All, Hair loss, Managing side effects, Skin Care & Beauty

Handling chemo hairloss

Handling chemo hairloss

When you think of chemotherapy and cancer, one of the defining characteristics is hair loss. For women, our hair is a real defining feature, and a long, glossy mane is generally considered the holy grail in feminine beauty. So the prospect of losing your hair, for many women, can be one of the most traumatic aspects of cancer treatment.

Let’s face it when you think of cancer, one of the first images that springs to mind is one of a bald woman in a headscarf. The hair loss is one of the easiest ways to spot a fellow cancer sufferer, and although this may just be me, since losing my hair, I often find myself eyeing up women with very short hair and thinking “hmmm, I wonder if…” and offering small smiles of solidarity just in case – they probably just chose that hairstyle and think I’m nuts!

However, for me, as someone that had a real problem with the idea of being defined as “ill” or as a “patient” or someone to feel sorry for, this automatic identification was something I felt really uncomfortable with, and when cancer (or more specifically the treatment for cancer) seems to do so much to strip you of your identity, turning you into “that girl with cancer” the hair loss and it’s immediately visible outward sign that something is wrong was the bit I found hardest to take.

My hair loss story

When I was given my treatment plan, I was categorically told that with the type and intensity of my chemo regime, I would definitely lose my hair, and that whilst cold capping may minimise this, there was absolutely no guarantee and that I would still be looking at fairly significant hair loss.

Having tested whether I felt I could cope with the cold cap by sitting with a packet of frozen peas on my head (I lasted less than a minute!) I decided that if I was still going to lose significant amounts of hair, the discomfort wasn’t worth it so instead I would “brave the shave”. Two days before my first chemo session, my best friend and I went wig shopping, had lunch, several glasses of prosecco and then out came the razor. I may never have liked my hair much, always wishing for “different” hair – thicker, curlier, darker, but the idea of seeing my hair drop out, and being so out of control of it all, was something that I absolutely couldn’t bear the thought of.

I wanted to be in control of the process, make it something that was my choice, not a consequence of what I was going through. The day I shaved my hair I felt incredibly empowered and like I could literally take on the world! I was owning my life, bending my situation to my will, and nothing was going to stop me from doing exactly what I wanted with my body, my hair, especially not some stupid lump of rogue cells.

Interestingly, I’ve since had a breast care nurse tell me that in doing it this way, it is possible that mentally I didn’t allow myself to accept what I was going through, and maybe it would have been better to let it fall. Her opinion was that you should wait until it annoys you, and you want to be rid of it, and then shave it off. I have no idea whether this is true or not, or which approach is better, I feel that it is an intensely personal decision about when/if to shave your hair, and only you will know when it is the right time for you.

Whenever you decide to do it, I would recommend being with someone you trust implicitly, who can make you laugh, who will help distract you through the process and who will give you a big hug at the end and tell you that you look beautiful.

Incidentally, for all our worries about losing our hair, having since seen lots of people who have lost their hair through cancer, I would say that there is something about seeing a woman without hair (regardless of age or race) that is incredibly beautiful. Stripping away the hair lets you more clearly see the inner beauty and strength that they hold within – combine that look with a bit of lippy and my goodness, it is the definition of fierce!

What is it like to lose your hair?

About 10 days after my first chemo, even with my “Britney circa 2007” skinhead, the remaining hair on my head started to hurt. It constantly felt the way your hair feels after being kept in a tight ponytail – that weird ache you get when you let your hair down at the end of the day. It was sore and itchy, and I could tell this was where it was starting to fall out. It drove me crazy with how uncomfortable it was, and even though I just had very light stubble, I just wanted it fully gone. I ended up using DIY leg wax strips to take the last remnants off, and the relief was immediate.

Handling chemo hairloss
3 weeks post-chemo. Check out the peach fuzz!

My bald head was weird and fasinating – who knew I had so many little scars and bumps – the previously hidden evidence of just how clumsy I am naturally. Lots of people told me I had a good shaped head, apparently something to be grateful for, although I confess this wasn’t top of my gratitude list and I sometimes wonder what they would have said if it turned out I had an awful/weird shaped head… probably the same thing – it’s one of those things you are kind of obliged to tell a bald woman with cancer!

Of course, having got rid of all of my hair, I then went on an obsessive hair-watch for signs of it coming back. What is it they say about women never being happy with their hair??

Some days I was fine with my new look, other days I cried for my lost hair and the fact that I looked weird. My poor husband had no idea which way to go with it all – one minute we could be joking about whether I should dress as uncle Fester for Halloween, the next minute I would be shouting/crying that I hated it, that I looked like an alien and how was he ever going to fancy me again having seen me like this. It was an emotional rollercoaster for sure.

I made sure I took my biotin tablets every day, spent a lot of time hanging with my head upside down to encourage blood flow to my scalp and painstakingly massaged my scalp on a daily basis – initially with coconut oil, and then once I found it, with Watermans hair growth tonic.

I had new dilemmas that had never occurred to me before, and which in the grand scheme of things seem silly on reflection, but at the time gave me major pause for thought – how do you clean a bald scalp? Do you use shampoo on your head when you have no hair or just continue your body wash up over your head? When moisturing your face where do you stop… at your old hairline, further back or maybe even covering your whole head? I settled on body wash to clean my head, stopping my facial moisturiser at my old hairline and then using the coconut oil/serum to moisturise my scalp.

My hair started to grow back about 5 weeks after I switched to Paclitaxel, although around the same time my eyelashes and eyebrows waved the white surrender flag and did a major disappearing act on me… which is typical because I was just at the point of congratulating myself on having kept hold of them so long, and starting to hope that maybe I wouldn’t lose them. Just a few weeks after my last chemo, I had definite white blonde peach fuzz all over my head.

Tonight Matthew, I’m going to be…

Handling chemo hairloss
“Julietta” was half synthetic and half human hair and the most similar to my natural hair
Photo credit: Lauren Kennedy

I had not one but three wigs – Scarlett, Melissa and Julietta. I really liked messing with peoples minds, one day a fiery redhead, the next a blonde bombshell, and matching to my outfits and moods. However, what I did not expect was to find the wigs so uncomfortable. My skin went really sensitive from the chemo, and I found the wigs itchy and hot. I was also constantly paranoid about them falling off. I found a supersoft wig liner helped a lot with the itchy sweaty sensation and a wig grip was a lifesaver in making everything feel more secure without using glue which I was sure I would react to. Even so, I only really wore a wig if we were going out or if I was at work, the minute I could I would “take my hair off” and put on a beanie hat. When I didn’t have to worry about it, I much preferred wearing scarves and hats as a much more comfortable option or as my friend told a colleague one day “oh she doesn’t wear hair when she’s at home”. I got creative with clip-in fringes attached to wide elastic hairbands to give the impression of hair under hats which I found to be a happy compromise between wig or no wig – particularly when teamed with a baker boy hat. You can do a lot with a needle, thread, some hair extensions and a soft comfortable hairband – alternatively some companies sell halo hair which is basically the same thing, without having to sew it yourself.

As time went on, I wore my wig less and less, and just 3 months post-chemo I braved baring my ultra-short buzzcut to the world, I would never have dreamed of baring it before then (although I have so much respect for women than do!) and from that point I never really looked back. There are not many of them, but when I see pictures of my completely uncovered and completely bald head, it is shocking and I don’t recognise myself. This said, I love my short hair now, and can’t imagine ever going back to my pre-cancer hair either, which feels almost as unrecognisable as the bald head – belonging to a different woman from a different time. I still have the odd day when I gripe that I look like a boy and wish for longer hair again, but generally I’m braver with my hair choices now, embracing vibrant colour on the basis that it is “just hair” and if it all goes horribly wrong, it is not the end of the world. My hair is no longer an integral part of how I see myself. I still have my wigs as I can’t quite bring myself to get rid of them (just in case) and yet if the worst came to the worst and I did need them again, I don’t know that I would wear them as I don’t think they reflect the person I am today.

Hair loss tips

  • Contrary to popular belief, not all chemotherapy regimes will make you lose your hair. Speak to your medical team about how severe the impact will be and go from there. Whilst they can’t say for definite, they will have a very good idea on how harsh chemo will be on your hair.
  • However, if you are going to lose your hair, you will lose all of your hair and this means from your entire body! Everywhere, including places, I can guarantee you never considered! This has pros and cons. On the plus side, hair removal is not something you need to worry about for a while and trust me you will never get a bikini wax that comes close to “chemo-smooth” However, on the downside, it turns out that the hair in your nose keeps the snot in, and without it nose drip is a very real problem. Always keep a handkerchief/tissues to hand to avoid public humiliation!
  • Even if you have decided to cold-cap, it is worth looking into wigs or hats before you begin chemo as a backup measure. Either way, I would recommend that is worth having something (wig/hat/scarf) sorted before you begin chemo if you can, as the last thing you want to do is drag yourself out shopping if you are feeling ill or feeling like you have to panic buy something due to needing it immediately – better to take your time and find something you really like.
  • Your hair does a lot to keep you warm – a snug fitting beanie/nightcap is useful to avoid waking up with a freezing cold head in the middle of the night, it can also be useful to wear overnight if you are cold capping or before you start to lose your hair to avoid the distressing situation of very visible hair loss on the pillow in the morning
  • Wigs are often not very comfortable, even when they are good quality – they can be hot and itchy especially on a bald and potentially very sensitive scalp. A soft wig liner will help a lot, but it is also worth getting a slouchy beanie or ultra-comfortable hat that is easy to pop on when you are mooching about at home so you don’t scare the cat or the postman, and you can be comfortable when you are relaxing.
  • Apart from keeping you warm, and stopping you from looking like a newborn, the hair on your head, eyebrows and eyelashes are also very handy for keeping sweat and dirt out of your eyes. If it is very hot or if you are working out (yes really!) then you may well need to make use of an old fashioned handerchief for “mopping duty”, and eye drops are also a handy thing to carry around in case dust gets in your eyes.
  • Wearing mascara can make your eyelashes fall out faster, and is not recommended. If, like me, you are naturally very blonde, getting your eyelashes tinted before you begin chemo can give you at least a month of relatively “normal” looking lashes
  • Generally microblading and semi-permanent eyebrow tattoos cannot be done whilst having chemo due to the risk of infection, but can be done beforehand and afterwards (usually about 6 weeks post-chemo). Most reputable salons will ask for a letter from your medical team, but I’ve never heard of anyone being refused this. Whilst not a cheap option, both options work really well, and especially as my eyebrows grew back white blonde (aka invisible!) I am so pleased that I had mine done when I did.

And finally, whilst I know it is distressing to think about losing your hair before you know it, you too will be on hair-watch and seeing those first precious tufts emerge. In the meantime, embrace and own your new looks and experiment with hats, turbans, scarves, and wigs and have a bit of fun with it all – you never know, there may be an old-school turban-bound Hollywood glamourpuss inside you just waiting to be unleashed!

There is nothing more rare, nor more beautiful than a woman being unapologetically herself; comfortable in her perfect imprefection. To me, that is the true essence of beauty

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2 thoughts on “Handling chemo hairloss

  1. Sandra says:

    This blog is so helpful and I’m so glad I’ve seen it. I had pre-bought the necessary headwear which I am glad I did. The tips about Virgin Coconut oil, Biotin tablets etc have been amazingly helpful. Thank you Emma x

    1. I’m so glad you found it helpful and wish you all the best of luck with chemo xx

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