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.