Gallagher agrees that privacy is a top priority. "People with cancer can choose whom to tell about their diagnosis, but hair loss makes that information very public. Look for a wig shop that accepts private consultations or has concealed areas where clients will not feel they are on display," she says.
Dorsey admits that her doctors didn't give much attention to her hair loss. "It's just not a big deal to them; it's the mouth sores, dry mouth, and horrible gas pains they worry about." Dorsey turned to support groups, wig shops, cancer books, and chat rooms on the Internet for information.
According to Gallagher, getting a wig that works is an important step for many people with hair loss, but some need much more guidance. "Nurses can provide support and guidance about the sensations and experiences of hair loss," she says.
"Patients can usually predict how they will react to hair loss. Some view it as a minor annoyance; others see it as the worst part of the chemotherapy treatment. After listening to those concerns, a nurse can help create a plan of action with the patient." Gallagher reports that patients also appreciate hearing direct advice from their nurse or doctor--knowing when the hair is expected to fall out, how much, and practical tips on how to deal with it. "One of my patients reported that when she started losing hair, it would fall into her food or onto her pillow at night, leaving hair in her mouth. We found that wearing a turban to catch the hair during those times helped prevent feelings of resentment that surfaced. Nurses can offer small but real details like these."
Dorsey was often frustrated by how strangers reacted to her appearance. "I remember the first time I wore a turban and walked into a bakery--I scared the hell out of this woman. She looked at me with an expression that said 'cancer has just walked in.' I understood, though, because I used to be terrified of cancer too. Even in hospitals, if a friend and I walked down the hall wearing turbans, people would give us funny looks."
Nicholas shares a tip he learned from a client, "Wearing a scarf over a bald head looks unnatural because the scarf is too close to the scalp. Creating layers such as wearing two scarves or a scarf under a hat simulates the bulk of hair."
Dorsey felt pressured to wear her wig in certain settings, such as in front of strangers and children. "When you wear a wig, you're pretty much invisible. But wigs can get hot and uncomfortable." She and Libby Levinson, a woman in her support group, eventually tired of worrying about people's reactions and opted to wear scarves under baseball hats with various logos, dubbing it 'Chemo Chic.'
Hair is a protective shield for the scalp from sun, extreme temperatures, and other harsh elements. Both Gallagher and Nicholas recommend gentle hydrating scalp care--using a mild facial cleanser instead of shampoo, a daily moisturizer with an SPF of 15 or higher, and drinking adequate fluids (6-8 glasses of non-alcoholic, non-caffeinated beverages daily).
The American Cancer Society sponsors a community-based, free national program for women with cancer called "Look Good... Feel Better." These workshops are offered in cancer centers, hospitals, and other community settings across the country. Teams of trained beauty professionals teach skin care, makeup, hair and nails, and the use of wigs, hats, turbans and scarves. For more information, visit the American Cancer Society web site or call 1-800-395-LOOK to find programs in your area.
Now that Debbie Dorsey's hair has completely grown back, she sports a short, stylish cut. Reflecting on the experience she says, "I never really accepted or felt comfortable with the hair loss. But I learned that being bald didn't rob my femininity."
Gallagher says that she doesn't know if her patients overcome their feelings through the hair loss experience, but they eventually feel that they are managing it. "That's what I'm aiming for. If a person says "Oh everything's fine, I'll be fine,' I get nervous. That overly bright persona tends to be more fragile than someone who has natural ups and downs."
Dorsey's message to readers is for people to learn and talk about cancer and cancer prevention. "Until they can find a cure for cancer, we need to stop fearing it and take a proactive role by getting yearly screenings." Dorsey was featured in a recent PBS documentary titled "No Hair Day," which follows the making of a photography exhibit and the experiences of Dorsey and two other women undergoing chemotherapy.