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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 21, 2021

Yup, 2 weeks + 3 days equals = Sarah did you bath your doggo in the tub or take a shower yourself?

This blog is spot on, and I could not be more appreciative the advise. The itch and inflammation was driving me bonkers. It started a week after my first chemotherapy for breast cancer. So then the day after my 2nd chemo when I starting losing hair by the handful I went with a 1/2" buzz cut.

I had quite long hair, so I did two transition cuts prior to the buzz cut to help myself handle the baldness more easily. So far it’s worked. I’ve had moments of sadness, but spacing out the cuts, 2-4 days apart helped me tremendously from an emotional point of view.

Thank you again, and may we all be as comfortable as possible as we get treatment to beat the beast that is cancer.

Love, Sarah

Mar 21, 2021

Great information!!! Thank you very much. Can I do the same thing with scissors? I do not have anything else at hand and there is no hairdressers available at this time.

Thank you sooooo much

Mar 21, 2021

Thank you for sharing. My husband helped me cut my big beautiful curly Afro down to 2 inches of cuteness. I love it, although I know it will all be gone in a couple of weeks. Tomorrow is my first chemo treatment. My cool doc picked up my spirits by saying “Have fun with it ! You can have a different look everyday. " I am prepared with a curly wig and cute head coverings. May even go from bald to blonde. Now I know that I need a lint brush and an eyebrow pencil. Thanks again for sharing. I feel so much better.

Mar 21, 2021

Thank you for this excellent info. I was having difficulty deal with loss of my long hair but after reading your input I am feeling better about ii. I am trying to focus on the freedom of it. My daughter sent me several of your hats and scarves so I am focusing on my wardrobe not hair. Bless you!

Marilyn Baird
Mar 21, 2021

Thank you In the middle of chemo treatment & in lock down so can’t get to the hairdressers & not feeling confident about what to do Thanks again 😊

Debra Riches
Mar 21, 2021

Thank you for the very useful info. I cut my hair short as it began to fall out and currently have no plans to shave my head. I’m half way through my entire course of chemo & my hair is really patchy & thin (I wear scarves & hats to cover when I go out). Will every bit of what’s left fall out over the coming months making me bald?

Mar 21, 2021

Very useful information, very exact per the timeline… Im a breast cancer patient – started chemo in Jan. I remember in the beginning I could not put into words how losing my hair felt…. This is it!! I took my hair off in stages prior to chemo – from right below my back to 4 different lengths/short cuts… The emotional part of the feeling was the worst for me… My head hurt and the fallout when washing felt like cut grass rolling down my body in the shower.. After an emotional breakdown in the shower one Friday morning I said “today is the day“…. It all came off that night – the next day I went to the barber & got it cleaned up – Final touch was the straight blade… How amazing & invigorating I felt!! No razor stubble:) Now I have a standing spot every 2 wks. Good luck my BC Sisters & stay strong…. We are warriors! Enjoy your new G.I. Jane look – pair big earrings with it – you will look fabulous!

Mar 21, 2021

I’m late reading your article, darn it. I had very long hair, I cut it short after noticing it was falling out. This was about 3 weeks into chemo (3 kind of chemo at a time).
It started falling out rapidly and lots at a time. Today I had my daughter just shave it, short. I’m sure its shorter than you recommend. It’s been aggravating me all afternoon and is sore. I just went and shaved it closer, it feels better and I’m gonna try the lint brush. I’m not to worried about the tenderness, what worries me is will it all grow back. With it shaved so close, it’s still gonna grow back, right?? Please help.

Debora Farnsworth
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.


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