Several chemotherapy treatment options are available for breast cancer, each with unique possible side effects. If you’ve been diagnosed with HER2-positive breast cancer, your oncology team may recommend a targeted therapy called TCHP — a combination of four chemotherapy drugs. This regimen can effectively disrupt the growth of cancer cells — but can also cause side effects including alopecia (hair loss).

“I’m now about four months from my last infusion of the TCP and was just told yesterday that my hair looks like a (very) short haircut rather than chemo grow out,” one MyBCTeam member wrote.

Other members have said they lost their hair during treatment, only to regrow it after treatment ended. Here’s what they had to say about the experiences and what you might expect before undergoing TCHP.

What Is TCHP?

“TCHP” stands for the four medications that make up the regimen:

• T — Taxotere, a brand name formulation of docetaxel
• C — Carboplatin, a medication sold under the brand name Paraplatin
• H — Herceptin, a formulation of trastuzumab
• P — Perjeta, a formulation of pertuzumab

The combined effects of the four powerful medications in TCHP aggressively target cancer cells, disrupting their growth. Most people need several cycles of TCHP, so the total treatment time can take five to six months.

Because hair loss is common with this regimen, your oncologist may suggest protective measures to reduce this effect. One technique is called scalp cooling, which entails wearing a cooling cap or applying ice packs to your scalp before, during, and after a chemo treatment.

How Long Until Hair Starts To Fall Out?

MyBCTeam members have shared a range of time frames between when they began TCHP therapy and when they experienced hair loss, but two weeks is the most common. “It took two weeks for my hair to start to fall out. So I buzzed it short,” one member wrote. “Then even that was falling out, so my husband shaved my head.”

Another said, “I lost mine 15 days after my first infusion.”

Most people begin losing hair within the first two to three weeks of starting TCHP. “I was told 14 days from my first infusion, and that was right on the dot,” shared a MyBCTeam member.

You may also notice scalp tenderness with treatment, so it’s important to protect your scalp from the sun and cold weather. Wearing hats, scarves, or wigs and using moisturizing lotion and sunscreen can help reduce itchiness and the effects of exposure to the elements.

Should You Cut Your Hair Before Treatment?

Because hair loss is such a common side effect of TCHP, you may wonder if you should just go ahead and cut or shave your hair before starting treatment. “I cut 12 inches off after my first round,” shared a MyBCTeam member. “About three to four days after the second round, I shaved my head (not to the skin but left like a quarter inch or so). I probably could have kept my hair for a few more days, but it was starting to fall out, and that was upsetting me. Once it was gone, I wasn’t waiting on it to fall out and just felt relieved.”

There’s no right or wrong choice in getting a haircut before treatment. You can wait to see how your hair responds, or you can take the plunge in advance. Most MyBCTeam members reported cutting their hair after they noticed some loss to reduce the number of long strands that needed to be cleaned up around the house. “I went short, then shaved. It was just easier than dealing with hair everywhere!” explained one member.

Where Will You Lose Hair?

TCHP may affect hair anywhere on your body. However, everyone’s response is different, so you might be surprised by how it affects your hair. “I cut my hair before chemo even started,” said a MyBCTeam member. “My son shaved the rest of it after the second round because it was falling out everywhere. I never lost my eyebrows, eyelashes, or armpit hair.”

How Will You Feel After Hair Loss?

Perhaps the biggest concern is how losing your hair may affect your self-image. If you have long hair or a signature hairstyle, it’s normal to feel disappointed or upset about your hair loss. Because hair loss with TCHP can be a reminder of your breast cancer diagnosis, you may feel less like yourself.

Nonetheless, most MyBCTeam members reported overall positive outlooks about hair loss with TCHP, especially when reflecting on the experience. Here’s what they had to say:

• “Now, a year later, I am loving my super short hair. I used to love my long hair. Change is good!”
• “My hubby and daughter helped me shave my head, and it was not as awful as I thought it would be. I got a henna crown four and a half months later, and it was truly liberating!”
• “It’s been six weeks. No new hair growth yet. I had long, curly white hair, now just stubble. I never realized how hot hair was. I think I look pretty good without hair. Been rockin’ some pretty fancy hats, too!”
• “I had my first proper haircut a month ago. My hair is now like it was before the chemo. It is a joy to be back to normal. It took 19 months.”

Your timeline for hair regrowth may be different from that of others, but connecting with a support group of people who can relate can make all the difference on your journey with chemo. If you’re struggling to adjust to the challenging side effects of chemotherapy drugs, follow up with your care team for resources to help you look and feel your best.

Talk With Others Who Understand

On MyBCTeam, the social network for people with breast cancer and their loved ones, more than 64,000 members come together to ask questions, give advice, and share their tips with others who understand life with breast cancer.

Did you experience hair loss with TCHP chemotherapy or other chemotherapy regimens? If you tried cold caps or other strategies from your oncologist, how did they affect your breast cancer treatment side effects? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.