Cancer treatment can impact the skin in a range of different ways. These skin changes can also include the scalp, which can become tender and painful. Here we talk about why this is and what you can do to help manage it.

Why does cancer treatment cause sensitive scalp?

If you are having chemotherapy that causes hair loss, you may find your scalp becomes tender or even painful while you are losing your hair. There hasn’t been much research into this, but one small study has been carried out with women having chemo for breast cancer. This reported that more than 4 out of 10 women had scalp pain at this time. 

The researchers suggest that this pain may be due to severe stress in the hair follicles, which seems a reasonable explanation. As well as attacking cancer cells, chemotherapy attacks healthy cells that divide and multiply frequently. This includes hair follicle cells, which get killed off during your treatment. That’s why your hair thins or falls out completely. 

Some chemo drugs can make your skin dry, itchy and more sensitive to the sun and this will include the skin on your head and scalp.

If you’re having radiotherapy to the brain or for a head and neck cancer, the skin on your head may become sore if it’s included in the treatment area. Skin can become red and inflamed, a little like sunburn. The skin on the scalp isn’t normally exposed to the sun so it’s more sensitive to burning. 

While you have hair loss (whether from chemo or radiotherapy), your scalp will be exposed to the elements and so could be made sore by sun, wind or cold. 

What can I do about sensitive scalp?

Although it isn’t much comfort, if scalp pain is due to your hair is falling out, this may go away once you’ve lost your hair.

If you still have some hair and are using shampoo, it’s worth switching to a gentle shampoo, such as baby shampoo. Washing removes natural oils so shampoo your hair as little as possible so you don’t dry the skin even further. Some people use aqueous cream instead of shampoo. Be gentle - don’t rub or massage your scalp.

If your scalp is dry and itchy, moisturiser may help. Don’t use anything perfumed. Try aqueous cream or a cream for eczema. You can also try oils and lotions formulated especially for sensitive and itchy scalp like Defiant Beauty Scalp Care Oil or Ozalys Soothing Care Soft Scalp LotionPlease note: If you’re having radiotherapy, don’t put anything on skin in the treatment area without checking with your nurse or radiographer. Some creams can increase risk of soreness and burning.

While your hair is thinned or lost, you must protect your scalp from the elements. Do cover your head while you’re out when it’s windy or cold. You must also cover your head in the sun or apply sunscreen

If your scalp is tender or itchy, you may find wearing a wig too uncomfortable. Scarves and turbans may be better, particularly if they’re made of a soft natural fibre, such as fine cotton, bamboo or silk.