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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.

Mar 14, 2020

I’m so glad I saw this post now. I just had my first chemo treatment for ovarian cancer yesterday and have heard all sorts of things about hair loss. I have already cut my hair short but the next steps I wasn’t sure of. Thank you!

Jolene Wester
Mar 04, 2020

I buzzed mine to 1/4 inch just before my first round six weeks ago. It’s very slowly thinning, but not coming out in clumps. It’s been very itchy and irritated. I also have “mab rash” (I believe… going to Doc today to make sure it isn’t infection) and my skin is a hot mess. Cancer sucks…. but pushing through.

I ran the lint roller over it today. Feels much better. Thanks for the advice.

Stacy
Mar 04, 2020

Thank you for the advice. I’m exactly two weeks into chemo for breast cancer and my hair is starting to fall out. I’m glad I saw your article before shaving, very useful information.

Thank you
Tammie

Tammie
Mar 04, 2020

I’m late at looking this up. But, I’m glad I did. I just had my 2nd / 3 week chemo session. I’ve had a very tender scalp! So I’m going to have my daughter use the #2 blade tonite. I’m hoping I dont jump like a Cat on A Hot Tin Roof! But , I might! Is there anything you can recommend like Coconut or Cocoa butter that may condition it help with tenderness?

Denise Pilkington
Mar 04, 2020

Wish I would have found this article last week. I also shaved my hair to short and now have painful red bumps and it feels like I am laying on hot needles. Do you have any helpful advice. I would greatly appreciate it.

Thanks from a new cancer patient,

Eva Church
Eva Church
Mar 04, 2020

Hi I have been having chemotherapy for coming up 2 months now, my hair is past my shoulders but feels very fine and thin, I’m ready to shave it, how do I get it smooth and not stubbly? Thank you

Jodi walker
Jan 30, 2020

Thank you so much for this advice! It was like you were sitting in my bedroom watching me struggle with this and read my mind! I’ve been trying to come up with a way to get this #2 stubble off my head for two days now… I tried your lint roller trick and it’s working perfectly. My head is still quite tender, but somehow it feels really good, and again I feel like I have some control over the hair loss!

Denise Olson
Jan 30, 2020

THANK YOU THANK YOU THANK YOU FOR THIS!!!!!
I’m at that exact point in my treatment for breast cancer, and you just saved me a hell of a lot of trouble.
You are so kind to take the time, and it means the world to hear the details from a professional!!

Happy Holidays, you are an angel.

Kristen LoGiudice

Kristen LoGiudice
Jan 30, 2020

It is absolutely true. I have had long hair all my life. Acceptance of losing it was a process. I was driven to cut my hair to two inches when I was tired of my hair ending up in my food. they changed chemos and my hair came back, then another change and now I am almost bald, the remainder I shave as you have directed. I am going to try the lint roller. I also have rashes and skin sores and a shaved head makes it easier to apply the medicine. Thank you so much for the kind advice!

Dena
Jan 30, 2020

What a useful post, thank you.

Sandra

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