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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.

Jan 28, 2024


Carolina Burkholder
Jan 28, 2024

Hello, I am receiving chemotherapy in small doses for 12 weeks. At week three, my hair started thinning. It is not falling out in clumps just thinning every day.

Any recommendations for a haircut that does not involve shaving my head.

Before chemo my hair was 1 inch below my chin length in a bob. I had it trimmed to chin length.

Your help would be appreciated.

Mary Lou Boyer
Jan 28, 2024

Thank you so much for making this video. I went through all the steps and my hubby helped me gently shave my hair this morning. It is a gem of a find and made the whole process so much easier. Thank you again.
Best wishes,

Jan 28, 2024

I had a delay in between chemo treatments. I now have new hair growth coming through … have restarted chemo, should I expect to lose my new growth?

Jan 28, 2024

I had triple negative breaths and had si had 8 lymph nodes that there also with chemo. I have just finished my chemo and radiation and my hair is back in now and I am curious if and when I want to color it when is it safe to do do so and do the they make non permanently color dyed? I am talking about the non conventional colors.

Jan 28, 2024

I have to do chemotherapy for life now and I have lost most of my is it a good idea to shave my hair

Lorraine Haskell
Jan 28, 2024

Thank you so much for the advice. I got my hair cut into a short pixie. Tomorrow will be my 2 week mark since chemotherapy and I’m quite nervous. You have really helped me prepare. Thanks again!

Jan 28, 2024

About 3 weeks ago I did the number two in the lint rollers but never went completely bald now do I just leave it and my hair will grow back or do I shave it down to being bald not sure what I should do

Jan 28, 2024

Your advice helped me soo much, exactly when I needed it. Thank you

Jan 28, 2024

I just finished my third chemo. No signs of hair loss, but because of this excellent read, I know how to go about my transition. Thank you. I have radiation every week day and expect that will also have extra bearing on my situation

Donna Cole

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