Before treatment for a blood cancer or a hematopoietic stem cell transplant, the conditioning chemotherapy usually causes hair to fall out. For this reason, many people choose to shave their head before it starts coming out in clumps. Waking up to hair scattered across the pillow and clothes each day can feel harder than deciding on your own timing and taking control of the moment.
Even so, feeling frightened or sad as the day approaches is entirely natural. Hair has been part of how you have seen yourself for many years. If you had surgery on your head as a child and carry a scar on your scalp, or if you feel self-conscious about the shape of your head, it is understandable to worry that shaving will suddenly reveal what your hair once covered.
In practice, a scar or head shape is often far less noticeable than people fear. Older surgical scars usually settle to a color close to the surrounding scalp, and they are easily hidden by a hat, a scarf, or a wig. If a bare scalp makes you uneasy, keeping a soft indoor beanie or a cotton head wrap on hand can make home feel more comfortable.
It also helps to know how to shave safely. During a transplant or chemotherapy there are periods when the platelet count drops, so a nick from a sharp razor may bleed more than usual or raise the risk of infection. For this reason, electric clippers — whose blade does not touch the skin directly — are generally recommended for trimming close. When to shave, and whether your counts are safe right now, are best decided together with your care team.
Caring for the scalp afterward matters. The scalp is skin too, so it dries easily and is sensitive to sun. Apply a gentle moisturizer in a thin layer, and protect your head with a hat or sun protection when you go out. If the feeling of your scalp rubbing against the pillow bothers you at night, a soft sleep cap can help.
If you plan to use a wig, arranging it before your hair falls out makes it easier to match your original color and style. There are many options — human hair, synthetic hair, breathable cap styles — so it is worth trying them on before choosing. On days a wig feels stuffy, you can alternate with a scarf or hat, and it is perfectly fine to wear nothing and simply rest at home.
Above all, hair usually grows back once treatment is over. The first regrowth may feel a little different in texture, but it settles with time. When your heart wavers before shaving, it can help to hear from others who have walked the same path, or to talk openly with your family. Simply naming a worry out loud can lighten it.
This article is for general information and does not replace individual medical care. Please discuss the timing of shaving, scalp and wound care, and anything related to your blood counts with your own care team.