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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.

Feb 07, 2023

Hair loss is hard first day of second round of chemo and I have very thin long hair left. Your article really helped me I’m going to go and get the razor and get the clip that has the number two. I just wish people understood how emotional it is

Chris Urarro
Feb 07, 2023

I started on Citsplatin 1st and was taking this chemo for 3 months with no hair loss. Then I started on Taxol & Carboplatin and my long hair fell out and had side effects with this new chemo. I lost my hair after the 1st treatment. Next week I am on my 3rd and last treatment, I hope! I wish you all well on your journey!

Sylvia
Feb 07, 2023

Thank you very helpful information ♥️

Sandra
Feb 07, 2023

I had hairdresser clip hair 2 inch blade 16 days after 1 at chemo. I just completed 4th session, not all hair has fallen out, should I shave it all off?

Cheryl
Feb 07, 2023

Thankyou for your helpful detailed information. I’m 2 week post chemo. Hair started to fall out yesterday.
Shaved head yesterday eve. Felt confident with your advise.

Christine Waters
Feb 07, 2023

Thankyou for your helpful detailed information. I’m 2 week post chemo. Hair started to fall out yesterday.
Shaved head yesterday eve. Felt confident with your advise.

Christine Waters
Feb 07, 2023

So, I made the mistake of clipping my hair super short and now I have bumps all over the back of my head. Do you have any advice on what to do?

Cathy
Feb 07, 2023

Thank you very much for your wonderful advise. You answered every question I had in your one article. Perfect .

Sally
Feb 07, 2023

Question, I am in week nine of chemo and most of my hair has fallen out however I have strands throughout the entire scalp. My question is I have four more chemo treatments. Would it be better for regrowth to leave the rest or is it better for my scalp to just shave it and start fresh after done with chemo?

melissa
Feb 07, 2023

Your post is very informative, thank you.
I am about to have Chemo session 8 of 12 next week. My hair has thinned and fallen out in patches and I have bald spots. I was thinking of shaving my head just before my 12th session as I am concerned with the result of new hair growing back and having some existing, they will possibly be very different. I would love some feed back on this as I am very confused what to do.
Warmest wishes,
Robin

Robin

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