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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 30, 2020

THANK YOU for this information!
I have been asking the medical staff (nurses, doctors, etc) and all I’ve gotten is “everyone is different” regarding the timing. Now I know more of what to expect. I have been diagnosed with breast cancer and begin chemo next week so I want to be prepared. I have long, thick curly hair so it’s going to be hard but I know it will grow back and I want to look good in-between.
Thanks again,
Betsy

Betsy Immer
Jan 30, 2020

Hello!

Sadly my hairdresser did not know the above and shaved my hair down to a stubble. It is about a millimeter long now and feels like painful splinters on my head. I have numerous extremely painful ingrown hairs.

Do you have any advice for extracting the remaining hair on my head (stubble) or any other way of preventing/treating the ingrown ones? I am in so much pain!! I wish I could get them all out by the root but I don’t know how. Should I try shaving with a safety razor?

I would be so grateful for your help.
Thank you,
Rebecca

Rebecca Waggoner
Jan 30, 2020

I just came across your website this morning, looking for chemo hats & scarves that are big enough for my larger head, ( although I think it’s average! :) )
I ordered some and I’m optimistic and assume they will fit. Thank You for the hair loss information. I needed this and read it at the right time, as I went to my neighbors this morning and had mine cut a little shorter. Thank You for the very helpful information!

Jane
Jan 30, 2020

Been using the lint roller to get loose hairs out of my caps. Today I used it all over my head. Worked like a charm with no pulling or sticking. Don’t have to worry about one of those little hairs getting in my mouth!!!
Blessings.

Elizabeth
Jan 30, 2020

Nikki,
Thank you so much for this info. I start chemo in a couple of days and I am a sensitive person, so, this info is critical for me.
My question is, you say to wash your bald head everyday. I don’t wash my hair that often now. Maybe, every 3 days.
Should I still wash it everyday?
Thank you so much!
I really appreciate you!

Jill

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