Shedding – Why It’s A Crucial Part of the Capping Process and How to Manage It

Published: 28 Mar 2018

As a professional capper of more than six years, I know the most worrisome part of capping is the 18-21 day period after the first chemo treatment.  Why?  It’s when shedding will likely begin.

Focus on the Hair on Your Head – Not What’s Been Shed

Once shedding starts, the most common concern is that it won’t stop.  It will (barring any extenuating circumstances such as allergic reactions to chemo drugs or improper capping techniques), have faith.  Shedding is a necessary and even positive part of the process.  Regrowth is right behind that fallen hair.

Some Background Science About Hair Follicles

The young to medium aged hair follicle bulbs are protected during scalp cooling therapy.  Chemotherapeutic drugs accelerate the shedding from the oldest ones, making it almost impossible to predict.  I have seen anecdotal evidence with metastatic cancer clients who had previously gone bald.  Their newly regrown hair barely sheds during subsequent treatment with caps, lending credence to the young vs. old follicle bulb concept.

Individuals metabolize chemo differently which also affects shedding.  Some shed in the beginning of treatment; others at the end.  But shed they must.  Expect it.  Embrace it.  Use whichever analogy works – rebirthing, regrowth, renewal.  Hair will grow in rapidly, and in most instances the hair on one’s head will greatly outweigh the amount that has been shed.

View Shedding as a Glass Half Full – And Remember to Keep Your Glass Full

Staying hydrated is essential because it pushes the chemo through the body and hair.  A good benchmark is to drink at least eight glasses of fluids daily.  (Note:  Patients with kidney or renal issues should consult their doctors about the proper amount).  Not only do hydrated clients tend to see positive results when shedding starts, they also feel better physically.  Hydration won’t stop shedding, but it may slow it.

Cover Sparse Areas – Not the Whole Head

There are many variables in determining a successful capping outcome, and results cannot be guaranteed.  However, clients who tolerate chemo well, are capped properly, follow the provided hair care instructions, and stay hydrated, typically end treatment with full coverage.  Their shedding/thinning occurs uniformly throughout the head, and most outsiders are unaware of any hair loss.  Conversely, those clients on a stronger protocol or who have had other issues along the way may develop sparse areas on the scalp.

Powder clogs follicles which means root touch-ups and dry shampoos with powder must be avoided.  The only two products that can safely cover sparse areas are Toppik and Style Edit spray.  Use sparingly and infrequently as less is more with capping.
Hats and wigs are inadvisable during capping as they create additional heat and will undoubtedly pull hair when removed.  The better approach is to cover any thinning spots with Toppik or Style Edit spray.

After the Last Treatment - And Before Your Hair Returns to Normal

The last treatment is cause for celebration although it will take a while for your hair to join the party.  Continue to baby hair until all shedding stops (anywhere from 1-3 months).  Take slow steps toward normalcy.  Instead of using the cold cap washing method every 4-5 days, try every 2-3 days.  If shedding doesn’t increase, massage the scalp lightly.  If still stable, blow it dry on a cool, low setting.  Brushing and dying will be the final steps.  Remember that it takes six months for the follicles to heal completely.

Also remember that your hair won’t know chemo has ended.  It has become familiar with the treatment cycle, be it every 1, 2, 3 weeks, etc.  Don’t be surprised if your hair sheds in a corresponding interval after the last session.  Maintain a positive attitude as it will grow back quickly with cold cap usage.  You’ve paid your dues, and a full head of hair will be your ultimate reward.

Claudia Falzarano e Right Arm Inc. e e 917-327-7091

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