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For many people the reality of cancer sets in when chemotherapy causes them to lose their hair, often all at once. Some people hide cancer under a wig, and some people wear hair replacements as a symbol of defiance of the disease.

Many oncologists tend to overlook hair loss as consequence of cancer treatment. "Plan to use your energy fighting cancer rather than worrying about how you look," a pamphlet from the Mayo Clinic advises. But if you have cancer, managing your appearance well can be not just a significant morale booster, but an important part of how you fight the disease.

F--- You, Cancer!

Pat Painter, the doyenne of hair replacement for cancer patients in Austin, Texas for many years, developed her reputation by maintaining a comprehensive line of wigs for chemotherapy patients available at very reasonable prices. Some of her customers, however, arrive not quite ready to put on a wig, but they are ready for a ball cap. Her best seller? A pink baseball cap with the slogan "F--- Cancer."When new cancer patients grow tired of the cap, they usually try out a wig.

Why Get a Wig If You Lose Your Hair to Chemo?

It's easy to overanalyze motivations for obtaining hair replacement when hair is lost to chemotherapy.

Some people who have never had the disease suggest that wigs and makeup are just a way of denying the reality of cancer.

That's ridiculous. Cancer isn't a disease you can ignore. The pain of the disease, the discomfort of the treatment, and the reality of death are constant. No amount of dressing up will allow you to hide yourself from cancer.

Some especially annoying self-proclaimed experts on the cancer experience suggest that wearing a wig is a refusal of solidarity with other people who have cancer. Showing the mutilations of cancer to the world, these misguided people contend, tells people that you want research for a cure. While you may in fact want research, and just about everyone wants a cure, it hardly seems necessary to show your literal scars to the world to say so.

One of the reasons people get wigs and pay special attention to makeup when they are getting cancer treatment is that they don't want to be instantly identified as cancer patients in every social situation. They want to hold on to the identities they had before cancer. They don't want to give up their lives and their selves to the disease.

But Can't You Prevent Hair Loss from Chemotherapy?

There are two methods that may prevent hair loss during chemotherapy. One approach is to wrap the scalp with an ice pack while receiving the drugs. 

The ice reduces circulation to the scalp, the scalp receives less of the drug, and fewer hair follicles die.

This method is not entirely unsuccessful. It may not totally prevent hair loss, although it usually reduces it. The problem with reducing circulation to the scalp to preserve hair follicles is that if cancer cells have circulated to the scalp, they are more likely to form tumors there.

The other method commonly used to prevent hair loss from chemotherapy is treating the scalp with Minoxidil (Rogaine). This is an over the counter medication used to prevent hormone-related hair loss in both men and women. It usually doesn't stop hair loss from chemo, but it may help hair come back faster.

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