How to handle hair loss caused by chemotherapy?

Helpline Question of the Month

I had a breast tumor the size of a pimple. So why did my doctor treat it with chemicals that sickened my innards and stripped my outards of hair? It was like dropping an atom bomb on a flea. But the type of cancer I had was known to grow rapidly and take root in distant organs. So systemic chemotherapy was deployed because it attacks fast-growing cells throughout the body—including, alas, those in hair follicles. The treatment was sound. My baldness was just collateral damage.

Still, losing my hair was a great indignity. And many women who call the SHARE helpline feel the same way.

Marjorie Schwartz, a helpline volunteer and support-group facilitator, understands. "It was one of the bitterest pills to swallow," she remembers. And no wonder. Hair is critical to the self-image of many women, who devote time and money to caring for it. Furthermore, Marjorie says losing her hair "made my status as a cancer patient public for all to see." And looking at herself in the mirror, she was forced to face "that bald person looking back"—and the knowledge that she had "crossed a line toward sickness and, perhaps, mortality." When she talks with newly diagnosed women, she tries "never to forget just how devastating this felt."

Margo, another helpline volunteer, has a different view, calling hair loss "a minor nuisance to save your life." Eight years later, she barely remembers it. She urges callers to be as aggressive as they can be in fighting breast cancer. "If that means losing your hair, so be it."

Koryn, a volunteer telephone counselor, says losing her long hair was harder than losing her breast. But she used the loss to help others. When her hair began to fall out, she and her 17-year-old son shaved their heads—and she donated 15 inches of her hair to Wigs for Kids. For anyone tempted to follow suit, she has some advice: "During chemo, you're at greater risk of infection from the slightest nick. DO NOT use a hand razor to get the remaining stubble off your head. Gently massage your scalp each day in the shower with a soft scrubby to slough it off. Use a lint roller to remove any hair that's left so it doesn't land in your food." Six years and many trims later, her hair is thick and shoulder-length—long enough that she can look back and laugh. "Now if they could only figure out how to get a breast to regrow!" she says.

Kathleen, a helpline volunteer, was afraid her teenage daughter would be upset by seeing Kathleen's hair fall out. So she got her head shaved at Supercuts and kept her scalp covered with inexpensive wigs from the American Cancer Society catalog. Not only were the wigs cozy but they also gave her a chance to try a new look. "My hair is frizzy and curly," she says. "I got a beautiful straight wig in my normal brown color, and I loved it. My sister said, 'You finally got the hair you always wanted!' " Kathleen's advice: Be careful when you're cooking because the heat from opening the oven can frizzle your wig. She varied her look with a headscarf and hoop earrings.

Nancy Singleton, a support-group facilitator and telephone counselor, recommends makeup lessons from Look Good Feel Better, an American Cancer Society program that supplies free wigs and cosmetics. Women may find those lessons particularly helpful if chemo knocks out their brows and lashes. Call 800-ACS-2345 to find out when and where the next session will be held. One wig tip from Nancy: Consider synthetic. Real-hair wigs are expensive and require a lot of care.

Mike, who counsels caregivers, played an active role in his wife Celeste's cancer experience. Not only did he discover her breast tumor in the first place but he was by her side throughout her cancer journey. When her hair began to fall out in clumps, he orchestrated a "good-bye hair" event. "We're going to get rid of the stuff. It's dead matter anyway," he told her. "And that seemed to help." After buzzing themselves with electric clippers, Mike said, he and Celeste "looked like eggshells, and that was such a cool experience of bonding that I think it overwhelmed her, and the subject of hair never raised its head again."

One advantage of the SHARE helpline is that we volunteers are able to draw from our personal experience. Another advantage is that we talk to many women who've had cancer, and we can draw from their experience as well. From callers, I've learned about an alternative to hair loss: cold caps, tight-fitting hats filled with subzero gel. The icy temperature constricts blood vessels in the scalp, preventing the drugs from reaching hair follicles. Women I've spoken with say cold caps enabled them to retain up to 85% of their hair. Caveat: Cold caps can be uncomfortable and expensive, and many insurance plans do not cover them.

Got a hair-loss tip? Please share!