Breast cancer as a young woman and mother.

Hair loss during chemotherapy.

Tips and what to expect.

Chemotherapy, our feared enemy but fiercest ally. Something that can save our lives, but in doing so strips us of so much that makes us “us”.  One of the most obvious ways it does this is by causing the recipient’s hair to fall out. It is a hard reality that many cancer patients have to face. As a 2 time survivor of triple negative breast cancer, I have now been through it twice. So, for those of you that are facing it I wanted to share my real experiences, what you can expect and my tips to help you through it.

Note: Not all chemotherapy drugs are made equal. Some are less potent than others and either won’t cause any hair loss at all, or just some thinning. Your oncologist and chemo nurses will let you know what to expect from the treatment you are having. 

Why does chemotherapy make you lose your hair?

Chemotherapy works by attacking all fast growing cells in the body. Cancer cells divide and grow faster than normal human cells, which is what causes them to be targeted by chemotherapy. Unfortunately the chemo also attacks other cells within the body that grow and change at a fast rate. This includes cells in the gastrointestinal tract, bone marrow, ovaries/sperm and hair follicles. As things stand there is no way to direct chemotherapy solely to the cancer cells. So, if you’re undergoing certain kinds of chemo, you can expect to lose your hair. 

Is there a way to prevent hair loss during chemotherapy?

In some cases, total hair loss can be prevented by using a “cold cap”. As the name suggests this is an ice cold hat that you wear during chemotherapy infusions. The idea is that it constricts the blood vessels in your scalp, essentially preventing the chemo from reaching your hair follicles. Unfortunately it is not a magic solution. It won’t prevent hair loss completely, can be painful and laborious and there are some chemotherapy drugs that it won’t work with at all. 

My oncologist told me that my treatments of AC and subsequently EC (aka the affectionately named “red devil”) are particularly potent, and cold capping would not be effective. So, my fate was sealed. But I’m not sure I would have opted for cold capping in any case. You already have enough on your plate during treatment without something else to deal with. 

When does the hair loss during chemotherapy begin?

This is slightly different for everyone, but generally you can expect your hair to start falling out 2-3 weeks after your first chemo infusion. It is a gradual process rather than sudden. You might start noticing more hair strands in your hairbrush, on your pillow or coming out in your hands. Your body hair, eyebrows and lashes will hold on for a few weeks longer as they grow more slowly than the hair on your head and so the chemo doesn’t target them immediately.

What does it feel like? 

Something you might experience when it begins is a slight pain or discomfort on your scalp. I liken it to that uncomfortable ache you get when you have had your hair tied up in a ponytail all day. Don’t worry, this will only last for a week or two and is never extreme. 

How to prepare. 

In some ways, there is nothing that can truly prepare you for the mental and emotional effects of losing your hair. But there are a few things you can do to help yourself feel better when the time comes. If you have long hair, the first thing to do is cut it a little shorter before your first infusion. This will lessen the shock and discomfort you feel, both physically and mentally, when it eventually starts falling out. 

Shop around for some hats, scarves and wigs ahead of time. You will soon figure out what you like best, but at first you will need to try a bit of everything to see what works for you. 

Personally, I am not a fan of wigs as I am intolerant to anything remotely uncomfortable during treatment. However I am not one of those amazing women that feel confident sporting a bald head in public. So instead I opt for light, comfortable headwear such as these slouchy hats and these pretty turban style hats. 

This time around I also purchased a beanie style hat with hair which I like to wear when I am out and about on colder days. They are a lot more comfortable than full head wigs and look very natural. 

I know that many women really enjoy their wigs, so I went ahead and asked some wig wearing breast cancer friends for tips and recommendations. These are their offerings;


  • Try and buy from an actual wig shop. They will be experienced in finding the right one for you and you can try it on before you buy. They will also advise you on how to best take care of it so that it lasts longer.
  • Beware of buying wigs online. There are some terrible quality ones made in China that are a waste of money.
  • Real human hair wigs are the best and most natural looking. They are expensive, but many women say they are well worth the investment. 
  • Go for a wig that is most similar to the color of your natural hair. This will be the color that best suits your complexion. 

Makeup and other accessories.

Another way to treat yourself is to buy some pretty new earrings and fresh make up. It can be difficult to feel good about yourself during chemo. Nothing brings your confidence down a few pegs than losing your hair, eyebrows and eyelashes. But with the right accessories and a little well placed makeup you can still look and feel great. And you deserve to. Take a look at these great makeup tips during treatment from the American cancer society. 

Some women have eyebrows tattooed on before treatment starts. This ensures that you will have immaculate eyebrows for the entire time. You need to make sure that you do it at least 2 weeks before chemo is due to begin to allow them to heal properly. It is quite expensive, so not for everyone. If you do decide to do it, be sure to find a tattoo artist with excellent reviews and experience doing eyebrows. 

When to shave your head.

This is completely down to personal preference. Some women shave their head even before treatment begins. Some wait until their hair starts falling out, and some hold off shaving until most of their hair has already gone. 

I felt most comfortable shaving it off when it started to fall out, which both times was about 15 days after my first infusion. My scalp was sore and seeing my hair in my hand in clumps was very detrimental emotionally. I found it empowering to take back the control by deciding myself when to shave it off. 

What is it like to have no hair? 

I won’t lie, it is pretty jarring at first, especially if you had long hair beforehand. For me the worst part is losing your eyebrows and lashes too as that is more obvious and less easy to hide.

 That said, there are some surprising and unexpected benefits! I don’t miss washing, drying or styling my hair. I don’t miss shaving my body hair. Showering takes 5 minutes and getting ready afterwards, even less. Obviously it’s not something I would choose to do at any other time, but I am happy to take the positives along with the negatives. 

How to take care of your bald head. 

Wash your head with something mild, moisturising and unfragranced. This rule applies to your whole body when you are having chemo, so I use the same thing on my head as I do everywhere else. I have two young children, so I just use the organic baby wash that I use on them as I know that it is gentle on sensitive skin. 

Do not use any hair growth stimulants or heavy lotions until after treatment. If your scalp gets dry, I recommend using organic raw coconut oil, such as this one. I also use coconut oil to moisturise my entire body and even face.

When will your hair start growing back? 

This varies from person to person depending on your age and hair type. Generally your hair will start to grow back once the chemotherapy is out of your system about 4-6 weeks after your final infusion. At first it will be what I call “duckling fuzz.” That is, soft, fine and possibly white. The first time I went through it someone recommended that shaving off the duckling fuzz would encourage more normal hair growth. It felt counter productive but I took her advice, and the hair that came through subsequently was indeed more like my normal thick dark hair. I will likely do the same again this time. 

Will your hair be the same as before? 

This is dependent on your age, menopausal status and general health. In some cases it can grow back more curly, or a different colour. The first time I lost my hair I was 35 years old, and it came back through as it was before. I am hoping for the same again this time, but as I am now 40 years old and this is the second time that I have lost it all, it may be different. Time will tell…

An important note.

Losing your hair sucks, there’s no way around it. For me though the hardest part is the reason for it happening, rather than the baldness itself. It’s the loss of control. It’s looking in the mirror and seeing a stranger looking back.

It is OK to grieve for it. To cry when it falls, whatever you need to do. But it is, hopefully, a temporary situation. It will grow back with the rest of you once treatment is over. It sounds trite but try and stay light hearted and have fun with it. 

And remember; you are not losing your hair because you are sick, you are losing it because you are getting well again.

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