Four years ago, Stephanie Bollinger gathered her husband and three children in the cozy, retro-inspired salon in the basement of their Lititz home and proceeded to have them shave her head.

There were tears and there were laughs, and at the end of the cut, all that remained of Bollinger's once-thick, straight brown hair were the few wisps lying at the base of her swiveling chair. Nearly two decades spent styling hair hadn't prepared her for the emotional roller coaster of losing her own locks to chemotherapy, or for the personal and professional changes that would come with her recovery from breast cancer.

Today, Bollinger is a not only a cosmetologist but a wig expert who caters to clients-she refers to them as patients-who suffer hair loss thanks to the "C word."

"Each person who comes in here is hard for me because it is a reminder that I had cancer," said Bollinger, owner of Classic Images. "You have to be able to sympathize. In that way, I can relate with them in a way a lot of people can't."

Bollinger is both a resource and a cheerleader, one who helps women deal with the loss of identity that accompanies cancer-related alopecia. She admits the job has its sad moments, but she also believes she provides clients with an empowering experience at a time when cancer leaves them so little they can control.

While women once hid the fact that they were bald due to illness, local stylists and medical professionals say modern patients are often frank about their condition. Many are ready and willing to talk about it or even reveal it in some public situations.

"We use the term 'out of the closet,' " said Kelly Edwards, who runs the American Cancer Society's Look Good, Feel Better program at Ephrata Community Hospital. "So many women have neighbors or family members or friends or friends-of-friends who have had cancer. There's no shame anymore. In fact, some of our programs are not as busy as they used to be when cancer was more secretive."

Facing less stigma, women are ready to put a new own spin on their appearance during treatment, whether that means donning a red wig or asking for a funky pixie cut and dye job once their hair starts to grow back.

Embracing the baldness

Meredith Jorgensen, a Lancaster County reporter and Saturday morning anchor for WGAL, has spent most of her professional life in the spotlight. So when she was diagnosed with a recurrence of gestational trophoblastic disease earlier this year — and told that a potent cycle of chemotherapy would almost certainly rob her of her hair — the emotions ran high.

In February, Jorgensen, 32, thought she might be pregnant, but instead found out cells that normally develop into a placenta had grown into a tumor. Jorgensen hadn't lost her hair or needed to leave work for an extended period during her initial treatments following the same diagnosis in 2008.

This time, the cancer had metastasized to her lungs. It would take more than a couple rounds of a single drug to keep her on her feet and in the studio. Learning that she would now go bald as she fought for her life was devastating.

"In the beginning, it was very, very important," said Jorgensen. "It's TV. We have consultants who come in and tell us how we should look, what to wear. … I lost it. I just knew I was going to feel more sick because I was going to lose my hair."

Her response was to create a plan of attack, much as she'd done in finding the most reliable information about her rare form of cancer and tracking down a top specialist who could monitor her case from Boston.

She'd kept her blond hair short to look more mature on-air, but now it was longer than it had been in years. So while she was still filing stories for WGAL and appearing regularly on camera, she had her stylist take the length from two feet to practically none in a series of four haircuts.

Then, 17 days after her chemo treatments began, Jorgensen asked husband Chris Cooke to shave her head in the privacy of their bathroom.

"I didn't know what it would look like. I didn't know if I would cry the whole time," she said, In the end, she tried to put on a brave face as they listened to music and used a pair of drug-store clippers and Cooke's best razor to remove the last remnants of her hair over 45 minutes.

Still undergoing treatment, Jorgensen said she often grocery shops with nothing on her head but a baseball cap, but she opts to wear one of three new wigs when in a more professional setting or around her young nieces or nephews.

She's not embarrassed by her baldness but wants others to feel comfortable around her. While she waits for her hair to return in a few months — she's expecting it will come back either curly, darker or both — she sometimes appreciates the ease of being hairless.

"It's a good lesson in empathy," she said.

Mirror, mirror

Bollinger, who fitted Jorgensen for her hairpieces, has witnessed her share of emotional reactions since a client talked her into starting the wig service about three years ago. Many clients purchase a wig from her before their chemotherapy actually begins then come back when tufts of hair begin to fall out regularly. (RELATED: Choosing the right wig)

Some women bring their best friends for support and "make a party of it," Bollinger said. Some grandmothers bring their grandchildren; other women bring their sisters. Some of the most trying days are when husbands accompany their wives to her salon.

"I've had a lot of men cry," she said. "It's a truly genuine reaction. They tear up because they want to take that (pain) away from their wives."

But Bollinger sees the head shave as the beginning of an uphill climb. Once they've faced their mortality and the loss of their hair, it becomes easier for some women to start looking up again. One tip she gives her clients: when looking into the mirror, try to focus on the face instead of the top of the head and the hair loss.

"It's your eyes that determine if you're happy or sad or angry," she said. "And you know, some women have beautiful heads. We don't look as silly as we think we will."

According to breastcancer.org, hair loss occurs during chemotherapy because the drugs target all rapidly dividing cells. Hair follicles are some of the fastest-growing, dividing every 23 to 72 hours in healthy people. They are an easy target for many classes of cancer-treating drugs, though not all patients will suffer complete hair loss.

For those who need an extra boost to face very visible physical changes, there are plenty of resources. Whether they want a makeover, a new wig or a chance to connect with others facing the same challenges, women can find a program that offers the right level of comfort.

Cate Gordon, manager and stylist of Country Hair Studio in Denver, volunteers monthly with the American Cancer Society to give expert hair and beauty advice to women undergoing chemo or radiation. Look Good, Feel Better offers expertise and hundreds of dollars worth of free, high-end beauty products, while a studio at the society's Good Drive location provides free wigs and scarves to patients referred by their doctors.

"These programs help them be proactive," said Gordon. "A woman can feel like a woman and not just someone who is sick."

In addition to losing their hair, many cancer patients lose their eyebrows and eyelashes, suffer from dry skin and become pale or withdrawn. Licensed professionals can help them regain confidence or even inspire new looks.

"Some people want to look as much like themselves as possible," Gordon said. "Others run with it."

They may maintain a change once their hair grows back in three to six months. After a stage when Bollinger describes new growth as thin and "bunny soft," it becomes clear whether the texture or color will change. Common post-chemo changes include kinky curls or an ashy color.

Some of Bollinger's clients want to celebrate their returning vitality with a style that matches. She works with them to create something suitable, though she refrains from coloring anyone's hair until they have the all-clear from an oncologist.

Getting back to "normal" is an exhilarating part of the recovery process, one that women can navigate with more ease and comfort than ever before.

"Whether they're 20 and going through this for the first time or 70 and going through it for the third time," said Gordon, "they just want to feel normal in the eyes of society and their families."

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