Confined to a hospital room, 15-year-old Vinesha Ramasamy’s body was responding to her first round of chemotherapy.
The Ontario teen had recently been diagnosed with bone cancer and the treatment had made her so sick that she hadn’t left her reclining bed in nearly a month. Her hair, once thick and curly, had thinned and knotted.
Nurses gently combed through Ramasamy’s dark hair, trying to salvage what they could. They spent hours taking out the tangles, and eventually told her and her mom the best thing to do was to shave it down.
“When I saw myself in the mirror, that’s when I started to see, ‘Oh, I’m actually sick,'” Ramasamy said.
“My dad had come to the hospital that evening, and when he saw me, I saw on his face it hit him, too.”
Dealing with hair loss
Between endless doctor’s appointments and chemotherapy or radiation, dealing with cancer can be an incredibly overwhelming experience both physically and emotionally.
Hair loss adds a layer to an already tough situation for patients, says Dr. Norma D’Agostino, a psychologist at Toronto’s Princess Margaret Cancer Centre.
“When their hair actually starts to fall out, it makes the reality of the situation sink in for people on a personal level. There tends to be like that moment of, ‘Oh my God, I’m a cancer patient,'” D’Agostino said.
“It also identifies them out into the world as a sick person rather than a healthy person, which makes them feel like their identity is now changing in the public and social realm.”
The Canadian Cancer Society points out that this experience can be distressing for patients. Not only are there emotional effects, patients also need to think about protecting their scalps from the elements, including the sun.
Chemotherapy drugs damage hair follicles, making hair fall out, explains the American Cancer society. This varies from person to person, but within a few weeks of starting chemo, a patient may lose some or all of their hair.
Hair loss can be gradual or sudden. It may start falling out in clumps, or become loose when brushing. Chemo can also cause hair loss on other parts of the body, including eyebrows and eyelashes.
Hair typically starts to grow back before chemotherapy treatment ends, or very soon afterwards, the Canadian Cancer Society adds.
For Ramasamy, losing her hair signalled to the outside world that she was sick. Culturally, she said this was challenging because her family was used to being private.
Going from having long hair to suddenly wearing scarves over her scalp was hard.
“For a long time, my parents didn’t tell anyone besides our very close aunts, uncles and immediate family that it was cancer because people talk about it rather than talk to you,” she said.
“It took a long time for even me to be able to share my story comfortably.”
Support for hair loss
Danielle Lozia, the owner of Unionville, Ont.-based Hair Care by Danielle, helps people living with cancer find wigs.
Lozia, who worked as a hairdresser for 20 years, says hair loss is an emotional time for many. People often feel overwhelmed by their diagnosis and don’t know where to start when it comes to their hair.
READ MORE: What it’s like to get cancer as a parent
Lozia says she walks patients through the process of finding a wig or hair topper based on the amount of hair they’ve lost and the type of treatment they’re undergoing.
Hairpieces can help boost patients’ self-esteem, she says, which is something that often takes a hit during chemo. Hair loss can make people feel self-conscious and unattractive.
“Our hair means so much to us. When our hair is done, it makes us feel really confident and secure,” Lozia said.
“I try to bring a part of themselves back during this whole process [and say], ‘You’re not losing who you are.'”
For teen cancer patients, D’Agostino says hair loss can be traumatic. During this developmental time, teens are coming to terms with their bodies and identities. Losing your hair can negatively affect self-perception.
Wigs can help ease this transition, D’Agostino says, but everybody’s comfort level is different.
“For some people, that’s their security blanket and helps them feel most comfortable,” she said. “But there are other people who absolutely hate wigs because they’re uncomfortable and itchy and too hot.”
On top of wigs, the Canadian Cancer Society suggests that for people who are sensitive about their hair loss, a scarf or hat can be a form of protection. The society also urges patients to check with their provincial and private health insurance to see if wig or toupee purchases are covered.
Ramasamy’s parents didn’t have private benefits that covered wigs, so her only option was a free one provided by a service.
“There wasn’t many ones that suited my colouring or my hair colour, so we just had to pick one that had black hair,” she said. “It was long, straight hair and it didn’t really look like me at all.”
After wearing the wig several times, Ramasamy decided she felt most comfortable wearing a scarf instead. The wig felt hot and also didn’t resemble her natural hair.
Growing back hair
Two years after Ramasamy’s cancer diagnosis, the then-17-year-old was staring at her head in her long bathroom mirror on a chilly Sunday night.
Standing in front of the sink, she closely examined her scalp, inspecting the way it looked from different angles.
She had recently finished chemotherapy, and her hair was slowly growing in. It was short and frizzy, unlike her natural thick and curly locks, but it was something.
At school, Ramasamy had been covering her head with bandanas, folded and tied securely in place. But time had passed, her mom said, and her hair was long enough now. She didn’t need them anymore.
On Monday morning, the teen came to school early. She sat at her desk, head down in her books, making no eye contact with the students fluttering in.
A high-energy girl sat at the desk next to her and began chatting. She looked at Ramasamy and made a remark that would change her life.
“She was like, ‘Wow, you look so cool! You look like G.I. Jane,'” Ramasamy recalled.
“I didn’t really know what to say in that moment, but for the first time in a couple of years, I didn’t feel like a boy but like a strong female, which is so different than my culture and any of my thought processes up to then.”
Without missing a beat, the girl continued chatting with Ramasamy about her weekend and math homework.
“I remember going home and I googled ‘G.I. Jane’ and looked at all these pictures,” she said.
“And then I went and looked in the mirror and I was like, ‘Wow, someone sees that in me? That’s so cool.'”
Ramasamy now works in finance and volunteers with various organizations including Canadian Blood Services, Childhood Cancer Survivor Canada and the Terry Fox Foundation as a mentor and speaker.
She lives outside Toronto.