Hair After Chemo: A Guide to Post-cancer Treatment
by Logan Davis

Every nickname I ever received was, in some way, about my hair.  No playground triumphs or hallway altercations ever demanded the notoriety for a moniker. I was born just ahead of the release of Gilmore Girls, so my name wasn’t quite as popular (and consequently ambiguous) as it would be for those a few years younger. Some folks called me “Lo” but that stopped after a doctor told my parents that was a cruel thing to do to a kid who was just diagnosed with depression. So the names were always about my hair. 

There is a lot of advice you’ll get about hair when you decide to go through chemo. Or when it’s determined that you need to go through it. Rarely, I imagine, does it feel like a choice. The doctors will tell you what to expect: You’ll feel tired, your skin will get irritated, you’ll feel your worst a week after the first session, etc. But the thing they will remark on, repeatedly, will be about hair. 

They’ll tell you that you’ll lose it, and probably  your eyebrows too, though that’s not as common these days. What they will allude to, more and more week after week, is what your hair will be after chemo. They start you off easy by saying “it will take some time, but it will come back.” But somewhere in between day one and three they give you the timeline of “a year or two” before it’ll become normal. Recently, now that it’s been a year, my oncologist informed me “It doesn’t ever really come back the way it was. They just say a year or two because that’s how long it usually takes for this to become the new normal. For things to settle.”

Now, a lot of guides will give you percentages and chances, and a quick google will lead you to the — as far as the search engine seems to care — expert of cancer percentages on the web: The Mayo Clinic. Though if you actually google “best cancer hospitals” they will only appear as #4. But math is only good at telling you what could likely happen, not how to be okay with what ends up happening. So I will avoid chance and tell you what I’ve had to become okay with. 

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My hair was curly red. Not orange; it was red. Auburn if you’re feeling particularly descriptive. And it was curly enough kids used to hide pencils in it when I was sleeping on the bus. They called me Chucky and Sideshow Bob. Once I found out I needed glasses, it was all about Hyde from that 70’s show. In just about every facet these names have not aged well. 

I got my hair from my grandmother, a woman of deep coppery haired pride. Though her hair color was lost to age, and her hair to chemo. She died about a decade and a half prior to my treatment. 

My name was chosen by her. It’s Scottish, from some steamy romance novel. I think she chose it because I was always said to have looked like her side of the family. Like her brothers. A “Hearty.”

My hair was thick; thick enough to break a buzzer. The running joke was that we needed to use sheep shears to cut it down and manage the exaggerated 20lbs of locks that stood 12” off my head. In reality, it was probably more like 10lbs at its peak. And my mother cut it with a pair of Revlon scissors in our kitchen, while yelling at the dogs for playing with the clippings.

I had a routine with my hair that I went through every day. It had to be every day. Otherwise it would turn into a Brillo pad. First, I’d jump into the scolding shower and soak my head like a dog who rolled through the mud. Weight it with water so it would almost hurt my neck. Then, comb it with that comb I used for years because I knew would always work. The one that says Revlon on the side and which I stole from home when I moved out because the scissors worked so why wouldn’t the comb. 

To get the comb through, I’d grasp my hair at the base and pull hard. Some strands would snap off, but that’s okay, I had millions more. But holding at the base was important, it kept my scalp from hurting. At the point my lower back would hurt from arching under a shower head too short for me,  I lathered with OGX argan oil shampoo. Then I’d step out of the shower because the next part is deeply important: put in the conditioner, also OGX, and don’t wash it out. Start at the hairline, drag it over, and work it in like one would ineffectively wring out a wet shirt. Don’t touch til it dries. 

Now I could make a joke about how losing my hair saved me money and time on that amalgam of hair care products and routine, but we know how expensive medical care is and how a lack of habit is the last thing you would want through treatment. Or I could try to comfort you in saying that you’ll finally look like all the cancer patients in the movies. But who wants to feel famous because they’re sick? Notoriety is a thing you gain, and although cancer is a thing that grows: it ultimately takes from you. 

I could also tell you about how I chose to shave my head before I lost my hair out, or how the hair didn’t look like mine right before I buzzed it. I might go on to describe the bed sheets people recommended to minimize friction against the follicles, since low thread counts will catch your hair and rip it out faster. Or the whole “freezing the eyebrows” technique to lessen the chemo’s affects on the tiny hairs by slowing their (now poisoned) growth. And there is something to be said for taking comfort where you can get it, cooling off, and slowing down. 

But in my experience, those things didn’t really matter once it all went. What mattered more was the room where I lost it. I don’t know the one you’ll lose it in. So I don’t really have advice for that. The only thing I can offer is a suggestion, to remove any photos of you with hair from the room. 

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It took about a month after finishing chemotherapy for hair to start growing back on my head. It came in straight, like salt and pepper peach fuzz. There were baby hairs that led it by a few weeks, but they didn’t stay for long. This may be your hair, it wasn’t mine. But I started to do the work to accept it as such. This moody reboot. What would my nicknames be now? 

The first hair to grow back will rarely be what stays, so don’t get attached to it. The texture, color, and thickness will fill out. By month six you should have a better idea. Between a year or two you’ll be sure. 

My hair settled about 4 months after it started coming back. Brown curls. Still a little red, but calling it auburn at that point would have been generous. But the curls were there. And the beard was even more red by comparison. 

It’s known that people’s hair might come back curly, or curlier, then it already was. These are sometimes referred to as “chemo curls.” Sometimes they go away, sometimes they don’t.  Whatever the case, I don’t recommend calling them that. This is your hair now, no reason to make it chemo’s. It’s easy — almost recommended — to carry your cancer and its treatment around with you afterward. But you had it cut out, why keep it by giving it another thicket to linger in? Even a linguistic one?

As someone who has had to figure out the cool “Ronald McDonald” length of curly hair a couple of times, let me give you a tip: get into sweaters. I don’t know why, but the whole sweater/big cardigan vibe really helps take the edge off of the small sun that your head will now resemble. Hats can help too. In fact, both of these items will be helpful given that you will get cold more easily after chemo; it does a number on your circulation. And when the hair first comes in, it will still likely be thinner than it was.

My hair is back now, but duller and thinner. A little weaker and a little more sensitive. Maybe some of its youth and stubbornness sapped out, now that it knows what it’s like to cease existing. Weary with that knowledge. But it’s mine and it’s still here, still curly, so that’s something. 

The first few months with new hair are going to be rough, habit wise. You’ll be tempted to reach for that old bottle of shampoo and conditioner. But your hair is different now. One of those products might not work. Possibly both. So experiment. Buy a random shampoo bottle because you like its design. Try to wear that conditioner some ex left in your house a while back. Break out and try the vinegar thing. Your hair will feel like a baby’s and you’ll learn how to take care of it again.

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My habit has changed a bit since chemo. It’s still every day. Still has to be every day. The soaking still happens, and I still have that one comb. But I am lighter with my hair now. I take the time to work the knots out slowly. My hair has been through a lot and I am very aware that this is the last of it I have. So it’s worth taking care of. Being tender with. It’s been through a lot recently. And that trauma will be with it forever now. 

The shampoo I use is Dr Bronner’s Almond Pure Castile Soap. Just a little bit. That’s all I need. It feels simpler, and I spent so much time putting so much into my hair, I need to keep it a little simpler this time. I try to ignore the weird God text all over the Dr. Bronner’s bottle, but from time to time I do spend a moment reading the lines just as an excuse to stay under the hot water a little longer. The conditioner changed too: Shea Moisture. Once the conditioner is worked in, I touch my hair just once. I make sure it is leaning to the left. I had to comb it straight back when in the shower because if I comb it any other way it gets frizzy. I don’t know why, it’s just that way now. Once the hair is leaning left, I let it dry. Then I attempt not to touch it until I go to sleep, but I am more patient with myself if I do, because sometimes letting it be a little messy and frazzled is okay. 

It will be a process, getting to know your new hair. Knowing when to change how you treat it, versus just knowing it’s changed, and that’s how it will be from now on. Even after your hair comes back, it might look like it’s falling out; clumps gathering in a shower drain. You might have a pang of panic about premature balding. How you never saw such quantities pre-cancer. But you probably have and your hair is probably fine. You’re just getting older. 

You might be frustrated and shave your hair off. Or you might grow over-attached and let it grow longer than you ever have. Your hair might bounce right back or it may never be the same. It might never come back at all. But you won’t know fo r a year or two. Not because it takes that long to change, it just takes that long to get used to it.

You have only a few moments in your life where you are past an old thing, not quite at a new thing, and you get to decide what to do. I can’t write a guide for what to chose there. The only piece I can help you through is the part right before that moment. To warn you about the parts where there are no decisions or choices to be made, where all you can do is watch what happens. Not how to make it easy. Not how to stop it. But just to tell you that it will settle, and that things will be different. And that’s normal. Then — and only then — will you have a choice to make: how to become okay with it. 

Logan Davis is a practicing artist in Austin, Texas. While primarily writing and taking photographs these days, he graduated with from Marlboro College with a focus in computer science. His work has been featured in Vol. 1 Brooklyn, Drury Gallery, and Lose The Film. Find Logan at Twitter or Instagram.

Image: Niklas Hamann/Unsplash

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