Cancer Treatment Centers of America

Coping with hair loss

Author: Diana Price

hair lossLauren Erdman was 19 years old and a sophomore in college when she was diagnosed with non-Hodgkin’s lymphoma. While her friends were studying for finals and going on dates, Lauren was facing down intensive chemotherapy treatments and the related side effects, including hair loss.

“One of the first questions out of my mouth,” Lauren says, describing her reaction to her diagnosis and prescribed treatment plan, “was ‘Am I going to go bald? What’s going to happen?’” Unfortunately, Lauren’s care team at the time did not offer much information about what she could expect in that area. “Nobody talked to me about how hair loss would happen,” she says. As a result, she was surprised when, almost as soon as she returned home after her weeklong inpatient chemotherapy treatment, her long hair began to fall out. Pretty soon Lauren realized that she would need to cut it short and, ultimately, shave her head as her hair continued to thin and fall out.

Despite her initial concerns over the impact of hair loss, Lauren says that the experience of losing her hair as a result of treatment became empowering, as she took pride in her altered appearance and what it symbolized and embraced the opportunity to become truly comfortable in her own skin. As she learned to love the new image she saw in the mirror, Lauren kept a fellow cancer survivor in her mind. “I had an image in my head of a woman I saw at the treatment center: she was totally bald—no hair, no eyelashes—but she had makeup on, and cute clothes, and she walked with her head high. I said to my mom, ‘That’s going to be me. I’m going to walk with pride. I’m not going to be ashamed that I don’t have hair.’”

Lauren moved ahead with determination, choosing stylish head coverings and playing up her makeup and accessories to ensure that she felt pretty and confident throughout treatment. Still, she acknowledges that there were definitely challenges and that not every day was a good one. “I had my days when I felt I’m so ugly,” she says, “but that’s natural. We’re connected to who we are on the outside, and, unfortunately, we often find our identity in what we look like. The media tells us today that women have hair, that it should be long and wavy and perfect, and that it’s soft, it never gets messed up, and it never goes gray. We’re all supposed to be young and healthy and vibrant, including our hair.”

Emotional impact

For many patients undergoing treatment, it’s difficult to shake this cultural and personal attachment to our hair, so experiencing hair loss may be difficult. “Hair loss can be a very emotional experience for patients going through chemotherapy or radiation,” says Rhonda Colley, MS, LPC, LMFT, mind-body therapist at Cancer Treatment Centers of America® in Tulsa, Oklahoma.

The emotional impact of hair loss can correlate with a person’s self-esteem, especially if his or her self-worth has been based on physical attractiveness. If that’s the case, the person may have a more difficult adjustment. Specifically, she says, “Patients may express concern about rejection in a relationship due to all of the physical changes in their body, and such worries can lead to anxiety.”

In addition to self-esteem issues and the potential for anxiety, Colley adds that patients may actually grieve the loss of their hair. “Our hair is often seen as our crowning glory, and some patients may view their hair as their most attractive feature,” she says. “Even when that is not the case, the sense of grief and loss can be just as strong. It is a part of our body and a part of who we are.”

Also affecting patients’ emotional response, Colley says, is how prepared they are for the change. Even if they have been well educated about when to expect the loss and how it will likely occur, they may still be shocked by the reality. At this point coping strategies can play a powerful role in helping patients manage the emotional challenge they are facing.

Talking with other patients, with a mind-body therapist, or with hair stylists who are familiar with the needs of cancer patients can be very helpful, Colley says. “With more information about the process, patients feel more in control of their world despite the hair loss itself, which is mostly out of their control.”

Coping tools

For many patients, wigs and head coverings—along with other fun accessories—are helpful coping tools when hair loss occurs during treatment. Pattie Cagney Sheehan, owner of Second Act, a fully accredited mastectomy boutique in downtown Chicago that offers wigs and post-surgery bras and prostheses, says that she learned the full emotional impact of treatment-related hair loss when she watched her mother’s response to it. “When my mother went through cancer, she was 80 years old. She’d put her wig on and she’d cry and say, ‘It doesn’t look right; it’s not like me,’ and she got frustrated. I said, ‘Mom, you’re 80. You’re happily married. What’s the big deal?’ And, boy, was that a mistake! It’s a big deal, even at 80.”

Whether 80 or 18, patients want to feel good about their looks, and, for many, wigs can help. To help women find a wig that suits them, Cagney Sheehan spends a lot of time educating her customers about different types of wigs and getting to know which might be a good fit—in style, ease of care, and cost.

Many different types and styles of wigs are available, ranging from custom human-hair wigs to less expensive synthetic varieties. Cagney Sheehan says that synthetic wigs are the best fit for most of her customers. “Synthetic hair is easier to handle, the quality is great, and it’s much more reasonably priced,” she says.

Wig prices in Cagney Sheehan’s shop range from $200 to $500, depending on whether the wig is hand-tied or machine made, but she says that human-hair wigs can cost more than $1,000. Although these pricier wigs can look more natural in some cases, they require much more styling— something cancer patients often don’t have the time or energy to undertake. “Just think how you’d feel if you were going through chemo and you had to spend 30 minutes styling your hair,” she says.

Once a patient has decided between synthetic and human hair, the next step is to find a color and a style that suits her face shape and skin tone. At this stage, Cagney Sheehan says, it’s helpful if patients can put aside their desire to maintain their current hairstyle and have fun experimenting with different styles and colors.

“Women often want the wig to look just like their hair, but I explain to them that it is a wig; though a wig is well colored and has highlights and lowlights, it is still a wig.” Once that reality is accepted, she says, many women find themselves loving the fresh look of a different style. “I have women who say, ‘Oh, this wig looks better than my hair did,’” she says. “If you’re willing to experiment, it can actually be a fun experience.”

Even when patients have the best possible experience, shopping for wigs can still be an emotional endeavor. For this reason, Cagney Sheehan suggests bringing along someone who can offer support. “I always recommend that patients bring a friend, a family member, a hair stylist, or someone who knows them well when they’re shopping for a wig.” That person can provide emotional support and can also offer insight into how the wig suits the patient’s lifestyle. “I always give them my honest opinion,” Cagney Sheehan says, “but it’s important that they bring someone with them whose opinion they trust and who can make them feel better about what they’re doing.”

Cagney Sheehan sees daily the depth of the emotional response that hair loss can inspire, but she also knows the positive impact that the right wig can have. The trick, she says, is being open to the possibilities of change: “Go in with an open mind, knowing that you’ll find something that will look good.”

Embrace the possibility of change

Hair loss during cancer treatment can present an emotional challenge because, as Colley says, “hair loss is often viewed as a ‘stamp of sickness’ in our culture.” She notes, however, that with adequate emotional support and other tools, including head-covering options, “patients can learn to reject the idea of being the ‘face of cancer.’” The fact is, she says, “while we cannot deny the reality of cancer, we can certainly deny the things it may try to tell us about who we are and who we are not.”