One of the major and most well known side effects of chemotherapy is hair loss. It’s important to note that not every type of chemo causes total hair loss, and even when it’s expected, individual responses vary.
You may wonder why hair loss is so common with chemotherapy. It’s pretty simple, really. These drugs target fast-growing cells, but cancer cells aren’t the only ones that grow quickly in our bodies. Hair follicles, especially, grow very fast, thereby attracting the attention of the chemo drugs.
The informational website breastcancer.org offers a handy summary of the typical hair loss responses from a few common chemotherapies used for breast cancer.
I have long hair. Thick hair. A lot of it. I’m one of those people who is often described by my hair. In fact, I’ve long argued that my long brown hair is the reason people often tell me I look “just like” their cousin/sister/aunt/best friend/brother’s ex-girlfriend, etc. People see a woman with long brown hair and glasses, and they see nothing else. I even gave this a name many years ago: “long brown haired woman syndrome.”
It is noteworthy, then, that I am going to lose this defining attribute as part of treatment, even if only for a little while. This is, of course, one of the most challenging outward aspects of chemotherapy for many people, especially women. It shouldn’t be too surprising that there is research underway to try to counteract this psychologically significant side effect. You may have heard of the cooling head caps that are said to minimize hair loss during chemo treatment, or perhaps the development of topical agents using nanoparticles that might reduce the accumulation of chemo drugs in hair follicles. That’s all well and good, but I won’t be using any of those things. I’m going whole hog, baby.
Don’t get me wrong: I know I’m going to freak out when I start losing my hair. I decided that it would be least traumatic for me to take some control of the situation by getting my hair cut short. I have this image of standing in the shower and sobbing as handfuls of hair come out of my head. This is the worst case scenario for me, and I want to avoid it. At least I can start by making sure that only small handfuls of hair come out. Plus, this allows me to try out a short haircut in a very low pressure way (I’ll probably only have it for a couple more weeks) and then donate the remainder.
This brings me to my Hair Loss Plan, or HLP.
HLP Step 1: take photo of self with long hair. Note length, texture, color and current status of brown to gray ratio. I think I’d give myself a B:G of 20:1 overall, with a 2:1 ratio over my forehead. I’m tracking that B:G ratio (sort of) for two reasons: wig makers don’t want hair with more than 5% grays (whew! Just made the cut), and I’m curious about how things will look when my hair grows back in a few months from now.
HLP Step 2: ask friend and awesome hairstylist to give me a short haircut. Pause while she squeals with glee. (No, not really. She was appropriately heartbroken, but you know how it goes with people who cut hair. Hairstylists gonna cut, just like surgeons.)
HLP Step 3: look at photos of short hairstyles to try to find something that…maybe?…will look good on me. Let’s pause for a moment to note that I have never had short hair in my life. Gulp. I have absolutely no idea what short hair will look like on me. I decided to shoot for something like this Michelle Williams look. But will my hair even do that??
HLP Step 4: down a couple of shots
Just kidding. No drinking for me right now. But if you want to get yourself one before proceeding, please go ahead.
HLP REAL Step 4: go for the haircut. Listen to friend’s expert opinion on short hair, including the fact that thin blonde hair is not likely to respond like thick brown hair. Hold breath. Marvel at the sheer quantity of hair that has been removed from your head.
HLP Step 5: look in mirror. Pick jaw up from floor. Breathe big sigh of relief that I don’t look like a circus clown. In fact, as Mom pointed out, maybe I sort of look like Rachel Maddow.
Hmmm. Am I now afflicted with short brown haired woman syndrome?
HLP Step 6: order a scalp prosthetic
In one of our earlier meetings with Dr. M in May, he gave me a prescription for a “scalp prosthetic,” or what we normal people would call a wig. I will use this prescription, not least because wigs can be very expensive, and this will reduce the cost significantly. But I don’t expect to wear a wig very often. As my mom pointed out, wigs are hot, and even though this has been an atypically cool and rainy spring for southern New England, summer will arrive eventually.
HLP Step 7: wait for the inevitable.
So that’s the HLP. Depending on how I’m feeling, there may be a step 8, which could be “do your best Telly Savalas impression with a rousing rendition of ‘Who Loves Ya Baby?'” or “find some Star Trek: The Next Generation togs and dress up like Captain Picard.”
Or, you know, just wrap up my head and wait to see what happens on the other side of this madness.