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Cold Cap Therapy Can Reduce Hair Loss Caused By Chemotherapy

Chemotherapy-induced hair loss is widely recognized as one of the most traumatic side effects associated with cancer treatment, and yet it is still one of the least explored. Cold Caps and Scalp Cooling Systems are changing that.

Chemotherapy works by targeting rapidly dividing cells, including cancer cells. But chemotherapy can’t tell the difference between cancer cells and other normal cells that also divide quickly, such as those in hair follicles. Chemotherapy damages hair follicles (at the root of the hair), resulting in hair loss about 2 weeks after the start of chemotherapy.

In some cases, chemotherapy may only lead to thinning hair. In others, it can cause all of the patient’s hair fall out. For example, studies have shown that most of the chemotherapy drugs used to treat breast cancer cause almost total hair loss in most patients.

While losing your hair may sound like a small price to pay for preventing cancer from coming back, it’s a side effect that’s often difficult to take. Not only can losing your hair be tough on your self-image, it’s also a vivid and constant reminder of a cancer diagnosis.

The use of scalp cooling and ‘cold caps’ is proven to be an effective way of combating chemotherapy-induced hair loss and can result in a high-level of retention or completely preserve the hair. For patients, this means the opportunity to regain some control, maintain their privacy as well as their sense of self, and encourage a positive attitude towards treatment.

How Does Cooling Help Limit Chemotherapy Induced Alopecia?

The idea of cooling the scalp to prevent hair loss has been around for some time. When cooled, the blood vessels beneath the skin of the scalp constrict, reducing blood flow, and thus the amount of chemotherapy medicine that reaches the hair follicles. With less chemotherapy medicine in the follicles, the patient’s hair is less likely to fall out. The cold also makes those cells less active, slowing cell division which prevents the chemotherapy drugs from target them as aggressively.

Cold Caps

Cold caps and scalp cooling systems are slightly different. Cold caps are similar to ice packs. Kept in a special freezer before they’re worn, cold caps thaw out during a chemotherapy infusion session and need to be replaced with a new cap about every 30 minutes. Women usually rent the caps and the special freezer. Penguin Cold Caps, Chemo Cold Caps, and Artic Cold Caps.

Scalp Cooling Systems

In 2015, however, the U.S. Food and Drug Administration approved a new type of scalp cooling system to reduce hair loss in those undergoing chemotherapy. The new caps have cold liquid circulating through them and are connected to a computer that maintains the temperature of the cap at around 32 degrees Fahrenheit. These caps also have a covering that keeps them in place and helps to keep the temperature constant. So the cap only has to be fitted once and doesn’t need to be changed during the chemotherapy session. Scalp cooling systems, such as the DigniCap System and the Paxman System (the only two FDA-cleared cooling caps in the U.S.), are purchased by a cancer treatment center and patients are charged to use the system while receiving chemotherapy.

Both systems are used for patients receiving taxane-based chemotherapy and anthracycline agents, and are not recommended for patients with lymphomas, leukemia, malignancies of the scalp, or patients who will receive radiation in the head or scalp area. The caps tends to be most effective, however, when used during a taxane regimen as anthracyclines cause particularly aggressive hair loss.

During each chemotherapy session, you wear the caps or scalp cooling system for:

  • 20 to 50 minutes before
  • during
  • after

Each chemotherapy session (the amount of time you wear the cap after the chemotherapy session depends on the type of chemotherapy you’re getting).

One recent study examined the effects of the newer cold caps in women undergoing chemotherapy treatment for early-stage breast cancer. Of those who wore a cap consistently cooled to 32 degrees for 30 minutes before their chemotherapy treatment, throughout every chemo session, and for 90 to 120 minutes afterward, 66 percent experienced hair loss of 50 percent or less. That was compared to another group undergoing chemotherapy that did not use the caps. All of those patients lost more than half of their hair.

Several minor side effects were noted in this study, including chills, headaches, scalp irritation, and neck and shoulder discomfort. Of the more than 100 women in the group who wore cold caps, only three stopped using the cap during the study because it made them feel too cold.

Some health care providers have been concerned that cold cap therapy could prevent chemotherapy from reaching cancer cells that may be in the scalp, making the chemotherapy less effective. In people who have used cold caps, reports of cancer appearing in the scalp are extremely rare. More research is needed, however, to clearly understand this potential risk.

How Much Does It Cost?

Another consideration regarding cold caps is the cost. At this time, most medical insurance companies do not cover the cost of cold cap therapy. If you are considering using a cold cap while undergoing chemotherapy, check with your insurance provider to see if your policy covers it or if you would have to pay for it yourself. Typically, cold cap therapy costs around $400 per session, while scalp cooling costs include the cost of the cap and an additional cost per cycle for the use of the machine. Click here for additional details on the Paxman Scalp Cooling System.

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