So I Guess I’m Losing My Hair
Grappling with one of women’s worst nightmares
When my oncologist advised me to start chemotherapy, he gave me two options.
“Chemo option number 1 will not lead to hair loss,” he said. “Chemo option number 2, which is in combination with immunotherapy, will lead to hair loss, two to three weeks after the start of treatment.”
I shared a look with my partner sitting next to me and chuckled.
I had (and still have) stage IV lung cancer, with no expectation of cure. Until that moment, I’d been under the impression that when a patient faced possible death, what happened to their hair would be more of a side note. Yet, hair loss was the first thing my oncologist mentioned.
Was that the main issue in people’s minds? In women’s minds? How silly. How about, Which one gives me the best fighting chance? Or, Which one will make me puke my guts out less often?
“Are people that worried about hair loss?” I asked.
The oncologist shrugged but didn’t answer.
He then told me what I truly wanted to know: the pros and cons of each treatment option. He went over the likelihood of them working against my type of cancer and for how long, and then the most common side-effects (your usual stuff: fatigue, nausea, pain…).
“Go home and think it over,” he said when he was finished. “It’s an important decision.”
I weighed all the factors, and two days later, I informed the doctor I was going for the second option — the one where I’d lose my hair.
That evening, as I stared at my face in the full-length mirror in my bedroom, framed by the straight dark brown hair that had been with me my entire life, reality started to sink in.
I’m going to be bald.
I used to care a lot about my hair. Particularly about its length.
From around the age of six, I convinced myself that having long hair (chin length at the very least) was a prerequisite for being accepted as a girl by society.
At 13, I unwittingly got a short hairstyle by a lying hairdresser who thought he knew best what looked good on me. My teenage male cousins teased me about it for the entire month we spent together during summer vacation.
“You’re a boy now,” they’d say. My face would turn red, and I’d run after them, trying to get a punch in.
I let my hair grow back, and from then until my late 20s, I kept it unchanged: straight, parted in the middle, shoulder-length. Safe, easy, normal.
When I reached 27, though, catastrophe hit my scalp. My hair started thinning out.
I couldn’t believe it. This was not something that happened to young women, was it? And even if it did, neither my mom nor my dad ever had hair loss issues, so why should I?
I started wearing bangs to cover my receding hairline. There wasn’t much else I could do to hide it, and it was getting worse by the month. So I went to the dermatologist. Even though she couldn’t get to the root cause of the issue, she prescribed topical medication that stopped the hair loss in its tracks. Seven puffs of spray in the morning and the evening were keeping me a normal woman. Phew, crisis averted.
That is, until six years later, when I chose the cancer treatment that would make me bald. In a way, I felt like it was meant to be. Like the universe thought, You think you’re smarter than me, stopping your hair from falling out with a stupid hair spray? Well then, here’s some cancer for you.
I vividly remember when, in 2004, news outlets in my home country of Portugal exploded with the fact that actress Fernanda Serrano shaved her head. She was doing this for her role as a breast cancer patient in a soap opera. I can’t remember a man’s hairstyle ever being such a big deal. But the fact that a woman accepted to be temporarily bald, even as part of her job, was mind-blowing. It was the top news story for several days. News anchors would say things like, “She is so brave,” and, “Wow, even without her hair, she is still beautiful.”
And who can forget the scandalous headlines when Britney Spears did it in 2007?
The underlying message was clear: Bald women are usually ugly — avoid this at all costs.
Hair loss is also a big deal for men, or you wouldn’t have a $4 billion industry of hair loss prevention and restoration products in the U.S. alone. My partner Matthias started losing his hair at the age of 24, which took a significant toll on this confidence.
As I stared at my reflection in the bedroom mirror, with my hair pulled back, I tried to imagine what I’d look like without hair. Masculine. Alien. Sick. Dying.
I had a healthy self-esteem and body image, so I didn’t think I’d look less pretty. I was also confident that Matthias would still find me attractive. However, I worried about what others would think. Even though there are many causes of hair loss in women, even though a woman can shave her head by choice, cancer is the first thing that springs to people’s minds when they see a bald woman. And that was the scariest part: that they’d see cancer before they saw me.
How was I going to do this? By googling How to manage hair loss from chemotherapy.
I read about this thing called a cold cap: a sort of helmet you can wear at the hospital during each treatment. It causes your scalp to go into hypothermia and might keep your hair from falling out. Nah, I wasn’t going to torture myself for an uncertain result.
I learned about full lace wigs vs. lace front wigs, artificial vs. human hair, and smaller hairpieces you can wear under hats. I watched tutorials on how to tie headscarves by the charity Look Good Feel Better. I saw how to create fake eyebrows and eyelashes (yes, those often fall out as well).
For the low-maintenance kind of woman I am, this seemed like a whole side-job. And with stage IV cancer, I felt like I had more important things to spend my time with, like enjoying life.
I told my friend Leslie I was wavering between all the available options.
“I don’t want to wear a wig,” I told her. “It doesn’t feel like me. But on the other hand, if I don’t wear one, people will think I have cancer as soon as they see me.”
“But you do have cancer,” she said.
She was stating a fact, and yet I’d never seen it that way. During my previous treatment, I’d felt safe in the fact that my cancer status wasn’t visible. I could pass as a perfectly healthy 33-year-old. However, having cancer is part of who I am. It’s a big part of my life. And I didn’t mind that people knew. I was already pretty open about my cancer diagnosis — most people around me knew. I felt comfortable explaining the situation if anyone asked. If anything, being bald would make people less surprised when they heard I had cancer.
Lots of research is being done on counteracting chemo-induced hair loss, because it’s a big deal to patients, especially women. Studies suggest that 8–14% of women refuse chemotherapy because of the fear of losing their hair. How sad is that?
Hair grows back. Life does not.
If we, as a society, are OK with a man being bald, we also shouldn’t make a big deal about a woman being bald, whatever the reason. And I think the only way to do this is to normalize female baldness.
So I decided I was not going to order a wig. I’d wear beanies for comfort and protection from the elements, but not for shame. I was going to be proud of my bald head.
If you’re curious about what happened when I actually lost my hair, you can read my follow-up piece:
And here you can find some other related pieces:
