Hair Loss May Become Rare....In the Meantime, Here are Tips to Cope

by Jane Ashley

Hair loss is one of the most common side effects of chemotherapy, stem cell transplant and targeted therapy or locally from radiation therapy. Looking back at my first oncology appointment, I remember my husband asking her, “Is my wife going to lose her hair?” He was asking because he knew losing my hair would probably be distressing to me. 

Bald Is Beautiful   Shave Your Head For Chemo

Hair Loss from Chemotherapy May Become a Rare Side Effect for Certain Cancer Patients

The Food and Drug Administration recently approved the use of the Paxman Scalp Cooling System, which reduces the likelihood of hair loss caused by chemotherapy, for use in patients with solid tumors. This system was approved for use in breast cancer patients in April 2017.
Solid tumor cancers include bladder, breast, colorectal, lung, ovarian and prostate.

The system, known as a cooling cap, is an apparatus that fits on the patient’s head and cools the head to narrow the blood vessels in the scalp reducing the amount of chemotherapy drug reaching the hair follicles. Most patients tolerate the cold treatment but do report discomfort especially for the first 20 minutes or so. The device remains on the patients head during the infusion. Over 200 systems are in use in the United States and 65 more systems are on order.

The bad news is that service is not currently approved for insurance reimbursement. The U.K.-based company is exploring ways to get this service approved. But patients who are able to financially able to pay the estimated $1,500-$3,000, depending on the number of chemo cycles needed, have been willing to pay to prevent losing their hair.

There is financial help available through Help is determined by income, and the income limits are 300 percent of the Federal Poverty Level. Ask your chemotherapy center if scalp cooling is available. 

Why does chemotherapy cause hair loss?

Because chemotherapy targets fast-growing cancer cells, it also affects other fast-growing cells in our bodies, including our hair follicles and our blood cells. That’s why it’s so common to see patients lose hair and experience low blood counts. 

Not all patients experience complete hair loss. Some patients experience thinning hair or hair that falls out in clumps. Some patients lose their hair all over their bodies, including their arms, armpits, legs, facial hair and pubic hair. Other patients just lose the hair on their heads. Every patient is different.

ASCO (American Society of Clinical Oncology) lists the chemotherapy and targeted therapy most likely to cause hair loss. 

Why are we so distressed over losing our hair?

The cancer diagnosis shakes us to our very core. We are scared that we might die. We worry about how much treatment will cost. We are frightened by the surgery that we might have.

Bald Woman In Mirror

But losing our hair is distressing because it changes our self-image. Outsiders may consider hair loss just a superficial loss. Friends and family may not understand what a big deal losing our hair is. They may admonish us by saying, “You’re going to be fine.” “It’s only hair.” “At least, you’re going to make it.”

But hair loss is one of the most traumatic parts of a cancer diagnosis for many people. It is an outward sign that everything in their lives has been turned upside down. Hair loss usually begins 3-6 weeks after chemotherapy starts and is an outward announcement to the world that you have cancer.

Losing our hair makes us feel vulnerable. For some of us, it robs us of our identity – our hair color or hairstyle might have been our “signature.” When we look in the mirror every morning, we don’t recognize ourselves. And if we lose our eyelashes and eyebrows, we feel even more destroyed. Tears are a normal part of this grieving process.

Don’t let comments about vanity or “it’s only hair” derail you from working through your feelings. Coming to terms with our hair loss brings acceptance and peace of mind. 

Finding the way to moving forward

Eventually, we’ll make peace with our hair loss. 

In my case, I already wore my hair very short. It is fine textured, and I color it to help give it body. I stopped coloring my hair when I was diagnosed because I thought that was a prudent thing to do. Every week, my hair thinned some more until finally, I could see my scalp beneath the wisps of baby fine, mousy brown hair. I admit it, “I hated the way that I looked. I felt horrible and defeated.”

Jane During Treatment Wig

I was still working in outside sales, calling on existing clients and potential clients. Would they want to still work with me if I looked like I had cancer? I lived in my territory and only saw my boss once a month. Would he keep going to bat for me if I didn’t look like myself?

So I asked my oncologist to write me a prescription for a “cranial prosthesis.” And off I went shopping for a wig. I found one that I loved. I felt good about myself again. The wig was my coping mechanism.

Wigs Are Not for Everyone

But a wig is not a solution for everyone. There are lots of other ideas:

• Some people decide to “rock being bald.” Especially if it’s not cold, many people eventually find that it’s liberating to let their baldness show. (Remember to use sunscreen.)

• Some patients might embrace the look of a henna-tattooed crown on their naked head. The henna is temporary. Check out this link to see if a henna crown might be right for you.

Baseball caps with hair or a ponytail are a stylish solution. 

• Turbans, scarves, slouchy soft fabric hats or hand knitted caps. Express yourself – some are sparkly and some feature dramatic prints. 

• Women of color might want to express their heritage with an ethnic head wrap. Here’s how.

• Scarf beneath a hat. I did this several times and loved it. The scarf protects your tender head, and the hat provides style. Here’s how. 

Feeling good about yourself during cancer treatment helps you endure side effects more easily. When you’re comfortable within yourself, it shows through your smile. 

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Whatever path you take if you experience hair loss, choose what feels right for you. 

What tips do you have for others that are going through hair loss now? Please share in the comments below.

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5 Wacky Ways Your Hair Might Grow Back After Chemo

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