According to the American Cancer Society, hair starts to fall out within one to three weeks after starting chemotherapy and may become noticeable one to two months later. Some scalps become tender and extremely sensitive to the touch.
Some people cut their hair shorter before chemo to make the hair loss less stressful. But if you’ve already begun chemo, it might not be worthwhile. My sister paid for an Anne Hathaway pixie cut to attempt a transition. But within half a day, it already looked less red-carpet Hathaway and more “Les Miserables” Hathaway, and we had to shave it off.
When you’re ready to shave, use electric clippers, not razors, and never clip down to the scalp, Hana says. Leave an inch in length, especially if you have stiff or coarse hair like Asians do. “If you clip it to the scalp, the rigid hair will push back inside and make your sensitive scalp even more tender when you sleep on it or touch it,” says Hana. “Leaving a little bit of length will let it fall flat into a forgiving cap.” You might find itchy hairs all over your pillow and clothes during hair loss. Wearing a mesh cap can help catch the strands.
If your goal is to match your wig to your real hair color, keep a lock of it to show your wig stylist. Visit a stylist before you lose all of your hair, if you can. Or at least take photos of your hairstyle as a reference. “If being able to look just like yourself is important, I would like to meet you while you still have hair to best understand where your hairline is and how dense your hair is,” Watts says.
For the most seamless transition, select your wig before starting chemo and then wait until your hair is just starting to thin to start wearing it.
You might want to wear it even as your hair begins to grow back. According to this 2019 study, most people experience hair regrowth around three months after completing their cancer treatment and stop wearing wigs one year after chemotherapy. But some people continue to wear wigs until their hair grows out longer or because their hair regrowth is initially different than their pre-chemo hair. Hana says her hair grew back looking like a blue S.O.S. steel wool pad.
During chemotherapy, it’s important to take care of your scalp, which will dry out because your skin stops producing body oils. “Support the health of your hair follicles so that the day that you stop all your treatment, your hair can start to grow back prolifically without any deterrence,” says Hana. Dry skin, she explains, is a deterrent because those layers of dead skin cells block the openings and make it hard for new hair to break through the surface. Exfoliate your scalp often using a soft brush or exfoliating gloves in the shower. A cleanser with salicylic acid or leave-in treatment, such as Aveda’s Scalp Remedy also helps slough off dry skin, says Hana. And finally, keep it moisturized with a gentle conditioner. Some people use castor oil to promote healthy hair regrowth, too.