We all have our vanities. “PCP, CMV, fungal and staph infections, bacterial pneumonia—I’ve survived each with style,” says Kenneth Hill, a Washington, DC, PWA. “But watching handfuls of my hair fall out in the shower every morning—that’s the one that broke me.”

Hair loss can break the hearts of HIVers. Some AIDS-related conditions—including such treatables as seborrhea, folliculitis, hypothyroidism, syphilis, deficiencies of essential fatty acids, hormonal imbalances—can make locks lose their luster, get stiff and brittle or just plain fall out. Meantime, many meds can mess with your mane. Among the meanest: Alpha interferon, 3TC (Epivir), hydroxyurea (Hydrea), hormone therapies (especially anabolic steroids like testosterone), famciclovir (Famvir) and high-dose fluconazole (Diflucan).

Mary Hanerfeld knows. Soon after starting 3TC, she encountered the lazy-hair syndrome: When she got up in the morning, some of her hair wanted to stay in bed. A striking and very active New Yorker, Hanerfeld wasn’t thrilled at the clumps of hair on her pillow. After rooting for remedies, she discovered this two-step protocol: First, brush hair at least 30 strokes to stimulate circulation in the scalp; then apply Revitalize—a natural shampoo/conditioner combo that contains extracts of fennel, hops, balm mint, mistletoe and peppermint oil, plus a who’s who of nutrients. It ain’t cheap ($17 for each 16-ounce bottle of either shampoo or conditioner), but Hanerfeld swears by it.

Certain drugs, however, can stymie even the best potion. The worst hair-razors may be such KS and lymphoma chemotherapies as Doxil, DaunoXome, Taxol (which can cause shedding of all body hair), etoposide and combinations of vincristine, vinblastine, bleomycin and doxorubicin (Adriamycin). Sometimes, all you can do is get bold, bald and through the regimen. Once you stop (or switch or lower) drug doses, hair often—but not always—comes back.

David Colbert, MD, a Manhattan dermatologist, notes that preventing inflammation of the scalp can prevent damage to the hair and its follicles. But this requires you to be aggressive about diagnosing and treating scalp infections. The hair-growth-enhancing product minoxidil (Rogaine) may help stimulate hair growth during chemotherapy. Colbert also advises his patients to use the dietary supplement biotin. Natural anti-inflammatories—powdered ginger or ginger tea, fish or flaxseed oil, and bioflavonoids such as quercetin—may also work. The oils  also provide the essential fatty acids needed for hair and scalp health.

Even with all this, hair loss may occur—so you might opt for Hill’s solution: That very sexy, very close buzzcut. He says, “My husband’s taken to calling me GI Jane, but it’s opened up a whole new fashion possibility with hats.”