These days, a lot of balding men shave their heads instead of going for a comb-over, and they wear their hairless pates proudly.
But when women lose their hair—due to chemotherapy, an illness or a congenital condition like alopecia—children stare and adults tend to look away and murmur something sympathetic. In response to hair loss, some women choose wigs, others opt for scarves, and a few take a cue from the men and rock the bald look.
"A lot of women do [go bald], and I admire them for doing it," said Diane Boyd of Buhl, Idaho, who has had cancer four times, each time losing her hair during chemotherapy. After her most recent bout with the disease, her hair didn't grow back. "That was quite disappointing that it didn't. It's just not the same as having your own hair."
Boyd usually wears wigs that match her youthful tresses, an investment she made early on.
"One thing I did do from the very beginning is I made a decision that I would get good wigs and I wouldn't worry about what they cost," she said.
Wigs are often not comfortable—they get overly warm in the summer, for example—but they do have an advantage, Boyd said. "Those rainy days when your hair is droopy and hanging down? My hair looks the same as it did when I walked out the door!"
For Boyd, getting on with her treatment and her life was important, her hair not as much: "It was just not something that I had a lot of time to worry about."
For others, hair loss is more traumatic.
"It's bad enough to have a scary disease that you're not sure you're going to get cured from, and taking a bunch of drugs that make you feel lousy, but you're walking around not feeling like yourself," said Sandy White of Heyburn, Idaho, an oncology nurse who has had cancer herself. "It makes you feel like an alien."
As her hair was falling out, she said, her head physically hurt. And once the hair was gone, it was strange how cold her head felt.
White said she welcomed sympathetic comments from friends and acquaintances, but she hated it when people tried to dismiss her grief and anxiety by telling her not to worry, that her hair would grow back. "That's not what you want to hear," she said.
But for some women, there never was much hair to begin with.
A Life Without Hair
When Krista Gehrke of Bellevue, Idaho, was 18 months old, all her hair fell out—eyebrows, eyelashes, everything. Many doctors three decades ago didn't know much about alopecia, so it took a specialist in Boise to diagnose Gehrke with the condition. As she grew up, some of her hair came in, but she remained self-conscious.
"By fifth grade you're talking about boys and your looks are coming more into play," she said, describing how she hid her condition from her friends by styling her hair in specific ways. "Getting ready in the mirror in the morning every morning was always a struggle."
Pregnancy changed the hormones in Gehrke's body, thickening her hair, but when she stopped breastfeeding, it all fell out.
"I had five strands of hair left. I was wearing a scarf, and went, 'Wait, what am I going to do, wear a scarf the rest of my life?"' she said. So she took a razor to her scalp. "I looked in the mirror and cried for about 10 minutes and then I felt free. I had so much attached to the vanity of it, to what I looked like, that once I let go, I was free of all that worry, what I looked like, what somebody else thought of me."
Random people would come up and hug her or offer her prayers, assuming she was undergoing chemotherapy, and she was regularly confused with another woman in the Wood River Valley who eventually died of cancer.
Gehrke said it wasn't easy to overcome the social associations between women and long, flowing hair—children sometimes ask if she's a man, because she's bald—but she is pleased that people today tend to be more accepting of people in all shapes, sizes and appearances.
And being bald has helped her teach her son, who was born without an anklebone, that everyone has something different about them.
Many women, however, especially those who are bald temporarily, don't want to look different.
"You know how you feel when you have a bad hair day, you don't feel quite right. [When you're bald] you think people are looking at you and whispering about you," said Vicky Probasco, a nurse at the Mountain States Tumor Institute at St. Luke's Magic Valley Medical Center who coordinates monthly classes to teach women how to tie scarves, adjust their makeup routines and style wigs.
Mark Lopshire, director of the Institute, said offering education in advance of treatment about hair loss and other side effects can help ease women's minds.
"What you have to consider is, where's your support group? Do you have somebody telling you your hair doesn't matter, it's your health that's what matters," he said. However, he said, it's important to acknowledge how hair can be representative of personality, especially for women. "We're emotionally connected to how our hair looks."
Whether women choose a wig, scarves or nothing at all, what all of the interviewees emphasized is that appearances are just that, and it's what is inside that matters.
"It took me 24 years to learn that," Gehrke said. "I'm really thankful I got to go through all that and learn this lesson in life and be OK with it."