Friday, November 22, 2024
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Coloring Hair After Chemotherapy Course of and Expertise


I have hundreds of photos in my camera roll that might seem like the musings of someone who never turns down a selfie. But if you look closer, the subject of these countless photos is my hair. You might think I’m a stylist’s dream—constantly chopping and coloring, with cool memories to accompany each change. But, in reality, my collection reminds me of what I’ve lost and how much further I must go to feel like myself again.

My diagnosis

It started in 2022 with a trip to the doctor for white bumps in the back of my throat, which I assumed was strep. From January through April, I bounced from ENT specialists, trying to figure out why these swollen bumps wouldn’t disappear after treating them with rounds of steroids. By May, I found out I had Diffuse Large B Cell Lymphoma (DLBCL), a type of non-Hodgkin lymphoma (NHL) that affects white blood cells. 

The irony was after years of having light brown hair, I finally started the journey to go blonde, getting it to the perfect golden shade a week before I received my diagnosis. I caught my cancer early, and everyone, from my doctor to well-intentioned friends, told me it was a “good cancer to get, meaning my outcome would likely be positive, and after treatment, I’d remain in remission. People automatically put me in the “cancer warrior category, but dealing with a diagnosis and starting treatment was anything but easy. My body experienced blood clots and cancer-induced asthma, to name a few. Despite all this, I made it through my six rounds of chemo and had one final PET scan standing between me and remission. I went in for my scan, and two weeks later, my doctor told me that everything looked good and that they’d see me in three months.

It was quite surreal after twelve emergency room visits, one collapsed lung, and seeing a slew of specialists. Medically speaking, I was cleared to rejoin society, but mentally and physically, I was still in shambles. My bald head and eyebrows were the most obvious signs I was still healing. I desperately counted down the days my hair would be below my shoulders or could be thrown up into a messy bun without needing a pin to secure still-growing flyaways. I regularly dreamt of sitting in my colorist’s chair, in hopes that the foils would put an end to the neon “cancer patient sign my hair (or lack thereof) communicated.

“People automatically put me in the ‘cancer warrior’ category, but dealing with a diagnosis and starting treatment was anything but easy.”

Hair loss and cancer treatment

See, hair loss is a common side effect of chemotherapy and, according to Beth N. McLellan, MD, and director of supportive oncodermatology at Montefiore Einstein Comprehensive Cancer Center, hair loss during treatment happens because chemo works by attacking rapidly dividing cells, like cancer cells. Unfortunately, some normal cells that divide rapidly can also be affected, like hair follicles, which are the second fastest-dividing cells your body produces, Dr. McLellan says. 

The most common side effects of chemotherapy are fatigue, nausea, mouth sores, loss of appetite, and hair loss, but each person’s experience is unique. “Hair shed typically happens in the first few weeks and grows back over the months following a patient’s last treatment, but some other cancer treatments can affect the texture or color of the hair, and some can cause thinning rather than complete hair loss, Dr. McLellan says.

Hair follicles go through four stages within a growth cycle: anagen (growth), catagen (intermediate phase), telogen (where the hair stops growing and rests in the follicle), and exogen (where hair falls out). “Certain chemotherapy treatments can cause the immediate release of hairs in the growth phase known as a type of hair loss called anagen effluvium, explains Anabel Kingsley, consultant trichologist and brand president at Philip Kingsley, meaning that after completing chemotherapy, your hair will grow back, but the treatment can cause it to return with a different texture and color, which can be another emotional ordeal for some people. “For many people, it’s not uncommon for hair to come back curlier, unpigmented, or slightly lighter. However, everyone’s scalp and hair will be more fragile at first following chemotherapy, says Kingsley.

For me, it took about four months to go from being completely bald to having a crew cut with thin eyebrows. However, I was overjoyed because I could go about my day publicly, and no one gave me a double take of pity. Granted, I was very far from my previous mid-back length but it was a start. I’m not the first person to experience cancer-related hair loss, and there are many forums online with people offering their advice to expedite hair growth and their lists of do’s and don’ts. I learned during my experience that some people instantly colored their hair after treatment, and others decided to keep their hair short and dye-free.

Dyeing my hair after chemotherapy

I really wanted to dye my hair because I thought if I looked how I did pre-chemo, I could cope with the trauma of having cancer quicker. Despite this desire, I knew I had to be cautious because if I truly wanted to return to a “normal life full of regular color appointments, I couldn’t rush it. That meant letting my hair grow untouched for up to eight months before taking the plunge.

Rogério Cavalcante, stylist and owner of The Second Floor Salon tells me he always advises clients to wait six to eight months before using chemical color on regrown hair since chemotherapy makes the scalp and hair more sensitive and fragile. To ensure your hair and scalp are ready for color, most professionals recommend an allergy patch test, where your colorist will apply a small amount of dye behind your ear to see if a reaction occurs within 48 hours.

This is especially important for people who have undergone chemotherapy because many permanent and semi-permanent hair dyes contain paraphenylenediamine or PPD, a chemical known to be an irritant and allergen. It’s a common cause of most reactions, and anyone can have an allergic reaction to it, especially when going brunette or shades of black, as darker dyes contain higher levels of it. Cavalacante also warns against dyes containing bleach and peroxide to avoid unnecessary breakage.  

“To everyone else around me, this was just another day at the salon. To me, it was a real step forward, marking that I was done with cancer and could feel like myself again.”

None of this matters, though, if your scalp isn’t completely healthy. Before chemo, I had experienced outbreaks of redness around my hairline, and chemo brought this back, accompanied by flakes and itchiness. “If you don’t have a healthy scalp, you can’t have healthy hair, says Marisa Garshick, MD, board-certified dermatologist. “Start with a gentle, sulfate-free shampoo and conditioner to keep your hair hydrated, avoid excessive use of heat-styling tools, and opt for air-drying to minimize damage, she says.

Fortunately, my scalp issues didn’t return, and by all accounts, I was a prime candidate to start coloring again. I waited 622 days, to be exact, before I could finally walk into NYC the Team on Fifth Avenue to dye my hair. To everyone else around me, this was just another day at the salon. To me, it was a real step forward, marking that I was done with cancer and could feel like myself again.

To prep for this appointment, I had a haircut three weeks prior and had both the stylist who cut my hair and my colorist sign off on my hair and scalp being strong enough for my service. I was deciding between a glaze and a balayage service. “Glazes are generally non-ammonia and don’t deeply penetrate the hair. It rather just coats and smooths out the cuticle, giving the hair luster and shine, Michelle Hong, colorist and founder of NYC the Team, explained to me. The glaze results typically fade in about eight to 10 washes, so I opted for the balayage with ammonia-free dye and a lower peroxide concentration to keep my hair as healthy as possible post-color. Since my hair handled the color so well, my colorist told me to maintain my current routine and consider adding a hair SPF to protect my fresh color from the sun and a shielding finishing spray to protect it from environmental elements.

I left the salon 90 minutes later, feeling lighter both literally and figuratively. To everyone else, I was just another woman with fresh color and a bouncy blowout to match. To me? It was much more significant.  Nothing about my new hairstyle says ‘former chemo patient. The experience of it all lies within my memories. My hair may not be what it once was, nor am I. However, this version of me is compelled to stop worrying and letting fear call the shots—so before leaving the salon, I made sure to put my next color appointment on the calendar. 

Final thoughts

Walking home with my hair bouncing and catching the light of golden hour was truly surreal. Going through treatment and all the complications left me very anxious. With lymphoma, the chance of relapse is high—so high that I’ll be seeing my doctor regularly for five more years. Many survivors report feeling symptoms they had pre-diagnosed and fearing their cancer would come back.

I can confirm: There’s a real sense of waiting for the other shoe to drop when my throat tingles or my arms aches for too long. However, being able to have an experience—like finally getting that hair color I waited so long for—that silences that fear is something I’ll always seek out and be grateful for. It’s my reminder when I look in the mirror that I’m in recovery and that everything will be okay. 


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