The Emotional Impact of Losing Your Hair After Cancer Treatments

For women going through cancer treatment, the hair-loss process is a topic that gets a lot of attention. What is not talked about as much, however, is what happens when the hair starts to return. In my experience as a recent ovarian cancer survivor, there’s still a lot that can come up — both physically and emotionally — during the hair-regrowth phase. 

I had long, dark curls for most of my life. Now that I’m about a year post-treatment, my hair is short and cut in a style I never would’ve chosen for myself, but really like now that I have it. How I feel about my hair can change from day to day, though: Sometimes I love it and want to keep it short, the other days, I miss my long curls. On Monday, my short hair is an empowering ode to what I’ve been through, but by Tuesday, I wonder if I’m too attached to my cancer survivor identity.

Kristie Redfield, LCSW-R, a clinical social worker at Memorial Sloan Kettering Cancer Center's cancer survivorship program, Resources for Life After Cancer, sees the hair regrowth process as emblematic of the survivorship experience overall. Once your hair starts to grow back, people often assume you're all better and the cancer is behind you.

"It's a metaphor for what a lot of patients describe as the difference between their internal experience and the expectations of the world around them," Redfield says. "Everyone else expects you to go back to 'normal' [because] the cancer’s over and you look great. But often patients don’t feel that way inside. They’re still recovering, and the transition to survivorship can actually be profoundly painful."

The expectation might be that once you're done with active treatment (and you have hair on your head again) you can just snap back to normal, but the reality is that emotionally recovering from what you've been through as a cancer patient — and growing back your hair — takes time.

Hair falls out during treatment because many types of chemotherapies target rapidly-dividing cells, like cancer cells, explains Jolyn Taylor, assistant professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center. Hair follicles are also rapidly dividing cells and therefore can be affected by chemotherapy agents as well, she says, and the hair on the scalp is particularly vulnerable to the effects of many types of chemotherapy. Taylor notes that people in treatment will start to see hair loss quite quickly, usually within the first several weeks of starting chemotherapy — but the time it takes to grow back can vary greatly.

In some cases, hair can start to regrow while you’re still getting chemotherapy. But Taylor says it takes several months, even up to and beyond six months, to grow a significant amount of hair back after completing chemo. And, she points out, several factors can affect the rate of regrowth, like what dose of chemotherapy you’re on, what your schedule is for receiving it, how healthy the hair was prior to chemo, and your nutritional status.

To complicate things, the hair that grows in may look different than it did before treatment. It could be a different shape, texture, or even color, says Taylor. Most commonly within the cancer community, people talk about "chemo curls" — when your hair was straight before treatment and then grows curly afterward. There’s actually a scientific explanation for this, having to do with the anatomy of the hair follicle. The shape of the inner root sheath determines whether the hair is curly or straight, and chemotherapy can affect cells of the inner root sheath, which can then lead to changes in texture as hair regrows. These changes are usually temporary, and hair tends to revert back to its normal texture with time.

Whether you're experiencing chemo curls or not, there's still that awkward, in-between phase to get through when you’re growing your hair out after it's been shaved. Penelope Love, hairstylist at Sam Brocato Salon in New York City and for Road to Bald, a program that offers free haircuts for women undergoing chemotherapy, has some tips for getting through this difficult and tedious phase.

While you may want to just grow out your hair as fast as possible and avoid the salon altogether during this period, Love advises getting trims every eight to 10 weeks, or every six to eight weeks for those who really want to keep the shape of their haircut.

Love notes that the hair in the back nape area of your head will grow quickly compared to the hair on top of your head, so the best way to grow out a short pixie cut is to keep the back and sides short as the top grows out and catches up. When the top gets to chin-length, you can try a very short bob. Once the hair is all or mostly one length at the chin, the grow-out process from there becomes a lot easier, Love says. And hair accessories are a must for getting through that awkward phase. "In the summer, I love a silk scarf wrap and there are so many YouTube videos on different ways to tie a scarf," Love says. "We’ve also seen such a resurgence in barrettes which have been really on-trend. Barrettes embellished with rhinestones or pearls are a fun way to get the change or variation in the look that you’re seeking."

Love says to be prepared for it to take about two years to go from a shaved head to shoulder-length hair. "After you finish treatment it’s a very natural and normal reaction to want everything to be done. You often want to celebrate being done with this phase and move on but the hair growth is slow, so be gentle with yourself," Taylor says. "I would suggest practicing self-love and [trying to] see past the physicality of it," Love adds. "I’m a hairstylist so I know hair is very important, but I think loving yourself is the most important part and can really be a powerful thing."

Plenty of cancer survivors would agree with that sentiment. We spoke to six of them on how they grew back their hair after treatment, how they got through the awkward phase, and what advice they have for other women going through this process right now.

"At the beginning of treatment, I started to take a picture every day to document my hair journey," recalls Regina Matthews, 34, an artist and barber-in-training living in Los Angeles. "I stopped early on because I found it to be triggering to my mental health — it was sort of like picking a wound." In her candid essay, she shares her self-love journey.

"After being stripped of what I thought made me ‘feminine,’ I've learned that I am not my hair," writes Sarah Ochoa, a 35-year-old executive assistant in Seattle. “I am not any physical piece of me."

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