How Chemotherapy & Radiation Effect Hair
This was my experience with hair loss and regrowth following a twelve week, twelve round chemotherapy regimen including Taxol and Herceptin, followed directly by a three-week maintenance dose cycle of Herceptin for the remainder of a year, and twenty rounds of radiation. My experience may differ from someone else’s but it may be helpful to show how long it takes for hair to grow back following chemotherapy, how radiation effects hair, and how I handled the inevitable loss of my hair.
From the moment I found out that I would need chemotherapy I was determined to not need chemotherapy. Yes, you read that right. I even went into my first appointment with the oncologist with my hair down, all 27” of it, in the hopes of persuading him to change his mind, because how could he make someone lose such amazing hair?! Fast forward a month, and I completely changed my perspective on losing my hair. Rather than letting my hair fall out on its own, I was urged by every single person I spoke to, to shave my head. Right away, don’t wait, just shave it and keep shaving it, because watching your hair fall out in clumps in the shower is traumatizing, and your hair will fall out. So what changed that made me almost excited to take a pair of kitchen shears to my locks? Rather than letting my hair fall out, which I had no control over, I decided one day that I was going to donate it. I would take control of the situation, and in doing so, I felt like I had some control over one part of what was about to happen to my body. I gave in and let reality take over. Whether I liked it or not, my hair, hair that I had spent five years growing out, hair that I had struggled to grow past a pixie cut for a decade, would be gone soon.
So I embraced it as best I could. I did research about where I could donate it, and because I dyed my hair, was limited to what places would take it. Eventually, I found the organization, Children With Hair Loss, and knew this was where I would send my hair after chopping it off. One week before starting chemotherapy, I took a pair of kitchen shears and had my husband film me cutting off 18” of hair, leaving me with a chin length, very blunt, haircut. I had been informed by my oncologist and nurses that people would usually begin to lose their hair after their second round of chemo. Week two of chemo, I planned on shaving my head myself, but first, since I was going to lose it anyways, I decided to do something really edgy with it.
I went to the hairdresser and had my hair dyed blue (for my former student Monique who passed away from Ewing Sarcoma) and got a very short haircut, one that I would never have got if I wasn’t about to shave my head. I figured that since it was all going to fall out, I may as well do something crazy with it while it was still there. A few days later, I took some clippers to it and shaved it all off. My husband then shaved it with a razor down to the skin every single week until March 11, 2020 (my final round of Taxol/Herceptin was January 7, 2020).
During the twelve weeks of chemotherapy, we shaved my head weekly, so I never noticed if it fell out or not. However, I did notice other changes in hair on other parts of my body. The first hair that seemed to disappear was on my legs. Within the first month of starting chemo, I had noticeably less hair on my legs, and eventually didn’t even need to shave them at all. Next was my armpit hair which followed suit, slowing down and eventually barely growing at all for months. My body hair on my pubic area thinned out and slowed down a lot too after probably two months of chemo, and same with hair on my toes.
I was hyper concerned about losing my eyebrows and lashes, and looking back on old photos I can tell they definitely thinned out, but the majority of them hung on until six weeks after my last round of Taxol, when they all fell out over the course of a few days. Thankfully baby lashes and brows were already growing in as the old ones were all falling out, so I only had to go without brows for a few weeks. My arm hair also started falling out at this time as well - six weeks after I got my last round of Taxol.
I’ve heard people say that losing your hair through treatment hurts, or that it tingles. I didn’t feel either of these sensations on any part of my body except my lashes and brows. My lashes hurt (like how it feels if you have a sty only on all your lashes) and my eyebrows tingled a lot before falling out.
Radiation’s Impact on Hair
One thing that I wasn’t prepared for, or aware of, was that radiation can also impact your hair. Having radiation in my armpits, due to the way the rays crossed my body during the treatment, made it so that the hair on the bottom half of both of my armpits stopped growing. Now, I have a very distinct angled line where the hair stops in both of my armpits. I’m not sure if the hair will ever grow back but as of right now (three months after my last round of rads) I still have a very unusual looking set of armpits.
Hair Regrowth
After having my last round of TH chemotherapy I was very anxious to have my hair back. I knew that it wouldn’t be overnight, but I couldn’t wait to have hair again after being bald for twelve+ weeks. The unfortunate thing about chemotherapy is that it takes such a toll on the body that you will not bounce back right away upon finishing treatment. Getting maintenance doses of Herceptin every three weeks until October, 2021 will also impact hair regrowth because although less severe, one of the side effects of Herceptin is hair thinning out. On top of that, it isn’t unusual for people to lose their eyebrows/lashes more than once after finishing a chemotherapy regimen because of the hair growth cycle.
Because I knew that what little hair I had would be very fine and thin for a while after finishing TH, I chose to continue shaving my head weekly until I could see enough hair in the follicles that I knew that it wouldn’t be super thin once I let it grow out. By the beginning of March I had enough hair to allow it to grow back without looking thin, fine, or patchy. My lashes and brows seem a bit thin still, but I could just be hyperfocusing on them and that’s why I think they are still thin.
I noticed that my hair grew back in the same order that it fell out. I had to start shaving my legs and armpits again within a month of my last round of TH on a consistent basis. Next, my hair in my pubic area became thicker and like it was pre chemo as well as hair on my toes. My hair on my head was the last place to get back to full thickness.
Color and Texture
One of the side effects of chemo on hair is that it can impact what your hair looks like when it grows back. My hair is the same color that it was before chemo but it might be a little curlier. It’s still hard to tell because my hair was curly before having chemo.
Final Thoughts
Be patient. It will take time. It will take a few months before your hair is back to how thick it was before chemo. I know that it’s hard to see your hair not returning to its full thickness right after finishing treatment but eventually it will grow back. I highly recommend shaving your head through treatment as well as for at least a month after finishing your last round of chemo. Losing my lashes and brows was the most traumatic side effect that I endured during treatment. I can’t even imagine how horrible it would’ve been to lose my hair, too.
A lot of people attempt to keep their hair through chemo, using things like cold caps to minimize hair loss, but when I looked into this option it was completely unrealistic, extremely expensive, and seemed like quite a nuisance with very minimal benefits. As much as I hated hearing it before starting chemo, it is just hair. Since going through treatment, hair has become such an unimportant facet of my life that now I don’t even think about how it looks most days, I just put on a hat and go about my day. Cancer has a way of stripping you down and making you realize what is really important. I say, embrace the newfound perspective on life.
