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Chemotherapy Hair Loss: To Shave or Not to Shave

Chemotherapy Hair Loss: To Shave or Not to Shave


Not all chemotherapy drugs cause hair loss, but the ones that do are fairly predictable. If your doctor has told you to expect hair loss, this is what usually happens: 

One and a half weeks after your first treatment, your scalp may become tender. Some people don't feel this at all, and for others their scalp becomes quite sore. This is normal and goes away after the hair loss is complete.

Hair loss begins about two weeks to the day after your first treatment and takes 3-7 days. I promise you, you will not lose your hair before two weeks, and you will not wake up one morning bald without warning.

You can generally wear your hair normally for the first few days, but by the third or fourth day (after the two week mark) you'll be ready to comb out what's left and cut it short, if you haven't already.

Whether or not to cut your hair before you begin treatment is a matter of personal preference. For some women, having their hair cut into a shorter style helps them get used to it, and it's less traumatic when the hair begins to fall.

For others, particularly if you love your hair, cutting it any sooner than you have to is more traumatic. Either way, you'll definitely want to have it cut short once hair loss begins.

100 hairs that are two inches long are much easier to deal with than 100 hairs that are 6 or 10 inches long. Also keep in mind that even before your hair begins to fall out, it will probably look dull and lose body.

In my 25 years as a hairdresser helping cancer patients through this process, here are my best recommendations:

When your scalp becomes tender is a great time to cut your hair short, down to about 2 inches. Don't shave it yet. I'll explain more later. Cutting your hair short at this point will greatly relive the tenderness.

Three to five days after the two week mark, your hair loss will really pick up speed and you'll be tired of dealing with it. At this point you want to encourage the hair to come out.

Gently comb out your hair. Then shampoo and rinse. A lot more will come out. Apply your regular conditioner and comb through your hair with the conditioner in. This puts just enough tension on your hair to gently coax it from the follicle. This will probably remove about 80% of your hair and it will not hurt.

Rinse out the conditioner, dry your hair and now you are ready to clip it down. It's very important that you do not clip it all the way to the scalp. Please use a #2 attachment.

If you clip it all the way to the scalp, those little whiskers will get caught in the follicle. They will detach from the papilla, the bulb that feeds the hair, but be stuck in the follicle. This will be like a splinter or ingrown hair and you will get tiny red bumps or sores. This is not good and can be totally avoided if you use an attachment and leave a little bit of hair.

Okay, so you've clipped your hair with a #2 attachment. Now take one of those masking tape lint rollers and roll it over your head. You will be amazed at how much more hair comes out. Use the lint roller several times a day to get the rest of it out. Your head will feel so much better. When the hair follicle is inflamed even the weight of a couple inches of hair can be uncomfortable.

Continue to wash your scalp with a mild shampoo (not bar soap) every day, even after you've lost your hair. Your oil glands will put out the same amount of oil whether you have hair or not, and this will keep your wig, hats and scarves cleaner.

Feb 05, 2024

Thanks so much for your video.. I’m coming up to the two week mark after my first cycle of chemo and this information has really helped me feel more confident about how to deal with my approaching hair loss.

Feb 05, 2024

This was so helpful. I go for my third round of chemo Thursday and my hair started falling out 2 days after my second round. I decided to take control and get it completely cut off. I go tomorrow for the cut and even though I know it’s going to be emotional it gives me encouragement knowing that I’m not alone in this fight. Stay strong and have faith!

Janet South
Jan 28, 2024

Thank you for this information. My hair started falling out yesterday, exactly 2 weeks after my first chemo treatment. I had absolutely no idea how to go about shaving or cutting down, or even the process of easing tension on my scalp while deciding. Again, thank you for such a detailed and well written explanation on what to expect and how to care for my scalp.

Love from NY

Toni from NY
Jan 28, 2024

This was very helpful. It’s been 3 days and mist of my hair is gone. Should I shave it bald or just let it do its thing? Lint roller really helps. I have constant head pain.

Linnea Ripka
Jan 28, 2024

Very grateful to have found your information on how to deal with hair loss during chemo. I am having chemo weekly and the day after my 3rd treatment my hair started to fall out. The next day was worse so I went straight to a number 2 clipper cut as you suggested. The lint roller is brilliant. Part of my scalp is tender but I read that’s normal. I have an assortment of colourful fun turban scarves to wear. Thank you for the advise.

Jan 28, 2024

Thanks for your advice to or not to cut. My hair has gotten real thin and has come out on the sides and in the middle. I’m going to my beautician next week and identify what styles she can do. I want my hair to always look its best and not have to wear a scarf all the time. I’ve come to accept what is happening.

Brenetta Glass
Jan 28, 2024

Thank you for your kind instructions. You answered my questions and gave me information that I needed.

Again Thank you,

Jamie Kent
Jan 28, 2024

It’s been a month since chemotherapy is over.

I never shaved my hair off. I lost most of it but a few hairs are left that are about 2-3 inches long.
Will this slow the rest of my hair from growing back?

Do I need to shave it off?

Marcia Kaye
Jan 28, 2024

Hello All,
I’m starting my first round of chemo on 10/25/23 and am preparing to lose my long, almost waist length hair. I have an idea that I wanted to share & get feedback please: as I get a few days past my 1st round, I want to attach pony tail bands close to the scalp (1-2” out) and then make as many skinny braids as possible, securely attaching bands to the bottoms of each braid. Then, I want to use 1 braided piece along w/ 2 other synthetic hair colors, to make wider braids. I would then attach these “interesting” braids with clips inside a beanie. I bought several different colored beanies and probably 15 colors of long strands of synthetic hair. If you can imagine this, or have tried this, I’d love to hear your thoughts. Thanks everyone! Catherine

Jan 28, 2024

Thank you for that beautiful video. This is my second time and did learn a lot from your video. God bless.


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