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Hair Loss Part 1: How to Care for Your Hair and Scalp Before Chemo

In the first in a series of posts, Sonya Keshwani offers some insights into how to feel empowered, comfortable and beautiful during the hair loss process. In this interview, we cover what to do to before treatment to prepare for hair loss. 

Brilliantly: Before we dive into the questions from the community, tell us a little bit about yourself.

Sonya: I am a young breast cancer survivor. I was diagnosed at age 29 with early-stage breast cancer. So much of the experience was scary, and there were times I felt isolated and unprepared. I didn't have any family members with a history of breast cancer that I could lean on or know any other young survivors who I could ask questions.

I luckily had great doctors, but they weren't able to offer any resources for the lifestyle issues I was facing. One of the things that I felt really underprepared for was my hair falling out.

Even though so many people experience hair loss, there weren’t reliable sources to prepare me on what to expect or how to care for myself throughout the process. It's so much more than just your hair falling out. It’s what you do after hair has fallen out and how you kind of care for yourself while it's growing back, which can take quite a while.

Brilliantly: I think oftentimes doctors simply explain that a thing is going to happen, but are less often able to explain how day in and day out you can manage or find ways to feel more like yourself.

Sonya: I agree. I’ve learned so much from my experience and I wanted to create the resources that I didn't have. This goes beyond our fashionable head wraps that bring joy, beauty and color to the hair loss process. This about how to tend to yourself and to your scalp health while you're dealing with all the other things that go along with cancer treatment.

Brilliantly: What a fantastic idea. So many women are already benefiting from your gorgeous head wraps.

Sonya: Women are so taken care of by the beauty and fashion industry when we're in good health. If something goes wrong, there's a big gap in that space that you never really saw before. My goal is to close that gap.

Brilliantly: Let’s start closing the information gap and answer one of the community questions. Does all chemo make your hair fall out?

Sonya: Not necessarily, and sometimes not all of it comes out. Depending on treatment, your hair might just thin. Treatments typically involve different phases and a combination of different drugs. It's important to ask your oncologist about how each treatment phase and will affect your hair.

Also, it is very common to start a treatment protocol and see how your body's reacting to it and making adjustments along the way. Your treatment may change, and how your hair reacts might change too.

Brilliantly: Understanding how your body is likely to react can help you decide if you want to preemptively shave your head or wait and see what happens.

Sonya: Your hair is one way that you can define your journey. If you know hair loss is going to happen you have the chance to decide how you want to handle it. For a lot of people, getting a very short haircut before it starts to fall out is a way to ease into it. That way you're not experiencing such a drastic change when treatment starts.

It was really tough for me personally when it felt like a lot of my choices and control were being taken away. I worked early on in my journey to try to accept hair loss and the idea that it is a finite journey. This is your hair, it will come back to you. Reminding myself that I had control over my internal conversations set me up in the long-run to cope better.

Brilliantly: How quickly after treatment does hair start to falling out?

Sonya: The first round of chemo is usually the catalyst of hair thinning. By the second round of chemo you may begin to see significant hair loss. Still, it's really dependent on the drugs.

Brilliantly: And what do you do when it first starts to fall out?

Sonya: There's a few different options. I've seen so many women who make an event out of getting their hair cut or shaved. They have family or close friends support them while a loved shaves their hair. That can be a nice way to feel safe in that situation.

My salon in New York, and I think there are other salons out there like this, donates products and services to cancer patients. When I went the first time, I had my family with me and I just wanted to shave my head. They washed it, gave me a scalp massage, and then cut it before shaving my head. It was the nicest way to deal with the situation, I actually felt pampered.

Brilliantly: As women, so much of our identity is tied to how we look and a lot of that is around hair. I'd love to hear kind of your take on hair and femininity and identity.

Sonya: Losing your hair is a clear indicator that you're sick. Many medical diagnoses are an internal issue and unless you tell someone, they might not even know that you're sick. That's also a difficult thing when you are suffering and it's like a secret. Hair loss puts you out there for better or worse.  Hair defines your face and personal style. It represents the first fashion choice you make every day. However, because of culture and trends, I think hair can unintentionally become a box that we fall into. It was defining me in a way that I didn’t even realize until I was faced with losing it.

That said, I used this difficult change as an opportunity to explore new ways of representing my personal style. That’s why I’m trying to help women take a step back from hair and look into new, interesting things to try.

There are so many other trends and ways to define your look. Maybe you are a little bit on the conservative side with your makeup and you want to try bright pink and red lipsticks. Or maybe you want to test different accessories, like bold earrings or head wraps. It’s possible to tailor your style into a different medium. That can be fun and exciting.

Brilliantly: That's so powerful. There's so many areas where you can shape your story. Telling yourself a positive version of your story matters. It matters while you're going through it, it matters while you're healing, it matters for the rest of your life.

Sonya: By treating yourself to new experiences, you’re also creating positive memories. Wearing earrings or lipstick is just for you. I had fun with it at even at home. There were many days where I couldn't go out or be very active because of treatment but playing around with my personal style reminded me that I was still myself. I am a fluid person. I am not defined by this one experience.

Brilliantly: Right. There are small ways to keep yourself feeling normal. And I think that can translate into any part of this, whether you're the patient or the caregiver.

Sonya: That’s how the head wraps came to be. When I was in treatment, I was living and working full-time in Washington, DC and I was getting treated in New York City, so I was traveling every three weeks for chemo.

I took a train back and forth. And when you're going through treatment and hair loss, you feel the air conditioning and temperature change so much more. I was freezing. I could not believe how cold I was without hair. I had never experienced that before. And so, I started to experiment with some Indian cloths at home and I made my first satiny, cream head wrap.

Then I started to look at different fabrics, a little bit of a thicker, bigger cotton and knit-style wraps. I saw creating head wraps as a solution because, for me, wearing a wig was not an option for long-term travel or even a full workday. Wigs are essentially putting a very uncomfortable bandage over a very big problem, so I really did turn to different fabrics that provided that comfort and coverage as well.

Brilliantly: I love the idea of having different wraps for different moods, outfits, and weather.

Sonya: I recommend finding a few different head wraps in several different styles. We send out our head wraps in breathable cases so you can take them anywhere, have that variety, and if you wanna switch between a head wrap and something else, you can easily do that.

If you lose it, having very little hair is going to be the state of things for months. That’s why it’s important to think about what you have in your wardrobe that will help you live your life well for the coming seasons as your hair grows back. And depending on what season you're starting treatment in you might want a cozy scarf or breezy coverup to match your wrap. Having layers is essential to staying comfortable.

Brilliantly: What are the other parts of hair loss that you can prepare yourself for?

Sonya: Hair loss is definitely much more than just the hair falling out. Your scalp will become very sensitive to the touch, and you're also going to find that you might be susceptible to headaches or migraines. Just putting your head down on a pillow can cause pain. It’s normal. It's unfortunate, but it's normal.

Brilliantly: Is there something you can start putting on your scalp to help prepare or deal with that once it starts happening?

Sonya: My recommendation is a migraine cap. It’s basically a cap with insertable thin ice packs that fits around in your head. It really helped me. Every time I'd come home, I would take it out of the freezer and put it on my head and feel instant relief. It soothed my entire scalp. It helped both ease the sensitivity issue while also calming down any headache I was having.

Brilliantly: If you met a woman who was just diagnosed and knew she was going to lose her hair, are there any other tips that you share?

Sonya:  I think many women wear wigs to keep up our image at work or when we're out and about, but make sure you anticipate that you're not going to want to wear it all the time.

Think about what you're comfortable with, whether that's rocking the bald look, or if you like a head covering, and make those arrangements ahead of time so you have them on hand when you need them.

Brilliantly: So much energy and time is spent thinking about and preparing for surgery, and thinking about survival, and yet, there are so many other things to think about. Thanks for providing such helpful insights.

Sonya Keshwani was diagnosed with breast cancer at 29 and founded StyleEsteem Wardrobe when she lost her hair to chemo and needed a comfortable and fashionable solution. Wearing a wig after hair loss was extremely painful on her sensitive skin and felt untrue to her identity. And the head wraps she found in stores were either too boring or made her look like a cancer patient. So she started to experiment with fabric between rounds of chemotherapy, and came up with designs that made her feel stylish and confident again, and transformed her quality of life.

Sonya launched StyleEsteem to give other women the same option she had – runway-worthy head wraps for every season and occasion, so you can live your best life while you heal. StyleEsteem head wraps have presented at New York Fashion Week and other runways, and been covered by the New York Times, CBS News and more. StyleEsteem has also partnered with organizations like the Susan G. Komen Foundation to harness grassroots fundraising for cancer research. StyleEsteem has also pledged to donate one head wrap in need to a cancer patient for each head wrap sold.

Sonya hopes that StyleEsteem helps every woman empower her personal style with self-love and fierceness throughout her hair journey.

Brilliantly aims to improve women’s feelings of ease through thoughtful products and services, share practical wisdom and a community of support, and amplify stories of radiant women whose lives have been impacted by breast cancer. Learn more about Brilliantly here.

This dialogue belongs to a three part series. 

Hair Loss Part 2: How to Care for Your Hair and Scalp During Chemo

Hair Loss Part 3: How to Care for Your Hair and Scalp After Chemo

All our favorite product picks for hair loss & regrowth can be found here. Any proceeds from affiliate links will directly support our 1 for 1 head wrap donation program. Thank you for making this mission possible.

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