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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

Thank you. Just had first treatment and was wondering what to do about hair loss. So very helpful.

Judy
Mar 21, 2021

Thank you so much for this! You’ve described exactly what is happening to me. Pins and needles followed by it coming out beginning on Day 14. Now I know how to manage the hair loss and take care of my scalp. And I have some pretty scarves and hats to wear. I’m so glad I found your site.

Susan
Mar 21, 2021

I will be starting chemo on August 24, 2020. I’m so glad I ran across this article. I love your approach! Thank You for sharing.

Dawn
Mar 21, 2021

Thank you for the important information. I will be starting my chemo on August 13th and this will put me ahead of the situation. Be well

Betty

Betty
Mar 21, 2021

This is very helpful. I am a little confused by my hair that was shoulder length, do I cut that and then use #2 buzzer on head?

Nancy
Mar 21, 2021

I will be starting chemo next month, unless plans change, and this video makes so much sense. Thank you so much.

Elizabeth
Mar 21, 2021

Having a professional’s insight is very reassuring. I’m 19 days after my 1st treatment for Non-Hodgkins lymphoma. My next chemo is in 2 days. I’ve got slight tenderness, and in the past 2 days I’ve really noticed my very thick, hair is beginning to thin. I’ve been sleeping on a satin pillowcase, which is helping with the friction. They also make satin lined chemo caps for anyone interested. You can find both of these products on Amazon. Thank you so much for your information. I’m so glad I found this prior to making any decisions on “shaving” my head. Hopefully, this will prevent the sores, as you cautioned. Thanks again for everyone’s stories and hope, and your professionalism. May God bless us all.

P. Sells
Mar 21, 2021

Thank you for your great tips! I start my chemo today and wasn’s sure if I should shave it off completely in a couple of weeks. I am glad I read your post!

So which attachment number should I use to achieve a 2 inch long cut? I have a Conair hair clipper, but I don’t know if numbers are standard for all brands.

Thanks in advance for your reply!

Diana
Mar 21, 2021

I can’t thank you enough for this article. It was very informative. I was within literally 5 mins of shaving my head with no guard. This is not one of the topics brought up in chemo class and definitely should be. I’m talking to my oncologist at my next appt about adding it to the class. Again I can’t thank you enough!

Carrie
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

Sarah

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