Hair thinning or hair loss is often one of the first real outward signs of being sick. It can happen all over the body or just on the head, depending on the type of chemotherapy or radiation therapy.
Some kids take hair loss in stride, but it's traumatic for others. In most cases, the hair will grow back. But sometimes after treatment with a transplant and/or radiation therapy to the head, hair doesn't grow back or small areas of hair loss remain. Also, hair that grows back may be a different texture and slightly different color.
When the hair starts to fall out, kids might choose to wear a baseball cap, hat, bandanna, turban, or scarf. Some wear wigs, most of which are made from donated hair by organizations like Locks of Love, a nonprofit group that uses donor ponytails to create wigs for people with cancer.
Before the hair even begins to fall out, some kids decide to shave it all off. This can make it easier when hair does begin to fall out and also provide a much-needed and empowering sense of control over what's happening to their bodies.
Other kids (particularly younger kids who are less appearance-conscious) decide not to shave their heads or wear anything at all — a courageous and bold move that can also give them a feeling of empowerment. It's fine to go bald indoors, but kids should cover their sensitive skin with a hat or sunscreen when they're outside.
Chemotherapy drugs often cause rashes, redness, and other types of skin irritation — especially if a child has had radiation in the past. Radiation alone can cause similar symptoms (along with blisters, peeling, and swelling) in the area of treatment.
Wearing loose, soft cotton clothing may help with the discomfort. Your doctor also might recommend or prescribe creams or ointments to treat irritated skin. Good skin care is important, not only for looking good but to help prevent infections, which can be serious in kids with cancer.
Tips for kids with sensitive skin:
Choose a mild soap or shampoo. Avoid those with dyes, perfumes, or alcohol. Especially avoid acne soaps and washes, which can make problems worse by further drying out the skin.
Have your child take baths or showers in lukewarm instead of hot water.
Moisturize your child's skin right after bathing with a hypoallergenic moisturizer.
Discourage your child from picking at pimples or scratching itchy spots, which could cause an infection.
When outside, your child should wear a hat and sunscreen with an SPF of at least 30 because skin is especially sun-sensitive during cancer treatment.
To help cover up pimples, rashes, or other skin imperfections, the doctor can recommend special makeup or concealers. Just make sure that your child never shares makeup with anyone else, as this can increase the chance of infection.
Many kids being treated for cancer have weight gain or weight loss. It's common for those who take steroids to have an increased appetite and gain weight in unusual places, like the cheeks or the back of the neck. Other kids have decreased appetites due to the medicines they're taking or trouble keeping food down from side effects like nausea and vomiting.
If you're concerned, talk to your doctor about how to help your child maintain a healthy weight based on his or her medical needs. A dietitian also can offer advice about how to stay at a healthy weight. Sometimes it helps to eat small, frequent meals and nutritious snacks.
If old clothes no longer fit, consider a quick shopping trip to lift your child's spirits. If new clothes aren't an option, perhaps you can borrow clothes from friends or relatives, visit a thrift or consignment store, or even get creative by reconstructing old clothes in fun and inventive ways.
And remind your child that weight changes are only temporary. When treatment ends, most kids return to their previous weight.
How Can I Help My Child?
Dealing with the cosmetic effects of cancer treatment can be an added blow to a child who's already coping with serious illness. But it's important to remember that they're part of a necessary treatment to help your child. So, while your child might feel bad now, something good is also happening — your child is getting what's needed to fight the cancer.
During this time, try to surround your child with friends and family members who are supportive and uplifting. If you find that feelings of self-consciousness about appearance are making your child want to withdraw from social events or other enjoyable activities, find a counselor or psychologist who can help your child work through these difficult emotions.