Cheryl Tankersley (right) works with Casey Fajohn at Planet Hair in Henrico County. (Photo by Ash Daniel)
During a family vacation at Lake Gaston in late August, Casey Fajohn and her 4-year-old daughter, Aria, playfully swam. Aria wriggled and splashed in the warm water. At one point her little feet collided with her mom's chest — an accidental kick that led to a dark discovery.
Fajohn noticed a lump and redness on her breast that she thought was bruising from the kick. But two weeks later, the lump remained, so she decided to go in for a mammogram and breast ultrasound in case something was wrong. The tests led to a diagnosis of stage 2 cancer.
“It was the biggest shock ever; I thought I was too young to get cancer,” Fajohn, 34, says. “My first thought was my daughter. She can’t lose her mom.”
The Midlothian resident is receiving chemotherapy and expects to undergo a double mastectomy and radiation. Her prognosis is good, but she still faces the physical and emotional tolls of the potentially lifesaving treatments, including the loss of her hair and breasts.
To regain a sense of self during and after treatment, cancer patients often turn to local stylists for handcrafted wigs and hairpieces and to mastectomy fitters for external breast prostheses and mastectomy bras. Some of the providers also act as informal counselors, helping patients navigate the emotions — and paperwork — of cancer treatment.
Wigs can be covered partly or in full during cancer treatment, depending on the insurance provider. (Photo by Ash Daniel)
Coping With Loss
In November, following her second round of chemo, Fajohn’s hair began to come out in clumps. Chemotherapy attacks rapidly growing cells, including healthy cells in follicles, causing hair loss. It grows back after treatment for most patients, but in a small percentage, patchy hair loss can remain, says Dr. William Irvin Jr., medical director of oncology at Bon Secours Richmond. For people living with and recovering from cancer, hair loss can be devastating.
But Fajohn was prepared. In the days before she began losing hair, she visited Cheryl Tankersley at Planet Hair in Henrico. The family-owned business is one of the region’s leading providers of wigs made from human hair and styled for people experiencing cancer. Tankersley had helped Fajohn’s mother, Cathy Sly, during her battle with breast cancer.
Tankersley opened Planet Hair as a salon in 1997. However, following her own battle with hair loss after a life-threatening infection about 15 years ago, she pivoted to helping other women with the same experience. She now exclusively serves people suffering from hair loss. About 80% of her clients are currently or have been cancer patients; others have alopecia or similar conditions.
Losing hair can be hard for women, in particular, Tankersley says. “It’s like a death to them,” she says, “It’s hard because it’s part of their identity, and people treat you differently when they know you’re sick.”
Planet Hair is part of a network of private businesses, charities, hospital systems and donors that provide high-quality wigs to people who have lost their hair due to cancer treatments. Synthetic and human hair options are available, and both can be cut and colored to suit each client. Human hair wigs are often more realistic and easier to style than synthetic wigs, but they are also more expensive; prices can reach a few thousand dollars for handmade wigs.
Mastectomy fitter Barb Van Tolingen of Pink Ribbon Boutique in Henrico provides a similar service to women who have had breasts removed during treatment. About a third of women choose breast reconstruction after mastectomy, according to a 2024 report in the journal of the American Society of Plastic Surgeons, while the remainder “go flat,” or opt out. The timing for reconstruction can vary based on each patient’s treatment plan, tolerance for additional surgeries, other health conditions, and insurance coverage — and those who “go flat” may want to supplement their new physique — creating a broad audience for external breast prostheses and mastectomy bras.
Van Tolingen owns one of a handful of small businesses in Virginia that provide standard and complex mastectomy fittings. Part of her job is taking images to create custom molds for women who have had more complex surgeries. She also fits garments that comfortably hold surgical drains — tubing used to remove excess fluids from surgical sites — post mastectomy.
“The first time they come in, they’re really scared, and then they have a good cry. You hold a lot of naked women,” Van Tolingen says.
Wig Salon Manager and cosmetologist Mone' Bailey (right) styles a scarf for patient Johnell Smith-Hunt at VCU Massey Comprehensive Cancer Center. (Photo courtesy VCU Massey Comprehensive Cancer Center)
Women Helping Women
Beyond their professional expertise at dealing with hair loss, sensitive surgical sites and the emotions that come with cancer treatment, stylists and mastectomy fitters also help women access affordable services and navigate insurance coverage for prosthetic services.
“They’re physically challenged and [now] they have to fight the insurance companies,” Tankersley says.
Only a few states mandate that insurers provide some degree of annual coverage for people who experience hair loss related to cancer treatment. Virginia isn’t one of these states, according to a review published in the Journal of the American Academy of Dermatology. However, Tankersley estimates that about 75% of insurance companies cover wigs for cancer-related hair loss with a physician letter, and she guides clients through the process of insurance filing.
Under the Women’s Health and Cancer Rights Act, most insurers are required to cover breast prosthesis for women who have undergone a medically necessary mastectomy, but limitations often apply. Van Tolingen has several full-time staff dedicated to communicating with insurers and getting clinical notes from doctors to find out what each client’s insurance will cover.
Businesses also fundraise and offer free services to provide wigs, cosmetology advice, and prosthesis to women and children in need. At least three women a week with limited or no insurance come to Pink Ribbon Boutique, Van Tolingen says. She typically fits them with gently used prosthesis and bras for free. She fears that rising health insurance premiums will increase that need.
Lameisha Weatherspoon, the owner of Bombshell Wigs Galore in Midlothian and a wigmaker who often serves people experiencing cancer-related hair loss, donated her services to restore the confidence of Mila Freeman, a child with hair loss who survived an aggressive form of brain cancer.
Mila’s mother, Kristen Lux, reached out to Freeman after Mila was bullied at school. In October, Weatherspoon quickly launched a grassroots fundraiser to pay for hair and mesh, then donated her time and customized a hair piece for Mila.
“It’s already enough that [Mila] had to deal with getting back to being herself, going back to school,” Weatherspoon says. “Hair is a huge thing in all of our lives and to lose it drastically is devastating.”
Tankersley provides human hair wigs at no charge to any child fighting or recovering from cancer. She receives donations of hair from across the country, which are tied into wig caps by Wigs for Kids and customized by Planet Hair. Four years ago, to fully fund the cost of the children’s wigs, Tankersley opened a second salon where stylists rent space.
Hospital systems also help people experiencing hair loss. Bon Secours aims to reduce or prevent chemotherapy-related hair loss with cool capping. Worn on the head during chemotherapy sessions, cool caps make the scalp extremely cold, narrowing surrounding blood vessels. Blood flow is reduced to hair follicles, which means less chemotherapy reaches the area. The treatment is available free of charge to all Bon Secours’ patients undergoing chemotherapy or radiation treatment.
Virginia Commonwealth University’s Massey Comprehensive Cancer Center provides free wigs and accessories to any Virginia resident experiencing cancer-related hair loss. Massey stylist Kaydreanna “Kay” Jackson colors and styles wigs at the Massey Wig Salon at VCU Medical Center, often helping patients who are receiving treatment while staying in the hospital. The new looks lift patients’ spirits.
“I’m happy to be part of something that aids in the healing, giving people a sense of, I don’t have to look like what I’m going through,” Jackson says. “It puts a big smile on my face. It warms my heart.”
Strength to Fight
During Fajohn’s visit last fall, Tankersley helped her choose a human hair wig, which was then colored at Planet Hair to match Fajohn’s natural hair.
Fajohn’s mother and husband joined her in a private room as Tankersley shaved her head with a size one guard on the clippers, working carefully to avoid nicking her scalp. Protecting the scalp is important because cancer patients often have weakened immune systems, Tankersley says. Fajohn was stoic as her thick locks were buzzed.
“Most guys keep their hair short, but I think women put a lot of identity in their hair,” Fajohn says. “I cried about it this morning a little bit, but I’m trying to look on the bright side. It will grow back.”
But there were laughter and play, too, as Tankersley shaped Fajohn’s hair into a rocker-style mohawk, spray-colored pink, before the final cut. She taught Fajohn how to wear the wig and make it last. No one would know that the meticulously crafted wig wasn’t Fajohn’s own hair.
Tankersley and others bringing a sense of normalcy to cancer patients spoke of their work as both a mission and passion.
“I’m a very strong Christian, and I believe we all have a calling or an assignment,” Tankersley says. “When I went through my own health journey, it opened my eyes to what I can do to help women and children with cancer. That’s my assignment now.”
