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Managing Hair Loss

Posted 11/14/2014

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  This is a recurring and important issue for many of us. Yesterday I spoke with three people who are embarking on new chemotherapy regimens and are very distressed about impending hair loss. One is a woman in her early 70s who maintains a busy professional life and is determined that her clients and colleagues don't know about her cancer treatment. Her primary wig concern is that it look exactly, or almost exactly, like her own hair. The second was a young woman in her early 30s who has beautiful long hair and is very upset about losing it. Various people suggesting that she can donate it to Locks of Love has not soothed her sadness at all--and why should it? The third was a man in his 50s who is not one bit happy about being bald.

Most women and some men feel that hair loss is the most difficult side effect of chemotherapy. There are two kinds of hair loss that can result from chemotherapy drugs: gradual thinning which is nerve-wracking because you don’t know how much hair will eventually disappear, and near total alopecia (hair loss) that happens 14-21 days after the first treatment. Your doctor can tell you which to anticipate. If your medications put you in the first group, the best suggestions are to get a layered haircut and to have a few hats or scarves, or even a wig, at home, so you are prepared if you feel you must cover your head.

If you are receiving drugs that are sure to cause alopecia, you may experience intense scalp tenderness for a day or two first. If this happens, recognize it as a 48 hour warning; the tenderness will stop when the hair comes out. Hair does not all come out at once. Instead, it comes out in handfuls or patches when you touch, comb, or wash your hair, and sheds continuously. It can take less than a day or several weeks or longer to lose it all.

** Consider having your head shaved or buzzed before the loss begins. Schedule an appointment with your hairdresser or a friend with clippers 10-12 days after your initial chemotherapy. Some women prefer to wait until the hair begins to fall, and then quickly have it buzzed.
** If you want to hold on to as much hair for as long as possible, sleep in a hairnet or soft cap and refrain from touching or washing it. This may buy you a little more time.
** If your hair is very long, you can donate ponytails of at least 10” to Locks of Love ( which makes wigs for children.
** Our Feathered Friends: If you put strands of hair in bushes and trees, the birds will use it to make warm, soft nests.
** Winter: A bald head is a cold head. Consider wearing a soft cap to bed.
** Summer: Wigs are hot. Keep a package of baby wipes in the freezer, and put a cold one between your head and the wig.
** Wigs: Human hair wigs are expensive and have all the problems of human hair. Most people are happy with blends (human and synthetic) or all synthetic wigs. Most insurance companies help with the cost; you will need a prescription from your doctor. Try on several: some that are similar and some that are different from your usual style. Some women have fun with wigs that are strikingly unique or unlike their normal hair. Most wigs have too much hair in them and will benefit from a trim.
** Hats: Look for hats that come low enough over your ears and forehead to camouflage the baldness. Beware of baseball caps with a large hole in the back. Remember that scarves, headbands, and jewelry can all be used to add interest to hats.
** Scarves: Cotton or rayon scarves stay on a bald head; silk ones don’t and can only be used as a second layer. You can buy inexpensive fabric (a yard will do) and make your own. There are many dramatic and beautiful ways to tie scarves. Look for ideas online, especially at films on YouTube.

Hair does grow back. Most women feel able to go uncovered approximately three months after their final chemo. It may be gray, likely will be curly, and may have a different texture than your old hair. Manage this new hair with “product” and know you will never again complain of a “bad hair day.”


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