Losing Your Crowning Glory
This is another one of those ‘you don’t know how you feel til you’re in it’ situations. Losing your hair is horrible.
You probably haven’t ever spent much time thinking whether or not you’d have a wig if you lost your hair but suddenly here you are and time may not be on your side.
From the beginning of treatment you are told that you will lose your hair…..if you are anything like me you cling on to a hope that you will be the one person who defies the odds. It’s much easier to be where I am now and give advice but it was really hard to accept at the time.
You are not alone. I have talked to many patients and friends over the years and hair loss is a thing most women really struggle with. This doesn’t mean you’re vain its just you are venturing into the complete unknown.
For me it was around week 3 of chemo which on my regime was a week after the second treatment (My ECs were accelerated and only 2 weeks apart) when it becme clear that my hair was starting to come out despite the use of Cold Capping. I know I was in denial and thought if I didn’t acknowledge this thing that was happening then it wouldn’t happen. GUESS WHAT? It did.
When it Happens
The physical process of losing your hair is horrible. It hits you at a time when you don’t feel your best physically and mentally anyway. It doesn’t matter how many times the professionals mention it to you be prepared to be shocked.
At the start the hair loss seems slightly more than day to day normal hair loss and you may try and tell yourself that this is the worst it is going to get. You may then start noticing hair on your pillow in the morning.
During this time it is really important that you are kind and gentle to your hair:
- Stop scraping it back in tight styles.
- Try not to wash it too frequently.
- Brush it gently with a softer brush but do brush it.
- Use a gentle shampoo and plenty of conditioner.
- Avoid colouring your hair – you just have to accept you may turn into a Grey Goddess (temporarily!).
You may also want to consider getting your hair cut into a shorter style. This is really personal choice. I know women who are determined to keep their long hair as much as they can through this process but that wasn’t for me.
Leading up to hair loss your scalp may feel quite sore. This is something you are not always warned about, it can feel quite tingly and uncomfortable. This is normal and there isn’t much you can do to alleviate this odd sensation.
Then comes the day you have been expecting – handfuls of hair start to come out looking rather like pets. You may also find that big matts of hair form. This is because the dead hair that is being shed becomes tangled up with the live hair. This can be very painful and the only way of dealing with it is to cut the matts out.
You may have used or be using the Cold Cap. I did for my first three treatments. What I noticed was that when had had my hair clippered the cold cap was more effective but also more painful. It may be that if you have thick hair the cold cap isn’t quite as successful as the cold needs to directly shut off the tiny blood vessels of the scalp (very much like getting cold, painful fingers in the winter) to prevent the chemotherapy affecting the hair follicles.
At this point you may decide to get your hair cut short or clippered. It is important that you have a hairdresser you feel comfortable with. I was lucky, mine did a home visit which meant I could be in my kitchen with family going about their normal life and music blaring. Some women I have spoken to were given appointments before the salon opened or after it had closed. Don’t be surprised if having your head clippered feels very private, its quite normal to feel vulnerable.
I do recommend a hairdresser with a good sense of humour, this really helps make a potentially depressing situation into one that is much more bearable!
The Hairy Question
Everyone you meet will have a view on whether or not you should have a wig. By all means listen to them and then put their opinions to one side and ask yourself what you want to do and what you feel comfortable with.
What are the options?
- Do nothing – you don’t have to cover your head, it may be worth having a plan B though as you won’t know how confident you feel until you are baring your head in public.
- Wigs – modern wigs can look amazing. There are two main types available – human hair or synthetic.
- Headscarves/hats – in various fabrics, lovely colours, coordinating with outfits.
So How do You Choose What is Best for You?
There are no hard and fast rules. Bear in mind some of the treatment you have may plunge you into menopause (LINK). With this go the delightful symptoms of hot flushes and complete loss of temperature control. About 90% of body heat is lost through the scalp so it may be worth taking this into consideration.
Human hair wigs need TLC just the same as human hair and this doesn’t appeal to everybody whereas synthetic wigs can be rinsed to clean them and left to dry.
Human Hair wigs are more expensive than synthetic wigs.
Synthetic wigs are available on the NHS. In England certain criteria need to be met to qualify for a free wig but currently in other parts of the UK wigs are free on prescription. For private patients many insurance companies will offer some reimbursement for the cost of a wig.
If you are considering a wig at all it is worth making an appointment at your chosen supplier before you lose your hair. (This may be a private wig shop or a hairdresser associated with your oncology unit). This enables the wig fitter to see the colour and style of your usual hair and also means you can have a bit of a practice with the wig. If you are buying a wig then you shouldn’t have to pay VAT.
You may decide to try and copy your usual hair do or you may decide to do something completely different – now may be the time to try something you have always wanted to do!
At the end of the day if you have a wig and don’t end up wearing it very much that is fine, you need to be happy with your choice and if you don’t want your wig any more there are a few charities and some hospitals who accept second hand wigs and find them new owners!
It’s a Wrap!
There are a lot of lovely wig alternatives out there too.
Depending on the time of year you may choose a beanie style hat or brightly coloured head scarves. There are a lot of online companies who specifically cater for chemotherapy patients but there are also many other makes of headgear that would be suitable.
There are some things you may wish to consider when choosing your hat or scarf.
Your skin may feel quite tender and sore especially in the early days so opt for soft, non itchy fabrics.
At night, especially in the winter the newly revealed bald head can become very cold so its worth having some type of head covering that doesn’t have any bows/flowers/lumps of any kind that you can sleep comfortably in. (For the first time I could see the sense of those hats bald men used to wear with their nightgowns many years ago!)
Look for fabrics or materials that don’t feel too hot. The dreaded hot flushes have already been mentioned. Ideally you want a head covering that doesn’t make your head too sweaty! Cotton is obviously good and bamboo has the benefit of being very soft, a good insulator, moisture absorbing and antibacterial.
Having a bald scalp (or very thin hair) brings another problem you have probably not considered before which is sun protection. SPF 50 ought to be applied to the scalp and the tops of the ears if the head is exposed but be careful of the fabrics you choose for scarves too – not all of them are UV protective, particularly if they are a more open weave.
There are some really good pretied, elasticated headscarves available and these are great to keep in your handbag or around the house to quickly slip on.
There may come a time when you feel happy not to wear anything on your head and that’s great. It can vary with the situation you are in – sometimes you will feel more comfortable than others. If this is what you choose to do carry a headscarf in your bag to quickly whip out if needed and don’t forget sun protection!
The Curse of Folliculitis
Folliculitis is an infection of the hair follicles. It is commonly seen in people when they shave their bikini areas or in men who shave their chests. Guess what? it can also happen on your scalp when you experience hair loss. It can be itchy and sore and looks like acne on your head. It’s often made worse by the steroids that are often given at the same time as the chemo so you may be able to negotiate your dose with your oncologist.
The good news is it responds very well to lymecycline an antibiotic which is given in a low dose for a couple of months.
At the End of the Day…..
I have spoken to a lot of women who have been through chemo and hair loss is a really big thing. Everyone deals with it differently and experiences differing degrees of self consciousness. One of my friends told me she keeps a hair towel in her hall so that if somebody comes to the door then she can quickly put it on and pretend she’s just stepped out of the shower.
This is a rubbish experience but with a little thought and a lot of humour one that you can and will get through. This could be a chance to get adventurous and reinvent yourself!