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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

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
Jan 28, 2024

My last chemo is on May 30, 2023. I still have half of my hair left, can I not shave it off? Can I just keep cutting it short until it evens out? I appreciate it, thank you!

Berni Alger
Jan 28, 2024

I wish I had read this all first! My hair got clipped extra short and now I have A LOT of pimple type red bumps on my scalp. My head is bristly and I felt the short hair picking at my scalp every night. Have I made an even bigger problem for myself.? It hurts too. Chemo left me some hair. Thank you.

Jan 28, 2024

Thank you Nicki for your informative and very helpful advice. I will shampoo/conditon & comb hair and then go and get the hairdresser to clip my hair using a number 2 attatchment. Chemotherapy ENHERTU patient Innomar Clinic, Ontario, Canada.

Jan 28, 2024

Thank you for the excellent advice. My husband used #2 blade. We did not have a lint roller, but duct tape works great! All my little leftovers are almost gone and my skull no longer hurts from the weight. Thank you, thank you!

Sheri Webster
Jan 28, 2024

Wow!!!I wish I had seen this before I shaved my head!!! What can I do about whisky head?

Joanne Jimenez
Jan 28, 2024

Thanks so much for this wonderful article!! Oh I wish I would’ve seen this before I shaved my head shorter than #2!!

I’ve always had coarser hair—now I’m left with this stubborn coarse stubble —like wishers that are stuck in the hair follicle like you describe (it does pull out without any feeling)

My question—how can I get rid of the rest of this stubbly hair while I’m also currently getting all my new peach fuzzy hair in that’s about 1/2 inch long so far?

I’ve been moisturizing, massaging, and exfoliating..but none really works.

Thanks so much!!

Jan 28, 2024

Thank-you for the post. I now have the courage to use a shaver with a #2 attachment. I’m grateful for the information.

Jan 28, 2024

Thank you SOOOO much for article. I was wondering about pre-cutting before shaving my head. Leaned a lot from you. The timing for me to read your article. Seems meant to be is more like it. I hope many ladies who are wondering what to do find your wonderful article.

Pat Distasio
Feb 07, 2023

I just wanted to take a moment to tell you how grateful I am you made this post. My hair started falling out today and was driving me crazy. I made the decision to shave it and googled to find out the best way. I can’t believe how much came out with the wash and conditioner step.
Just waiting for my hair to dry and my 8yo will be doing the honours.
Thank you for your helpful post.


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