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Hair Loss After Chemo: Regrowth, Treatments, and Identity

hair loss, cancer, chemotherapy, chemo curls, regrowth, minoxidil, Rogaine, female pattern hair loss, dermatology, scalp cooling, cold capping, hair growth, treatments, supplements, biotin, collagen, zinc, hair products, wellness industry, identity, confidence, body image, alopecia, medical conditions, medications, psychological distress, women's health, beauty, health, haircare.

It’s funny, the things we take for granted until they’re gone. I never truly understood how much I subconsciously strived for a certain standard of beauty, a conventional hotness, until cancer stripped it all away. In 2023, as I battled advanced-stage Hodgkin lymphoma with twelve grueling rounds of chemotherapy, I became, by societal standards, undeniably "uglier." The bald head, the weakened, muscle-free body, the steroid-induced puffiness, and the meager three eyelashes – it was a stark departure from the image I had of myself. The Mitski lyric, "But if I gave up on being pretty, I wouldn’t know how to be alive," echoed in my mind. It felt like a core part of my identity was being erased.

Ironically, as my hair, once a wild, often-frizzy mane that I constantly fought with, fluttered to the ground during those initial treatments, I realized just how central it was to my overall look. I desperately tried to cling to it. During the first few chemo rounds, I opted for "cold capping," a relatively new process. The patient wears an incredibly cold cap before, during, and after each chemo session. For some, it can significantly reduce hair loss by up to 50%. (New York recently mandated insurance coverage for scalp cooling; I had to drain a significant portion of my GoFundMe to afford it.)

The cap, unfortunately, lived up to its reputation as a torture device. Barely fifteen seconds into my first treatment with that frozen helmet clamped to my head, with six more hours stretching ahead, the cold became unbearable. I downed more Advil and Tylenol, even begging for more Ativan. An hour later, the nurse, bless her heart, returned with the benzos and began pumping me full of four types of poison as I shivered on what felt like the most depressing floor in all of Murray Hill.

Once I truly experienced the brutality of chemotherapy, choosing to endure additional discomfort became unimaginable. The moment I stopped cold capping, the hair loss accelerated, rapidly thinning my already compromised wavy bob. Every day, I found myself wrestling with the same questions: Is today the day I shave it all off? Would a classic bald look actually be better at this point? How much longer can I realistically cling to the illusion of hair normalcy? When I started finding clumps of hair caked to the pillow on my hospital stretcher, I finally asked the emergency room doctor to buzz it all off.

During the treatment, losing my hair was upsetting, no doubt about it, but I was facing much bigger problems, like the cancer itself and the constant threat of sepsis. The post-chemo hair regrowth process – slow, uneven, patchy, and isolating – has been far more emotionally gutting because I’m supposedly "normal" now. Society expects me to have bounced back. More than 80 million people in the US experience hair loss. In addition to cancer patients, hair loss is also a common, yet rarely openly discussed, side effect of perimenopause and childbirth. While baldness, thinning, and receding hairlines are often associated with men, female pattern hair loss is estimated to impact 40% of women before they even reach the age of 50. Hair loss in women is often caused by underlying medical conditions, medications, or even significant psychological distress. Regardless of the cause, it has a profound impact on a patient’s overall quality of life, but women, in particular, tend to experience more significant psychosocial problems as a result.

"Hair is deeply tied to our identity, our confidence, and even how we move through the world," says Dr. Asmi Berry, a board-certified dermatologist in Los Angeles. "Our hair is often one of the first things that people notice about us. So, when a patient, or anyone really, experiences hair loss, especially after something as life-altering as chemo, pregnancy, or a severe illness, it’s not just a physical thing. It can feel like you’ve lost a part of yourself, and that has a significant emotional impact."

People often talk about getting "chemo curls" after cancer treatment: hair that grows back thicker and curlier, sometimes even in a completely different color. My alleged curls sprouted up unevenly across my head, just as I was expected to jump back into the world of work, dating, and general normalcy. After much pleading, my oncologist finally referred me to a dermatologist at the cancer hospital. She prescribed me minoxidil (Rogaine), spironolactone (a heart medication that can also treat female pattern hair loss), a special scalp solution, and a military-grade anti-fungal shampoo, harsh enough to turn my remaining hair into straw. Neither the anti-fungal shampoo, which is also used to treat things like athlete’s foot and ringworm, nor the topical scalp solution are FDA-approved specifically for hair loss, but they have shown promise as adjunctive therapies and are frequently used by dermatologists as part of a broader treatment plan. Unfortunately for me, the hair growth process has remained agonizingly slow. I am grateful, though, that the dermatologist was willing to help me try – that she took my distress seriously.

"It’s just hair," people with an abundance of it often tell me, or "You’re rocking the short look!" Imagine if the most traumatizing thing that ever happened to you was permanently visible on your body, and people made upbeat, dismissive comments about it. When I finally worked up the courage to post a wig-free photo on my Instagram Stories, after hiding for over a year, someone commented that I looked like Stockard Channing’s Rizzo from Grease – the famously mid-30s actress playing a high schooler with a hairstyle I actively dislike. This is all to say, I’m not at all surprised that people go on hair plug vacations to Turkey. ("First stop is always Istanbul!" as they say). Sadly, there are few solutions for hair regrowth that are guaranteed to be effective.

"My advice is just to look for treatments that are backed by solid science and clinical data," Dr. Berry emphasizes. When people ask Lindy Segal, a beauty writer and author of the Gatekeeping newsletter, what hair growth products are actually "worth it," her answer is consistently the same: minoxidil, also known as Rogaine. "It’s still the only FDA-approved ingredient for hair growth in those assigned female at birth," Segal wrote in an email. Finasteride (Propecia) is the other FDA-approved medication to treat hair loss and pattern baldness, but it is only approved for use in men. "There’s some emerging research that red light therapy could potentially boost hair growth, but a $45 bottle of Rogaine is a safer financial bet than a $500 device," Segal says. "Girl math!"

And the girl math can quickly add up. There are countless supplements and hair products on the market, all boasting ingredients like biotin, collagen, and zinc, and not all of them are entirely bogus. Oral biotin, for example, is generally safe to ingest, and some studies suggest it could help prevent hair loss, though there isn’t yet enough robust research to definitively show that it actively encourages new hair growth. When I first saw my dermatologist, she ordered a comprehensive panel of bloodwork, in order to identify any other potential root causes of both the hair loss and the slow regrowth (aside from, you know, twelve infusions of the most toxic substances on Earth.) I was found to be very low in both zinc and vitamin B6, both of which are essential for healthy hair growth, so she prescribed me supplements for those, along with all the other pills and potions we tried.

"I think what’s really important in the whole conversation of hair loss is a root cause approach," Dr. Berry explains. "Figuring out, is the hair loss hormonal? Is there a nutritional component? Is it stress-induced? Getting a comprehensive evaluation by a qualified dermatologist can really help with avoiding wasted time, money, or even hope on the wrong, ineffective path."

Frustratingly, hair loss is often dismissed by doctors outside of dermatology, regarded as a superficial problem of mere vanity. After giving birth to her two-year-old son, my friend Alicia, a 35-year-old in North Carolina, watched in dismay as a significant amount of her hair began to fall out. When she brought the excessive shedding to the attention of her primary care physician, the doctor simply said, "Oh, it looks fine to me!" and didn’t even bother to refer her to a dermatologist.

“It was just a constant self-esteem bummer,” Alicia told me via text message. “I just felt like no matter how I tied it back or what I did, I couldn’t get it to look good. And there’s no makeup or anything you can do for your hair.”

The regrowth process was long, demoralizing, and incredibly expensive. “I gave a lot of my money to Vegamour,” Alicia says. She believes the Insta-friendly hair serum, which contains turmeric, caffeine, and biotin, helped to some extent. Other heavily advertised solutions that she purchased seemed less effective for her hair, including growth supplements containing biotin and acerola extract – a Brazilian fruit rich in vitamin C that is supposed to help boost collagen production. That’s the big problem in the wild world of hair regrowth: most stuff can’t hurt you, but most probably can’t genuinely help you, either. One website selling acerola as a hair supplement even cites a 1954 study on scurvy, the vitamin C deficiency that can cause hair loss. I’m assuming that, today, most people’s hair loss is no longer scurvy-induced.

Like mine, Alicia’s social media algorithm is constantly bombarded with hair growth ads boasting dubious claims. Indeed, it seems we are living in a time of unprecedented claims about hair. “There’s a lot of noise out there, and people market in ways that are really psychologically triggering,” Dr. Berry says. Lindy Segal has also observed a noticeable increase in the noise. “I’ve definitely noticed more products, brands, and general coverage targeted to hair growth for women in the last few years,” she says. She suspects some of it is related to the pandemic. Indeed, studies have indicated that roughly 20% of people who had Covid-19 later developed temporary hair shedding, usually starting a few months after recovering.

It’s best to be wary of any product that claims to regrow your hair “instantly” or “quickly.” Not to mention that viral over-the-counter products can potentially cause unforeseen side effects: Nutrofol, for example, has been linked to liver injury. I’ll admit that, out of sheer desperation, I’ve tried well-marketed hair regrowth products that aren’t exactly what you might call “vetted.” Herbal oils, turmeric scalp elixirs, collagen powders, “density” shampoos and conditioners, serums. I’ve been living in constant fear of more hair falling out, so I carefully ration hair brushing and washing, terrified to detach any more strands than absolutely inevitable.

A year and a half after finishing treatment, I finally worked up the courage to get my first blowout, which would involve brushing, washing, scrubbing, and, of course, hair blowing. The stylist showed me her comb and her hands after massaging my head. “See? Only a couple hairs came out, which is totally normal,” she said. I’d been expecting a wig’s worth. The blowout looked pretty, if noticeably thin. The varying lengths, caused by the uneven regrowth, almost looked like cool, choppy layers.

Patrice Grell Yursik, creator of the hair and beauty blog Afrobella, was diagnosed with multiple myeloma in January 2024. After bone marrow biopsies and weeks of hospitalization, she underwent a stem cell transplant, followed by chemotherapy, and, like me, lost all of her hair. Yursik is also currently in the regrowth phase. I asked her if she’d tried anything to encourage the process. “My oncologist is very wary of the wellness industry and doesn’t recommend any additional supplements or hair growth medicines for me at this time,” she wrote in a message, adding that she couldn’t cold cap because her type of cancer is located in the bone marrow, “so we didn’t want to basically refrigerate my skull while I was trying to heal.”

“I’ve tried a few topical products, specifically scalp oils intended to stimulate growth,” she says. “My hair is growing back super thick and coily at the roots, and it is absolutely fascinating. For someone who made so much of her name and identity around hair, it has been an unexpected education in learning to love myself at every stage of my new journey.”

For the rest of my life, I’ll undoubtedly have fewer hairs than I did before I got sick. No product will magically change that reality, and maybe, just maybe, that’s ultimately fine. But I’ll probably keep searching, just in case.

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