In the second interview in a series with Sonya Keshwani, she shares tips and tricks for caring for your scalp and hair during treatment.
Brilliantly: Let’s talk about hair and scalp care during chemo.
Sonya: During treatment your entire body is experiencing stress, and things that worked in the past to maintain your hair and skin health might no longer be a good fit.
Adjusting to the current state of your body, and exploring different products and techniques for self care are important. There are many natural, DIY, home-based remedies that are super helpful and safe.
Brilliantly: What are the things you can do to soothe your skin, or maintain the hair that is going to stay?
Sonya: When your hair starts to fall out, the skin and the hair follicles are going through trauma. Caring for your scalp and keeping it healthy is going to directly impact how healthy and how quickly your hair grows back. I think of it as maintaining the canvas.
Finding natural products and thinking about the seasonality of your needs will help you make a plan. If you’re going through treatment in the fall or winter, you’ll need to keep your scalp moisturized to avoid drying or cracking skin. During spring or summer, you'll need to think about protection from perspiration and giving your skin room to breathe while also avoiding exposure to the sun. It's really important for everyone to wear sunscreen, and especially during chemo when you are even more sensitive to sunlight. Even underneath a head wrap it’s important to put on an SPF moisturizer throughout the year if you plan on going out. Take the same one you use on your face and simply apply it upwards and onto your scalp when you are getting ready.
Brilliantly: Are there other daily changes that you can make?
Sonya: Yes, an easy, fun switch is pillowcases. Silk or satin ones are a gentler material against your hair and skin. The smoother texture will reduce scalp dryness and hair breakage as it starts growing back. Having some pretty, fun sets of pillow cases is uplifting, too. Sleeping in a satin head wrap will also help lock in moisture throughout the night, allowing you to start your days with a healthier feeling scalp.
Brilliantly: If you lose all your hair, should you still shampoo your scalp?
Sonya: Good question. I expected to not have to shampoo, but when I went to the salon to have my hair shaved off, they told me to continue shampooing to clean my scalp. I generally recommend shampooing as little as possible. Aim for once a week with a product that is very gentle, gives you a nice foam, and is fragrance-free. Also, you’ll want to be careful to use water that isn’t too hot. That can irritate and dry out sensitive skin.
Brilliantly: Are there specific shampoos designed for people undergoing chemotherapy?
Sonya: During chemo, using hair products that are sulfate, paraben and fragrance free is ideal. A baby shampoo + body wash combo product, an oil based face + body cleanser, or an organic or vegan product works great for gentle care. I know we tend to think those products are more expensive, but with the recent explosion of the organic beauty space, there are many options to choose from in a range of costs. Also, remember, now that you are shampooing about once a week, your products will last a very long time.
If you are finding that shampoo is irritating to your scalp, you can try putting a layer of oil, like coconut oil, on your scalp first. Just rub a small amount gently on your scalp and then use shampoo. That way, the coconut oil will work as a cleanser for surface level dirt, while also protecting the natural oils and moisture of your scalp that the shampoo would otherwise strip away.
If you don’t want to use shampoo at all, coconut oil is still a good way to clean your scalp. It's anti-inflammatory, very hydrating and won’t clog your pores, so you can use it without fear of it causing other skin problems. You can try putting a little bit on your palms, and just massaging it back into your scalp, then wiping it off with a warm washcloth.
It's a pretty versatile product. I even use it for makeup remover! I put coconut oil on my face and massage the makeup off before wiping my face with warm washcloth. Going through chemo really convinced me of the benefits of leaning on natural beauty solutions.
Brilliantly: Separate from shampoo and coconut oil, are there other products you’d suggest trying out?
Sonya: Argan oil can also be good. Some people prefer the scent of argan oil. It's not greasy, and can be used in the same way.
Castor oil is really good for your skin as well. It's just very thick. I would not recommend it for your face, but it is really wonderful for hair. It seals in and nourishes any area where you wanna grow hair. I’d mix it with an equal part coconut oil so it’s a little bit smooth and liquidy, and easier to spread. Then you can give yourself a little massage every time you get out of the shower, to get blood flowing to that skin and keep it nice and healthy.
You can even use castor oil to support eyebrow and eyelash regrowth. The one I use comes with several different applicators, including a mascara type brush and bottle, to make daily use very easy. I keep it in my little stand in the bathroom and use it as part of my nightly routine.
Brilliantly: What about hair loss on other areas of the body?
Sonya: One area that might prove challenging is your nostrils. Chemo drugs have the effect of drying out and dehydrating our body. This combined with hair loss can mean extremely dry, cracking and painful skin inside your nostrils.
A very simple and comforting solution for me was regularly clearing my nostrils of dust and other particles with saline spray, and moisturizing them with petroleum jelly. I would dab a tiny amount of petroleum jelly onto a Q-tip and coat the inside of my nostrils throughout the day. I recommend this petroleum jelly because of its organic ingredients and hygienic packaging. I like this saline spray because it is non-habit forming and can be used as often as needed.
Brilliantly: Having a routine is helpful. For women who are wearing wigs, are there special things they should be doing?
Sonya: It’s important to know that wigs won't stop your hair from growing back. But you want to respond to how your skin is reacting to wearing a wig. If you wear a wig during the day, when you’re home relaxing you should take off the wig and give your skin as much time to breathe as possible. Giving your scalp regular massages will help too.
I wanted to stop wearing a wig as soon as possible, but I still kept covered with head wraps for a long time because it's tough going out with patchy hair that's growing back, or hair that's almost like a buzz cut.
On my birthday in 2018 I wanted to be done covering up my head and just go out with nothing. I felt a big difference when I allowed my hair to breathe a little bit more. It helped me find some peace.
Brilliantly: What about at night. Do you suggest people sleep in a head wrap?
Sonya: First and foremost you need to be comfortable. Even in the summer, which is when I lost my hair, I was still very cold. I would sleep with a head wrap on, because I couldn't catch any sleep without something on my head.
If you're feeling cold, keeping your head covered will make a big difference in your comfort. I would recommend a head wrap that has a very soft or satiny fabric, that can stretch to fit while at the same time be snug.
Brilliantly: The last question is about food, and if there are things you should eat to encourage healthy hair and skin.
Sonya: I think a lot of us become extra health-conscious around the time of diagnosis. I think by the time you go through this, you become an expert on the diet and nutrition plan that works best for you. I like the idea of eating the rainbow! Here are my top ten recommendations:
It’s mostly balancing having a good amount of protein, vitamins and omega fatty acids. I think eggs are a really good go-to, because during chemo, you know, you don't necessarily have the time or the energy to do much more than the basics. And eggs are very good for your hair, because of the nutrients in the yolk, and the overall protein content.
While protein is critical as a building block for hair growth, you want to also remember foods that benefit your hair health once it starts to grow back. Although many people take biotin supplements, myself included, I like to make sure I am still getting biotin in my diet to keep my new hair strong. Alongside a daily 10,000 mcg dose of biotin, I make sure to get loads of almonds, eggs and mushrooms in my diet. While you can certainly go ahead and incorporate healthy foods into your meals, please consult with your doctor before taking supplements.
In addition to regular scalp massages, eating foods rich in nutrients like vitamin C, vitamin B5 and iron, will help maintain healthy blood flow to the scalp and prevent hair thinning and breakage. My staples for this are dark leafy greens, lentils and sweet potatoes, because they are delicious and easy to prepare!
Brows and lashes are also an important part of our hair journey that can benefit from the right diet. Zinc-loaded foods like nuts, legumes, shellfish and whole grains will keep your brows and lashes healthy overtime.
Lastly, I recommend boosting your intake of foods that are rich in omega-3 fatty acids. The healthy fats from foods like fish, walnuts and flax seeds will help grow fuller, and shinier hair overall. Brilliantly: Having simple, healthy things that don’t take a lot of effort to prepare is important.
Sonya: Exactly. It’s all about setting your intention and taking small steps to live well. Mainly it’s important to realize that when you live well for your hair, you are living well for your entire body, and vice versa.
Brilliantly: Thank you for that. With these tips, we can definitely practice hair care in a way that is fruitful during treatment and beyond.
This dialogue belongs to a three part series. Read What No One Tells You About Hair Loss Part 1: Before Treatment, here.