Hair loss has been ranked as a source of considerable distress and may add to the losses associated with the experience of cancer. Chemotherapy-induced hair loss (alopecia) is a public consequence of the non-selective action of specific antineoplastic agents on healthy tissue. The literature demonstrates a lack of research on hair loss. Nursing studies have focused on efforts to prevent hair loss or measure the impact of hair loss using body-image instruments. The purpose of this study was the detailed examination of the meanings of hair loss over time in a sample of women receiving alopecia-inducing cancer chemotherapy. A qualitative descriptive design using a semi-structured multiple interview format examined the meaning of hair loss over time. A purposive sample of ten women receiving alopecia-inducing chemotherapeutic agents at a metropolitan teaching hospital was used. Each woman was interviewed prior to hair loss, at the time of hair loss, and two-three months after initial hair loss. The specific research questions described the meanings of hair loss in the lives of women receiving alopecia-inducing agents. Supporting questions explored the status of hair loss among sources of cancer-related distress, the role of past experiences and expectations, and the role of other people and social demands on the experiences. Data analysis was based upon the words, metaphors, and language patterns used by participants in describing their feelings and experiences. Findings reflect the meaning and real substantive losses associated with both the threat and actual hair loss. Symptom responses are shaped by personal history, experiences as well as meanings of cancer images and one's hair. Analysis of the findings reflect three processes: affective anticipation rehearsal, confrontation of the hair losses, and management of the hair loss experience. The coping outcomes may be positive, regaining one's stride, or negative, not regaining one's stride. The findings are congruent with a number of theoretical frameworks, such as Lazarus, Benner, Mishel and Wright. The findings support both the significance of hair loss and its amenability to nursing treatment approaches. Nurses have the opportunity to explore the meanings of hair loss with an individual and to lessen the distress associated with the threat and actual impact of that experience.