Alopecia is the loss of all or some of your hair resulting from chemotherapy. Hair loss happens in when chemotherapy attacks rapidly dividing cells including those in your hair follicles. This hair loss takes place all over the body, not just the head and is experienced as a thinning of the hair or total hair loss. Feelings of anxiety and grief can be associated with this treatment side effect and can have an impact on how people feel about themselves as they go through cancer treatment.
Some patients find that their feelings around hair loss and cancer treatment are difficult to talk about. One reason for the difficulty is that people feel self-conscious about being perceived as vain. Patients can also feel invalidated by those around them who focus more on the temporary nature of the hair loss rather than making room for the feelings of loss. This loss is also minimized by the perception that compared to cancer it “shouldn’t matter”.
As a psychologist, I can say with confidence that this loss does matter and is one that many share as we talk about the challenges they are facing as a part of their treatment. Most people share that being bald is a physical reminder that they are ill and it can make patients feel less like a person they recognize when they look in the mirror. There is no right or wrong way to feel about hair loss.
Here are some things I ask patients to consider as they address challenges with alopecia during their cancer treatment:
1. Questions to ask: Not all chemotherapy causes hair loss so it can be helpful to ask your treatment team if hair loss is associated with your type or chemotherapy.For those undergoing radiation, it can also be helpful to ask about hair loss in the radiated area.
2. How hair loss is experienced: Hair loss usually begins about 2 – 4 weeks after the initiation of treatment. People will begin to notice hair on their pillow, in their underwear or in their hands as they wash their hair. Some people find that their heads are sensitive or tender as the hair begins to fall out.
Your hair will usually begin to regrow several weeks after the completion of chemotherapy. Your new hair may be a different color or texture than you had prior to treatment. For many, the hair begins to grow back and appears white or gray, which may change as the cells that control hair pigmentation begin to regenerate. Your hair may continue to change as it grows in.
3. Hair loss prevention: Studies suggest that cold-capping (the use of ice packs or cooling devices on the head during chemotherapy treatment) is an effective strategy for preventing or minimizing hair loss. Here is a link to information from the Mayo Clinic on how the cold cap works: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-cold-cap-therapy-can-reduce-hair-loss-caused-by-chemotherapy/\
If you decide to try the cold cap then you may need to set that up either through your cancer center or through an outside company. Most facilities have companies that they work with so ask your medical team for information.
4. Getting Prepared: You can take steps to get ready for treatment and hair loss. Either before beginning treatment or after you have had your first round of chemotherapy, I suggest that you go to a wig shop and/or get some scarves or hats. Your hospital may have a shop or office available that helps you to get fitted for wigs, hats and scarves. The American Cancer Society also has a program (Tender Loving Care) to help patients with these supplies as well. See information below for some resources in the Los Angeles area.
Consider cutting your hair. For many patients, the actual process of seeing their hair fall out is difficult. Many patients find it helpful to get their hair cut shorter before it begins to fall out and then to shave their heads to short buzz cut as the hair begins to fall out. Although it can be sad or scary to think about taking these steps, people most often report a sense of relief once they have begun to take steps toward taking control over this aspect of treatment.
5. Take care of yourself: It can help to find other ways to focus on feeling good about yourself. Trying new clothing styles, finding fun hats, wigs or scarves or wearing a different type of jewelry such a statement pieces can all be ways to help you adapt to your new look.
Here are some organization that can help you take some time for yourself:
Beauty Bus Foundation is an organization that provides salon treatments to patients and their caregivers. Services are free and are a great way to relax and get pampered.
The Look Good Feel Good Program from the American Cancer Society can also help you feel good about yourself by teaching you some make up tricks that can help during treatment,
6. Consider your self-talk: As mentioned earlier, patients sometimes begin to tell themselves that they are vain if they are worried about their hair loss. The truth is that in many cultures our hair become a symbol that we closely associate with who we are. When you see yourself without hair it can be a reminder that you are sick. If you find that you are using a lot of negative self-talk when thinking about your appearance or your reaction to your hair loss try to stop and take a moment to offer yourself some understanding. Think about what you might say to your best friend or a close family member and offer the same soothing remarks to yourself.
7. Get some help: If you continue to struggle with negative thoughts or feelings of grief or anxiety that begin to impact your functioning then you may benefit from the help of a mental health professional who can support you. Check with your cancer center or local support center for resources near you.
Los Angeles Resources:
Personal Appearance Center
Roy and Patricia Disney Cancer Center
Providence Saint Joseph Medical Center
501 S. Buena Vista Street
Burbank, CA 91505
Positive Image Center (open to the community)
City of Hope
1500 E. Duarte Rd.
Duarte, CA 91010
Reflections Boutique (open to the community)
UCLA Medical Center
200 UCLA Medical Plaza, Suite 163
Hours of Operation: M-F 8AM-3PM
Image Enhancement Center (open to the community)
USC Norris Comprehensive Cancer Center
1441 E. Lake Ave., Suite 1362
Los Angeles, CA 90033
Woodland Hills Location
22700 Ventura Blvd.
Woodland Hills, CA 91364
Thousand Oaks Location
2412 Thousand Oaks Blvd.
Thousand Oaks, CA 91361
American Cancer Society
Tender Loving Care (Hats, Scarves, Wigs, Bras)
Look Good Feel Better (make-up)
Beauty Bus Foundation (in-home services available)
2716 Ocean Park Blvd., Suite 1062
Santa Monica, CA 90405