Imagine looking in the mirror and not recognizing the person staring back at you. Many people who go through cancer treatment worry about looking and feeling good about themselves since chemotherapy can have unwelcomed side effects like hair loss, or alopecia.

Alopecia is a result of chemotherapy drugs attacking fast-growing cells. Because hair follicles grow rapidly, systemic chemo drugs that combat the disease often attack hair cells at the same time. 

While hair loss is a side effect of some cancer treatments, it doesn’t happen to everyone. Even when two people are taking the same drug, each person may experience different side effects. Your oncologist can answer questions about which side effects are more common with your treatment.

If hair loss is going to happen, it most often starts within two weeks of treatment and gets worse 1-2 months after starting therapy. Most often, hair comes off in clumps during shampoo or brushing. Other times, clumps of hair may come off while you are sleeping and can be found on your pillow in the morning. Hair often starts to grow back before treatment ends.

Losing your hair during cancer treatment is a common, but often traumatic, side effect of cancer treatment. For people with cancer, it’s not just hair they are losing, but part of their identity and confidence.

There are ways to manage hair loss before, during and after cancer treatment so you can cope during treatment:

• Treat your hair gently. Use a hairbrush with soft bristles or a wide-tooth comb. Avoid using hair dryers, irons or products such as gels or clips that may hurt your scalp. Wash your hair less often, with a mild shampoo and pat it dry with a soft towel. 
  
  
• Take matters into your own hands. Some people choose to cut their hair short to make it easier to deal with when it starts to fall out. Others choose to shave their head. If you shave your head, use an electric shaver so you won’t cut yourself. If you plan to buy a wig, get one while you still have hair so you can match it to your hair color. If you find wigs to be itchy and hot, try wearing a scarf, turban, hat or other headpiece.
  
  
• Protect and care for your scalp. If your scalp itches or feels tender, non-scented lotions and conditioners can help it feel better. Always put sunscreen on your face, neck, ears and head, even if you are wearing a wig or hat. Wear a soft turban or close-fitting hat while you sleep to keep body heat from escaping. Choose a comfortable scarf or hat that you enjoy and that keeps your head covered. Consider wearing a padded hat/wig liner if you have sensitive skin, or to help prevent your wig or hat from rubbing too much on your bare skin.
  
  
• Talk about your feelings. Many people feel angry, depressed or embarrassed about hair loss. It can help to share these feelings with someone who understands. Some people find it helpful to talk with other people who have lost their hair during cancer treatment. Talking openly and honestly with your children and other family members can also help you all. Tell them that you expect to lose your hair during treatment so everyone feels prepared.

It may take a while to adjust to not having hair. Also, lost hair is one of the most visible signs of cancer treatment so others around you may notice. To ease your fears before going out, consider:

• Asking a close friend or family member to go out with you if you feel self-conscious the first few times.
  
  
• Thinking ahead about how much you want to tell people. If someone asks a question that you do not want to answer, cut the conversation short. You might say, “This is a hard subject for me to talk about.”

How do you keep your spirits up? Tell us in the below comments. Learn makeup techniques, get skin and nail care advice, and learn about hair loss options, such as wigs, hats, scarves and other accessories, at the American Cancer Society’s Look Good Feel Better workshop.

Get more information or find a cancer-related support group.

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