AS YOU BEGIN CHEMOTHERAPY
Not all chemotherapy drugs cause hair loss, but the ones that do are fairly
predictable. If your doctor has told you to expect hair loss, this is what usually
happens:
One and a half weeks after your first treatment, your scalp may become tender.
Some people don't feel this at all, and for others their scalp is quite sore. This is
normal and goes away after the hair loss is complete.
With most chemotherapy drugs, hair loss begins about two weeks to the day after
your first treatment, and takes 3-7 days. Occasionally, hair loss doesn't begin until
three weeks, but be prepared for two, just to be on the safe side.
I promise you, you will not lose your hair before two weeks, and you will not wake
up one morning bald without warning. You can generally wear your hair normally for
the first few days, but by the third or fourth day, you'll be ready to brush out what's
left and cut it short, if you haven't already.
Whether or not to cut your hair before you begin treatment is a matter of personal
preference. For some women, having their hair cut into a shorter style helps them
get used to it, and it's less traumatic when the hair begins to fall. For others,
particularly if they love their hair, cutting it any sooner than they have to is more
traumatic. Either way, you'll definitely want to have it cut short once hair loss
begins. 100 hairs that are two inches long are much easier to deal with than 100
hairs that are 6 or 10 inches long.
Something to consider, particularly if you have long hair, is to go wig shopping
before you begin chemotherapy. Pick out a shorter style that you are comfortable
with and have your hair cut like the wig. When friends, co-workers and the cashier at
the grocery store see you, they'll notice your new hair cut. Later, when you
transition into wearing the wig, they won't notice the change and make a big deal
about it. This approach has been very helpful for many of my clients.
If you have long hair, and wish to donate it, Contact Locks of Love for more
information. www.locksoflove.org
Though some women shave their head when hair loss begins, keep in mind that all of
your hair doesn't come out on the first treatment. You'll lose 90-95% of your hair,
and if you shave it down to the scalp, what's left will feel rough and whiskery.
Instead, have it cut down to an inch or so. If you do use a clipper, use one of the
attachments (most patients prefer #2) so that your hair and scalp will still feel soft
to the touch.
Continue to wash your scalp with a mild shampoo (not bar soap) every day, even
after you've lost your hair. Your oil glands will put out the same amount of oil
whether you have hair or not, and this will keep your wig, hats and scarves cleaner.
MAKEUP
Lashes usually go rather quickly, but brows tend to hang in there longer. I found that
I wore my eye makeup exactly the same way, sans mascara. False eyelashes do not
work well because you don't have a base to set them on. Soft black or brown
eyeliner pencil makes the best substitute for lashes.
If you have thick, deeply rooted eyebrows, you may get by without having to do
anything, so don't rush out and buy eyebrow cosmetics until you see if you're going
to need them. If you are skilled with an eyebrow pencil, you can use it to fill in your
eyebrows by sharpening the tip and using tiny flicks to draw individual eyebrow
hairs. However, an easier solution is to use an eyebrow brush--a short, stiff angled
brush, and an eyebrow cake, similar to an eye shadow cake, to create a soft arch
along your natural brow line. Under no circumstances may you draw a solid line over
each eye!
Even if you don't wear eye makeup or eyeliner now, you may want to wear a small
amount during treatment. I prefer eyeliner pencil, rather than liquid. If you need
help, visit your local Aveda salon or the cosmetics counter at any major department
store. The American Cancer Society has a program called, Look Good Feel Better,
that offers free classes for women undergoing chemotherapy. Call 1-800-395-LOOK
or your local American Cancer Society for a time and location near you.
THE STRAIGHT SCOOP ON WIGS
The most exciting advancement in wig design is the monofilament top. It's a
transparent mesh top with individually tied hairs, so that wherever the hair parts,
you actually see your own scalp. This allows the designer to use less hair, because
they are not trying to cover up the wefting. Monofilament wigs are lighter, more
comfortable, cooler, and stay in place better than conventional wigs. They range in
price from $220-$320 compared to $120-$150 for a high-quality, conventional
synthetic wig.
Most women who continue to work during their treatment prefer to wear a wig, and
wear one every day. The only reason to have more than one wig is if you want a
different style or color, or if you want the reassurance of having a spare. If a
monofilament wig is within your budget, they are definitely worth the extra money.
If not, one regular, high-quality synthetic wig will be just fine.
Synthetic wigs have come a long way in terms of improved texture, color, style
and most importantly, the amount of hair they have. They wash up easily, just like
washing a sweater, and styling requires just a quick fluff with your fingers. They are
very light weight and most styles come in highlighted colors, just like today's foilweave techniques.
The drawbacks are heat and friction. You very likely would not be wearing your wig
while cooking, but if you do and you open the oven door and look in, the blast of
heat is enough to singe the front of your wig. Ditto with fireplaces, woodstoves,
barbeques and dishwashers. No curling irons, blow dryers or hot rollers.
A short wig is going to look more natural than a long wig, and be easier to care for.
If you do want a longer wig, I recommend that you get one that clears your
shoulders. Long wigs are okay for occasional wear, but if you wear a long wig all day
every day, the friction from your shoulders and collar will tangle and in a few months
the ends will frizz. There's no getting around it, even with the best brands. If you do
get a longer wig, be sure to spray the ends with wig conditioner and use a pick to
remove the tangles after every wearing.
Only use products made for synthetic hair--it does make a difference. Regular
hairspray and mousse are not compatible with synthetic fibers and will gum up the
hair.
The pluses for synthetic wigs are: they are less expensive than human hair,
lightweight, easy to care for, they come in a large variety of styles and colors, and
they look great. The life expectancy for a synthetic wig, worn all day, every day and
cared for properly is 9-12 months.
The general guidelines for washing are every 7-10 wearings. Obviously, if you live in
a warm climate or perspire a lot you may need to wash it more frequently. You can
tell when it needs to be washed because it loses it "oomph". It picks up dust from
the air, just like your own hair, and will lose its shine and body. If you use good
products, COLD water, and conditioner, they wash up beautifully. If you wear your
wig all day every day, wash it once a week.
Human hair wigs are slightly heavier than synthetic wigs because human hair
weighs more than synthetic fiber. They feel great to the touch and lay more
naturally, especially longer styles, because of the weight of the hair. They can be
styled a variety of ways with rollers, blow dryers and curling irons. However, unless
you like the wash-and-wear look, you have to do some styling. They can be colored
or permed, though use extreme caution and have it done professionally by a stylist
who is experienced with human hair wigs. Human hair wigs with a monofilament top
run $450-700 and up. The life expectancy for a good human hair wig is about 5
years.
The wig bottom line:
Never has the adage "you get what you pay for" been truer than it is with wigs. You
may wonder why you should go to a salon and pay $125 for a wig when you can
order one out of a catalog for $40-50?
Well, there is a huge difference in the quality of the fiber, workmanship and style. A
$50 wig will be dense and thick and dull. Even if you try to thin it out, it'll still be
thick at the scalp and the fibers will not have a natural feel, color or shine. If you
look really close at the pictures in the catalog, you can see how thick and unnatural
they look.
Every woman wants to look and feel beautiful, and it's especially important when
you're experiencing hair loss. If you buy a cheap wig that you hate, you're not going
to wear it or feel good about it and it'll just be a waste of money. If you can afford a
nice wig, please treat yourself. If you do find that an inexpensive wig from a catalog
is your only choice, take the catalog to your hairdresser and ask her advice. Also,
most oncology offices and hospitals have free wigs that have been donated either by
wig companies (new) or patients who no longer need them. Some of them are pretty
scary looking but you may get lucky. If it’s a used wig, be sure to wash it before
wearing.
Raquel Welch wigs are the very best wigs available today. Whenever possible, you
should go to a salon that specializes in wigs. It's nice to try on several, to touch
them and actually see the color up close, to have a professional guide you in what
style and color are best for you, and trim it up for you.
You can buy high-quality wigs, such as Raquel Welch, on the Internet, but read the
return policy very carefully. For some sites, if you so much as comb through the wig
it is not returnable, and how are you going to know what it looks like if you can't
comb through it?
Wigs on the Internet run about $20-30 less than in a salon, but by the time you pay
for shipping and pay a stylist to trim the wig for you, you haven't really saved
anything.
In my opinion, the only reason you should buy a wig on the Internet is if you live in
an area with no wig salon available, not to save money. I realize a lot of women fall
into this category, in which case I recommend that you take advantage of the free
phone consultation offered by most online wig companies.
HATS, SCARVES AND TURBANS
Even if you wear a wig for work or when you go out, you'll want something soft and
easy around the house. Turbans, berets, soft hats and scarves are perfect--kind of
like jammies or sweats for your head.
Some women wear the same pair of sweats every night at home, others like to dress
up a little, even when relaxing, and like to wear a variety of things. The same holds
true for head wear. Some women will have 1 or 2 basic turbans and some will have
dozens of hats and scarves.
My goal is to offer head coverings that "disappear" on your head--hats and scarves
that look great and are so comfortable you'll forget you're wearing anything. Here
are my top recommendations:
Hats
Small brimmed hats are great for around the house. Total comfort and great style
are important. Our office has hats in the chemo room. You are welcome to take a hat
for free. The hats have been made and donated by ladies in Albuquerque.
Chemotherapy drugs used to treat breast and other cancers makes your skin very
sun sensitive. It is recommended that you use a 30+ sun block when outside. You
might also want to consider a sun hat for added protection.
Scarves
I love scarves and find them to be a nice alternative to hats and turbans. They're
colorful, light, easy and elegant. Tying scarves is easier than you might think. With a
large square scarf, simply fold it into a triangle, then back again and tie at the nape.
Avoid silk or polyester scarves, as they will slip right off a bald head. Just pop it on
and enjoy.
A long narrow scarf works great for tying around a turban or hat to add color or
completely change the look. (Silk or polyester is fine) You probably already have
several that will work. Just sit down in front of a mirror and experiment.
Turbans
Turbans are a great alternative for casual comfort. Even if your wig is very
comfortable, the first thing you’ll want to do when you get home is take it off, rub
your head and put on something comfy. They can be worn alone or dressed up with
scarves and hatbands. If turbans are not your style, try a beret in either angora or
cotton knit. They're nice and roomy, with no seams or elastic, and come in lots of
colors. They make great sleep hats-angora for winter and cotton for summer.
Sleep Caps
You'll want a sleep cap, even in the summer. It's true that you lose 80% of your
body heat out the top of your head. The sleep cap made of fine combed cotton—is
perfect for the summertime. For winter, the Furry Fleece sleep cap or Angora Beret
are your best bets. I think a good basic headwear wardrobe would include 2-3
scarves, a couple turbans, 1 or 2 sleep caps and 2-3 hats. As your treatment
progresses, you'll discover what looks and feels best to you and you can expand your
headwear wardrobe accordingly. The nice thing about our headwear in the chemo
clinic is, most items are not "made for cancer patients." They are fashionable hats
and scarves that you'll wear long after your treatment is over.
NEW HAIR!
Your hair will start growing back right away, but it's about three and a half months
before you have enough hair to really cover your head. It usually comes back the
same color, but you'll be so happy to have hair again, you won't care if it's green
with pink stripes. And it usually comes back curly-at least for a while. Sometimes
women keep their curl for a year or so, but most often, once that first inch is cut off,
it's back to normal.
At first, it's just like baby hair-thin, wispy, maybe even blonde or transparent at the
tips. When you can comb your hair and hold it between your fingers, it's a great time
to get it trimmed. That may sound strange, since you'll be loath to part with even a
quarter inch of it, but trimming off those wispy ends will make it look like you have
short hair on purpose, rather than post-chemo hair. It'll give your hair more body
and style and you'll be well on your way to growing it back. For some reason, your
bangs may grow slower than the rest, and it may be several haircuts before they
reach your eyebrows, but hey-you've got hair!
Amy Gundelach RN, BSN, OCN
Women’s Cancer and Surgical Care, PC
Luis A. Padilla Paz, M.D.
500 Walter NE, Suite 508
Albuquerque, NM 87102
505-559-4495
Fax 505-842-8025
Chemotherapy and Hair loss