemo Affect Hair Growth?

When your hair begins to grow, you will likely notice only small traces of fuzzy regrowth at first. Over time, your hair will become longer and thicker, especially if you treat it gently. Remember that it can take as long as six months for hair to grow in enough so that you can style it.

Chemotherapy doesn’t just affect the hair on your head, however. These drugs can impair the functioning of a hair follicle in any place that hair grows, including the eyebrows, eyelashes, body and pubic area.

According to a study of nearly 1,500 cancer patients, 90% experienced eyebrow hair loss while 88% experienced eyelash hair loss. However, over one year later, 60 to 70% of patients recovered more than 80% of their brow and lash hair.

For people who are treated with particular types of chemotherapy, specifically busulfan (which can be used to treat certain types of leukemia and to prepare the body for a stem cell transplant) and cyclophosphamide (which can be used to treat leukemia, lymphomas and nephrotic syndrome), there is a higher possibility of permanent hair loss. Those undergoing radiation might also experience permanent hair loss.

A Quick Review

Chemo curls may be an unexpected side effect of chemotherapy but, for most people, these changes in hair texture are only temporary. While dealing with the physical side effects of these powerful drugs can be difficult, it is important to remember that chemotherapy remains a vital and effective tool in the fight against cancer.

Frequently Asked Questions

Are chemo curls permanent?

For most people, chemo curls are not permanent. As your hair begins to grow back, and look differently than it once did, you may be wondering if they go away. The short answer is yes. Over time, your hair will likely go back to the way it was before treatment.

How long does it take for your hair to be back to normal?

Typically, it takes two to three months for your hair to start growing back after treatment has ended. As far as how long will chemo curls last, typically after a year of growing back in your hair will return to the texture it was previously.

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