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Changes in Physical Appearance

Originally published on November 10, 2009
Most recently updated on April 10, 2013

For children (especially teenagers), self-esteem and self-confidence are often closely related to physical appearance. Changes in appearance may lead to an altered self-image.
A common side effect of chemotherapy and radiation therapy is hair loss, which will occur in varying degrees from child to child and treatment to treatment. For the minority of children who receive whole-brain radiation, hair loss can be permanent. Although bald patches around surgical scars may attract unwanted stares or questions, the hair will usually grow back. Scars, while more permanent, may in time come to symbolize healing or cure. But to a child, the time it takes for hair to grow is likely to seem 10 times longer than it would to an adult.

“Talking with other brain tumor patients gave me a sense of acceptance and wellness as I moved along with my treatment.”

Taking steroids (like Decadron) can cause children to gain weight and to have a puffy “moon” face and acne. You may want to talk about these changes ahead of time so that your child understands what to expect. These changes in appearance disappear once the steroids are stopped. Reassure your child (and yourself) that this look is temporary.

Consider buying a wig after surgery but before any treatment begins, so that you can match your child’s hair color. Check with your child’s social worker for a list of local wig salons that cater to pediatric cancer patients and some of the national groups that provide free wigs. Insurance plans often reimburse for wigs, if a prescription is submitted. The prescription should read: Cranial prosthesis. Many children prefer instead to wear a baseball hat, bandana, or other colorful headgear.

  • Locks of Love ( helps children obtain free or low-cost wigs. All wigs are made out of donated hair.
  • The American Cancer Society ( provides hats, wigs, or other beauty enhancers. They also have the Look Good, Feel Better program ( that can be tailored for teens.

Again, allow your child to express concerns, anxieties, fears, and frustrations. Show him or her that you accept any physical changes, even if they are more upsetting to you than to your child. Humor can be useful in talking about these changes and in encouraging conversation between your child and his or her peers. Your child’s cohorts need to understand that your child is still the same person inside. It might also help for your child to meet and talk with other children who are experiencing similar problems.


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