Why Losing Hair Means So Much

This article was originally published on BladderCancer.net and written by Alison Petok, MSW, LCSW, MPH.

Many types of cancer are linked to physical changes, ranging from surgery and reconstruction to weight loss or weight gain. Often, people confronting physical changes find these very distressing. Someone may suddenly notice that their clothes are either too small or very large. Weight loss is linked with illness and may prompt friends and family to encourage eating, which can feel emotionally overwhelming. Weight gain is a less expected side effect, which some people find surprising and upsetting.

Another side effect: Hair loss

More than weight changes and sometimes even surgery scars, one of the most distressing side effects of cancer treatment is chemotherapy-related hair loss (alopecia). Although alopecia is a common side effect, it is often underestimated how much of a mental impact it may have. Many people find alopecia traumatizing and stigmatizing. It impacts the person's self-image as well as how they are perceived by others.

A visible side effect of cancer

Since hair loss is a visible side effect often linked to cancer, people may feel it discloses their cancer or “sick” status to the world. The result may be feelings of shame, anger, embarrassment, sadness, helplessness, or even fear. Alopecia may also cause low self-esteem, anxiety, or depression.

There are a variety of head coverings, scarves, and wigs available. These are often used, but these items are sometimes still visibly a sign that you have cancer. Doctors are often unaware of the great lengths to which patients go to prevent or cope with hair loss. It may be overlooked by your treatment team, or you may feel shame in bringing the issue up with them even though these concerns are totally normal.

Grieving hair loss

The concept of hair loss has become overwhelming as a way to portray cancer in movies and television. Often we see characters losing hair and shaving their heads as a way to take control. Although this may appear to be straightforward in fiction, the reality can be much more challenging to cope with.

Coping with these changes

When hair loss happens, it tends to happen slowly - a few hairs at a time, then clumps, over a period of several weeks. This can be very jarring and even trigger a reminder of the feelings at your initial cancer diagnosis.

Cutting or shaving your head is a viable option to cope with these changes. Acknowledging the very real and reasonable grief associated with hair loss is also empowering.

Accepting these real emotions

Grief over hair loss may feel superficial or vain in light of a cancer diagnosis. However, it is common and very real. It is ok to grieve this loss. When hair does grow back after treatment ends, it may be a different color or texture. This surprises many people, and may even cause sadness or confusion.

These feelings may be related to the constant reminder of all you have been through and how you may have changed. Having friends who listen to and empathize with you, or joining a support group, may be a helpful way to find comfort as you move through the grieving process. Some practical tips for coping with hair loss include:¹

• Wigs may be covered by insurance. It must be coded as “cranial prosthesis.”
• Your cancer care team may have suggestions for local wig shops, as well as the American Cancer Society “tlc” collection.
• Protect your scalp with sunscreen when you go outside.
• When it is cold, wear hats or other head coverings to keep yourself warm.