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.
Thank you so much for this post! Very useful.
I’m done with chemo and want to prepare for my hair to grow back. I cut it short and I have some hair left that has grown since I cut it short. Can I shave now to get a fresh start and more even growth?
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Thank you for this so much. The past few days have been so emotional. I been undecided whether or not to shave my head. My hair has been falling out for about 6 days now, I am on my 20th day since I started chemo. After reading this I decided to go for it to avoid the mess every time I showered and to relieve some tenderness from my scalp. I would have have not known to use the number 2 unless I read this, also the lint roller works wonders. I am so glad I was able to follow this step by step. After doing it I have so much relief. Waiting for me seemed to add more stress, now that is gone.
Thank you so much for this article. It is exactly where I am and I was at a total loss on what to do to take care of my hair. The #2 blade and lint roller were the kind of practical advice I needed and worked great.
Thank you!
Great help! Thank you! I’m a week ahead of Tammy post bilateral and started Chemo 3 weeks ago, and my short cut is looking very thin and patchy bald, so I’m ready to do this! I so appreciate you sharing!
Nicki,
Thank you for this wealth of information. I am a hairdresser with a client that has just started chemotherapy and is coming in tomorrow to cut her hair. Your kind and calm approach to such an emotional situation is most appreciated.
I am 2 weeks and two days past my first chemotherapy treatment for breast cancer. I just shaved my head yesterday after 3 days of brushing and fingering handfuls out. Several people encouraged me to “just do it” but I wasn’t ready. My hair was shoulder blade length. I finally, in tears, asked my super-supportive boyfriend to help me get it over with. WHAT A RELIEF! I felt instantly at ease that it was finally behind me. I am now ready to move forward with my bald and beautiful self! Thanks for the tips as I have wondered about the remainder of the fine short hairs as they fall out. Will definitely try to lint roller.
This post helped me a lot. My head was soo tender and I would Sleep with my chemo cap / beanie on my head because I did not want to have the little hairs after I shaved my hair on my pillow cases. Using a lint roller definitely helped relieve the pain and to be honest it was oddly satisfying to see how much hair I can take out using the lint roller. I am almost 3 weeks into my first chemo. Going into my second session this Friday. I can’t speak for everyone but for myself; I am ready to just have all the stubble off my head so it’s not poking me when it falls off and irritating my skin and even getting hair splinters. I can say keep positive your hair will grow back and who cares if people stare at you because you have no hair. To be honest everyone is going through something in life especially with this covid stutation. Cancer sucks but lets not give up hope that we can survive and thrive even from this pandemic.
For me thinking about my looming undetermined chemo date and just the mere thought of my hair falling out is more stressful than scheduling an appointment to have my hair shaved too soon. It will be less traumatic for me this way as l will be used to not having any hair. Rather than getting my head shaved a day or so before chemo starts.
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