“Chemo Curls”: Understanding Hair Changes After Chemotherapy

“Chemo Curls”: Understanding Hair Changes After Chemotherapy

Many cancer patients notice changes in their hair when it grows back after chemotherapy. Straight hair may return curly, wavy, or frizzier than before, a phenomenon often called chemo curls. Doctors say these changes are usually temporary and happen because chemotherapy disrupts the normal function of hair follicles.

How Chemotherapy Affects Hair Follicles

Chemotherapy drugs target fast-dividing cells to kill cancer. Hair follicle cells also divide rapidly, which makes them vulnerable. This disruption often causes hair to fall out during treatment. As the follicles heal, their structure can change, which may temporarily alter the shape and texture of the new hair.

Hair regrowth typically starts 3–6 months after chemotherapy ends. The new hair may first appear as fine “peach fuzz,” then gradually thicken. In many cases, it grows back curly or with a different texture, giving rise to chemo curls.

What Do Chemo Curls Look Like?

• Hair that was once straight may come back curly or wavy.

• The new hair may look lighter or darker in color. Some patients also notice more gray strands.

• The texture can feel coarser or finer than before.

• Hair may appear patchy or uneven during the first few months of regrowth.

These changes vary from person to person and depend on the type of chemotherapy drugs, treatment duration, and individual factors such as age and genetics.

For most patients, chemo curls fade within a year as follicles continue to recover and return to their usual growth cycle. In some cases, minor changes in texture or curl pattern may persist, but permanent changes are uncommon.

Caring for Hair During Regrowth

New hair is fragile and requires gentle care. Experts recommend:

• Washing with mild shampoos and conditioners.

• Avoiding hot styling tools like flat irons or blow-dryers at high heat.

• Using a wide-tooth comb to reduce breakage.

• Keeping the scalp protected from sunburn.

• Avoiding chemical treatments such as coloring or perming until the hair strengthens.

Some patients use scalp cooling systems during chemotherapy, which may reduce hair loss by lowering blood flow to hair follicles during infusion. However, scalp cooling does not always prevent hair loss or chemo curls.

For many patients, hair loss is one of the most visible side effects of chemotherapy and can affect self-image. Regrowth, even with changes such as chemo curls, often provides reassurance that recovery is underway. Support groups, patient counseling, and access to resources like wigs and head coverings can help patients navigate this transition.

Reference

1) Freites-Martinez, Azael; Jerry Shapiro; Shari Goldfarb; Julie Nangia; Joaquin J. Jimenez; Ralf Paus; Mario E. Lacouture; et al. 2018. “Hair Disorders in Cancer Patients.” Journal of the American Academy of Dermatology 80, no. 5 (April): 1179-1196. doi:10.1016/j.jaad.2018.03.055. PMCID: PMC6186204.

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