Laura writes…

“Your hair will drop out if we use this kind of chemo, but it will grow back” my consultant said, not realising the emotional impact his statement had on me. I shrunk inside and touched my head protectively as the sentence rang in my ears. Despite being told I had a life-threatening illness, the hair loss that would result from its treatment was one of the things that scared me the most.

Nobody could say for sure how my body would react; two people on the same type of chemo will experience hair loss differently. Maybe my hair would just thin, maybe I’d be one of the few who kept it all, but most likely it would go. In the days leading up to my first treatment, I dreamt I was on a windy beach and the hair blew straight off my head. I wondered if I’d rise from bed one morning and leave my hair on the pillow. Or maybe I’d reach to remove a bobble and pull the whole ponytail out instead.

I’d always had lovely thick hair, thanks to the bowl cuts Mum gave me as a little girl. My blonde baby hair turned shimmery brown as I grew, developing reddish highlights in the winter and blonde ones in the summer. I’d never dyed or done anything too crazy with my hair because I liked it. It was me. I loved the way Mum would brush it into ponytails every day before school, how I’d crimp it for parties, the way it would frame my face and get stuck under the chin rest on my violin. I remember falling asleep as my childhood hairdresser cut my fringe, perched high upon a cushion on top of the chair. I went through every iteration of a fringe: full, wispy, layered (disaster), side, swooping, to none. A few months prior to my diagnosis, I found a few grey hairs. I panicked. It was the worst thing to happen that month.

I was told to ‘prepare for hair loss’, but with only a few whirlwind weeks between my diagnosis and the start of chemo, there wasn’t any time for that. Not that I knew how to anyway. I feared seeing myself with a bald head, scared of who I’d be without my hair. I’d still be me, of course, but hair forms such a big part of our identity. I was adamant that nobody would see me without hair, but I didn’t feel comfortable wearing headscarves. Sometimes I’d see someone in a headscarf and think, ‘oh, they must be a cancer patient going through chemo’, and I wasn’t ready to accept that identity yet. I didn’t want a physical marker of my disease when I was out in the world. So, I took the one step I could and went to buy a wig. It felt a lot like buying a plaster for a wound, a convenient way of masking all the pain that was to come.

Hair loss often starts around 10 days after the first treatment, so I stocked up on sleeping caps, head coverings and hair nets. I invested in a brush that would be gentler. I woke up each morning holding my breath and exhaled when I’d touched my head and found everything intact. I brushed my hair with trepidation, washed it with care. I hesitated in making plans to see people in case my hair suddenly started falling out. Nothing happened.

And then, in the third week of treatment, the first strands came loose. I stared in disbelief, clutching them tightly as the tears streamed down my face. It was shocking, it was real, it was happening. The next week the shedding intensified, the hair mostly coming loose when I brushed or washed it. Eventually small clumps would cut loose and fall. It continued to be shocking, but those first few strands were the worst of it.

I kept all the fallen hair in a box. I’d walk around running my hands down my hair to catch the loose strands, dutifully putting them in the box and stuffing them down as it filled up. Initially, I tried to keep every strand – I didn’t want to lose a single part of me – but ultimately that was too hard. I’d run my hands down the hair, ease out the loose strands, and let them fall wherever I was, be it the hospital, the car park, or my flat. “Your hair’s falling out” remarked one of the nurses. “I know”, I replied. I felt like I was disintegrating all over Cumbria.

Several people told me to just shave it all off and be done with it. It’d be a way to take control of the situation and avoid the trauma of watching it fall. But so much had already been taken, I didn’t want my hair to go just yet. I felt embarrassed and angry, but I knew it was better for me to watch it fall, rather than to shave it all off in one fell swoop. I had a hunch that watching it fall on the outside would help me to process what was happening on the inside. Since it’s not socially acceptable to emotionally disintegrate in public, the gradual hair loss was a way of telling people I wasn’t okay.

Another message fed to chemo patients is You’re losing your hair but don’t worry, now is your chance to go crazy and try out loads of new styles! This was odd to me, because I’d had a good head of hair for 29 years and could’ve tried a gazillion new styles during that time if I’d wanted to. Having a cancer diagnosis didn’t suddenly change the fact that I didn’t. I wanted to look like me. It felt a lot like saying You’ve lost your pet but don’t worry, now is your chance to go crazy and buy an iguana or a turtle or something that’s so much wackier than a dog! You don’t lose your hair and immediately feel comfortable in a wig. I just wanted to sit in the pain of it without having to develop a whole new personality.

As my treatment progressed, I slowly began to accept that I was a cancer patient. As the effects of the drugs became cumulative, I started feeling so bad that I wanted to walk around in a chemo headscarf so that people would know I was a cancer patient. I felt cripplingly self-conscious in my wigs and beanies but came to realise you look as good in a wig as you believe you look good in a wig. One night I wrote ‘the hair thing is bothering me less. I’m used to the shedding and almost wanting it all out now because it’s becoming quite annoying. But I also can’t imagine myself bald. At the start I didn’t want anyone to see me like this, but even that’s changing now.’

One day I realised that my hair wasn’t my hair anymore. It was thin and lifeless, and I wasn’t enjoying what was left. I felt a strong affinity to the autumnal trees, whose beautiful leaves fell and fell and fell. When the cold winter winds blew away the final stragglers, I knew it was time for my hair to go too. I found a hairdresser who understood the trauma and was gentle and kind. I came home and cried, but it was done. What happened to me? I’d think every time I looked at old photos or in the mirror, sadness bubbling up inside. Wigs are great, I even grew to like headscarves, but neither were a substitute for my hair. I missed it immensely.

Most patients going through hair loss could buy several new wigs if they had a pound for every time someone told them It will grow back. The phrase always made me feel prickly, because a cancer diagnosis involves several losses all at once – your hopes for the next months or years, finances, independence, body functions, health, work, freedom and ultimately life, depending on the type of cancer and the success of treatments – so it’s too easy to view hair loss as trivial.

If my hair had just dropped out prior to the diagnosis, I would have been devastated. With cancer it’s often accepted as the price you must pay, and a small one at that. But if these ‘smaller’ losses aren’t grieved, how will we ever be prepared to grieve the big ones? Wondering what was happening to my life was too much, too heavy, too overwhelming. The hair loss was something tangible I could attach my grief to; it was easier to grieve my hair than a dodgy lymphatic system and a nebulous sense of losing myself. The kindest thing anyone said to me about it was “I’m so sorry you have to go through this, it’s really, really hard.” Hair loss is a loss like any other.

My hair started growing back as a white blanket of snowdrops broke through the barren winter ground. I was stunned by life’s ability to endure. My new hair is soft and smooth, but also weak and not fully formed, which is exactly how coming out of treatment feels. I’m a baby in this post-cancer world, where everything is the same and yet imperceptibly different. Where the ground crumbled beneath me but I’m still above it rather than below it, wondering what that means. A friend said you’re only as healed as your hair regrowth is long, so I still have a long way to go. 

I’ve kept my box of hair at the back of a drawer. I haven’t looked inside it since, but neither can I bring myself to throw it away. In years to come maybe I’ll open the box and think yes, that’s what I went through to make me better. That’s what had to leave my body along with the disease. Maybe then I’ll see it as a small price I had to pay, but it was an unwanted price, and the cost of that was painful.

If it’s happening to you now, I’m so sorry. It’s really, really, hard. You don’t think you can cope with it, but you will, mostly because there isn’t another choice. It will grow back, but losing your hair symbolises the incredible number of changes happening in your life right now, many of which you won’t be able to name just yet, and that is always worth remembering.

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