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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 07, 2023

Great advice and thanks for explaining it all very straight forward and simple. At times like these any good advice is very helpful and comforting. I now feel empowered to do the right thing at the right time ! Thank you !

Mar 25, 2021

Hi, fantastic advice. 2nd chemo last Friday and my head is killing me. Tons of 2inch hair falling out. Following your plan and shaving down today. My halo wig is already here with my own very long hair.. Took care of that weeks ago. New ball caps 2. Thanks so much and god bless.

Mar 21, 2021

Thank you for posting this. I’ve had long, waist-length hair all my life. My hair started falling out 2 weeks to the day of my first chemo infusion (as you mentioned) so I had already made the decision to chop it all off. If I hadn’t read this on that day, I would have asked my husband to shave my head way too short.
As terrified as I was, I would wash my 2-inch hair in the sink. I lined the sink with some paper towels to catch the falling hair so I could just pick it up afterwards and put it in the trash to prevent clogging the drain. I still have a few stragglers and it’s hard to look at myself in the mirror, but my scalp does feel much better especially when laying in bed (I sleep with a cap on to catch any additional falling hair).
Nobody tells you what to expect or what to do, but losing your hair is an emotionally draining process so thank you so much for all the details.

Mar 21, 2021

Thank you so much for this very informative and helpful video! I start chemo on Thursday and will definitely be cutting my hair as you describe! Thanks!!

Mar 21, 2021

Very useful and timing couldn’t be more perfect. Loosing hair now and going to get it cut down to 2 inches and take it from there for the #2. Best wishes to all!

Donna Wilkinson
Mar 21, 2021

I was wondering if your advice would also apply to men. I’m at day 12 after my first treatment and everything you have said is exactly what is happening to me. So I was just wondering. Thank you

Mar 21, 2021

Thank you for this information.
I took you advice and when my hair started falling out I had it shaved short and was easier to handle the rest of the hair loss process! The hair loss process was very hard but you hats and scarf are my go to!
Th am you for your post they are so helpful at this hard time for some of us!

Ann Welsh
Mar 21, 2021

My hair has started to fall out, but I just cut it myself. I have not gone to the salon because of the coronavirus, I was going to let it fall out on its own. I had a coronavirus test and did not get the results yet. It is not in the shower or pillow case. Will it hurt if I let it fall out on its own.

Frances Casciotti
Mar 21, 2021

My hair is about 12 inches, tender scalp, I’m sorta in denial about loosing my hair. It’s in the food and coming out in the comb. Second round second week of chemo. Should I go straight to #2 blade?😭

Mar 21, 2021

Thank you for this excellent post. I’m just about 2 weeks in from my 1st treatment and found this post very helpful. I’m heading to my hairdresser in 2 days and wanted to be prepared in case she asked what wanted to do.


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