For many women, hair is sacred, helps them connect to their culture and identities, and their sense of self. Because of this, one of the most common questions from women while going through chemotherapy or radiation is “But what happens to my hair?”. If you’ve found yourself asking that question you aren’t alone, nor is it something you should feel weird asking. And when it comes to dealing with hair loss after chemotherapy, many women will also ask “To wig or not to wig?”. Let’s talk about it.
Facing Chemo’s Most Visible Side Effect
First, it’s important to note that chemotherapy isn’t the only reason you may lose your hair. There are many other reasons for hair loss during cancer treatment, including radiation and hormonal therapy. So the tips and information we share can help you if you’re going through those treatments too.
Simply put, these treatments can cause hair loss due to their targeting of the rapidly dividing cells that are characteristic of cancerous cells. But, since the treatments can’t differentiate between cancerous cells and rapidly dividing cells that aren’t, they tend to affect hair follicles as well. This tends to disrupt the hair growth cycle and cause hair loss during treatment.
During treatment, many women report hair loss within the first two to four weeks after starting their therapy. This includes chemotherapy and radiation therapy. However, there are a few differences to note. Chemotherapy drugs and treatment can cause hair loss on all parts of the body, with the scalp (usually) being affected the most. Radiation therapy mainly causes hair loss where the treatment is targeted.
Luckily, these therapies don’t usually come with other symptoms during hair loss, like a painful or itchy scalp. However, they can make the hair itself grow back different. In fact, many women report that their hair got curlier during and after treatment!
How To Deal With Hair Loss After Chemotherapy
Now that you know what causes hair loss after chemotherapy, let’s talk about what you can do to manage it and how to care for your new hair (even after treatment).
Managing Hair Loss
First, outside of going bald, wearing a wig, or trying to preserve your hair as best as you can, it’s important to know how to manage the hair you have and its changes.
There are a few things you can try to help you manage your hair loss, including being gentle to your hair. Now is the time to think about stopping bleaching, coloring, and perming or any other hair processes. They can be harsh on both your scalp and new hair growth, which may be more delicate after treatment.
Also, try to avoid heavy heat styling with tools like flat irons, curling irons, or dryers. If you can, focus on air-drying as often as possible. This can help keep your hair stronger, which makes it more likely to stay on your scalp.
Lastly, a quick tip: if you have long hair, consider a hair cut. This can help you get used to shorter hair, plus shorter hair can be easier to manage and tends to look fuller. That way, if it does start falling out, it won’t be as shocking of a difference.
How To Care For Your Hair During Chemotherapy
On top of trying to manage hair loss, there are many things you can do to care for your hair during chemotherapy (or other therapies!). You should still be gentle on your hair and scalp, but you can also:
- Use a soft brush
- Wash your hair only as often as necessary, preferably no more than 2-3 times per week
- Use a gentle shampoo (like a shampoo made for babies/children)
- Protect your scalp from the sun and/or cold air. You can do this with sunscreen, a hat, or any number of head coverings
- Keep styling to a minimum, and use moisturizing and/or strengthening products to keep your hair as strong as possible
- Wear a bonnet to protect your hair and scalp while you sleep
No matter what you choose when it comes to managing your hair, it’s important to care for both your hair and scalp before, during, and even after treatment.
To Wig Or Not To Wig?
Before we talk about wigs, it’s important to note that while many women choose to wear wigs during and after treatment, there are others who prefer to go bald or try to preserve their own hair. No matter what you choose, it’s the right choice if you love it and feel comfortable with it. If that’s with a wig, great! If not, that’s okay too! There is no wrong answer when it comes to doing what’s best for your self-confidence while going through treatment.
If you choose to get a wig, it’s essential to remember that sometimes it’s covered under insurance and can save you some money. If you have private insurance, there are many ways to find out if your wig will be covered or not. And if you have Medicaid or Medicare, know that Medicare parts A and B do not cover wigs for people undergoing chemotherapy, but some part C plans may have some options. Medicaid does not offer coverage for wigs at this time.
If you do file with your insurance, it should be done as a “cranial hair prosthesis” prescription that (which includes a diagnosis code and a National Provider Identifier (NPI) code). Your doctor can sign off on the insurance claim, and this may help get your wig covered.
Even if your insurance doesn’t pay for the wig, you can save your receipt for a potential medical tax deduction.
There are so many options for wigs these days, including those made with synthetic or human hair, wigs for those with curly or coily hair, and even wigs of different styles, sizes, and colors. So if this is the route you choose, don’t be afraid to experiment with your style!
Trying To Preserve Your Own Hair With Scalp Cooling
If you’d rather not wear a wig and want to preserve your hair as best you can, you can try scalp cooling. This technology is newer, and has been shown to be promising when it comes to helping reduce hair loss.
Basically, scalp cooling is almost like hypothermia (but safe and for your scalp). You’ll put on a cap that cools the scalp before, during and after receiving chemotherapy. The cold temperature will narrow your blood vessels in your scalp and decrease blood flow. This way, less of the chemotherapy drug reaches your hair follicles, which can help them avoid damage. Each cold cap is form-fitting and lowers the temperature of your scalp to approximately 3°C/37.4°F.
While there are a few minor side effects of cold caps like headaches and discomfort, it has been shown to reduce hair loss, and some patients have noted that the benefits outweigh the slight discomfort.
Scalp coolings effects and benefits will depend on your treatment plan, so please talk with your team of doctors to decide if it’s a good fit for you. Also, it’s worth noting that while scalp cooling is growing in popularity, it’s not available at all treatment centers and it is not usually covered under health insurance.
Other Hair Options
If you don’t like the idea of wigs or scalp cooling, some women choose to go completely bald, or cut their hair over time until they’re ready to shave or are done with treatment. There are many other options you can try. This includes wearing scarves, hats, and other hair coverings. This nonprofit, Hope Scarves, offers scarves for a minimum donation. They send scarves across the globe and offer support to those living with cancer. You may also choose to wear a wig “part-time” and then go bald on other days, whatever feels right for you.
As a quick note, the one thing you shouldn’t try when going through treatment is to wear hair extensions. Unlike wigs, extensions are attached to your “real hair”. This can weaken your strands over time and cause them to be brittle and break off, causing damage.
Tips For Regrowth (If You Want)
Once you’ve completed treatment, you may decide that you’re ready to regrow your hair. If that’s what you’d like to do, there are many ways to start your hair growth journey after treatment.
First, Minoxidil (Rogaine) is a medicine used for hair loss. Many women after chemotherapy use it to effectively regrow their hair. Of course, this is optional. But it’s worth looking into if you’re okay with trying a new medicine. You’ll also want to avoid dyes and harsh chemicals at least until your new hair growth is sustainable (typically 12-18 months later).
If you’d rather go the “natural” route, that’s okay! You’ll want to follow the steps we listed above on hair care. You can stimulate hair growth by regularly massage your scalp, typically inverted (upside down). You can also use soothing oils like rosemary or almond, depending on your hair and scalp.
Eating a balanced diet full of essential vitamins and minerals can support your overall health—including your hair. These include vitamins A, C, D, E, biotin, iron, zinc, and omega-3 fatty acids. These are the building blocks to healthy hair, so you want to ensure you’re getting enough of them! You can also try PRP therapy or red laser therapy, which may aid in hair regrowth. And of course, don’t forget to protect your scalp, especially in the cold, sun, and while you’re sleeping.
A few things you should avoid are tight hairstyles, heat styling, chronic stress, and washing too frequently (or with super hot water). These habits can easily damage hair, especially right after chemotherapy.
Your Crown, Your Rules
Hair loss can be one of the most emotional parts of treatment, especially if you’ve always had a deep connection to your hair. Whatever choice helps you feel strong—whether that’s cutting your hair, wearing a wig, rocking a scarf, or going completely bare—is the right one. When you’re ready, you get to decide how you want to show up in the world. The only thing that matters is that it feels right for you.
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