Cold Cap for Scalp Cooling

Scalp cooling uses a device called a cold cap. People wear a cold cap before, during, and after chemotherapy. The cooling technology may help prevent hair loss (alopecia) linked with this cancer treatment.

Why is scalp cooling used?

During chemotherapy (chemo), people often lose hair as a side effect of the chemo medicines. Cooling tightens blood vessels. This reduces the amount of chemo that reaches the hair follicles. The cold may also slow the metabolic activity of hair follicles. This may make the hair less likely to fall out.

What are the risks of scalp cooling?

Insurance may not pay for this treatment. Check with your insurance company to see what is covered. Some cooling treatments need a prescription. In other cases, you can rent a cold cap from a medical supply company. Some cancer centers may offer cold caps or cooling systems at an additional fee.

Cold caps can be uncomfortable for some. They can cause:

• Neck, shoulder, and scalp pain

• Headaches

• Dizziness

• Nausea

• Chills

How well cold caps work varies for each person. It depends on the hair type, the type of cancer, the type and dose of chemo used, and the scalp temperature achieved.

Scalp cooling is not advised for children or for people having brain radiation therapy. It’s also not advised for people with certain lung and skin cancers and some blood cancers, like leukemia.

How to get ready for scalp cooling

Before scalp cooling:

• Talk with your healthcare provider about the risks and benefits.

• Find out if your chosen treatment clinic or hospital offers or supports using scalp cooling.

• Ask your health insurance company if this therapy is covered.

• If it’s not covered, find out the out-of-pocket cost of cold caps and automated scalp cooling systems.

• Bring warm clothing or blankets with you to your treatment. Some people feel cold during scalp cooling.

What happens during scalp cooling

There are 2 main ways to do scalp cooling: manual cold caps and scalp cooling systems.

• Cold caps (manual cooling systems). These are tight-fitting caps filled with cooled liquid or gel ice packs. They must be kept in a cooler with dry ice or in a special freezer at the cancer facility until they are used. They need to be changed when they warm up during use. You may need to have someone with you who can help you change caps during chemo treatment.

• Scalp cooling systems (automated cooling systems). These are connected to a computer refrigeration system that controls the amount of cold liquid circulating. This type of cap does not need to be changed.

It's important to be fitted with the correct cap size. An insulating cap is generally placed over the cooling cap to keep it in place. The insulating cap also helps the cooling cap stay at the cold temperature. A protective covering is placed under the cooling cap to protect your scalp.

How well scalp cooling works will vary from person to person. Some research shows the success rate at 50% to 80%. This means a person loses less than half of their hair. Success may also depend on:

• Your chemo medicine type, dose, and schedule

• Past experience using scalp cooling

• How the cap fits you

• Your ability to tolerate scalp cooling

• Your hair type and thickness

After scalp cooling

During and after using scalp cooling, be extra gentle with your hair:

• Use gentle shampoo and shampoo only every third day or less, or as advised by your healthcare provider.

• Don’t dye your hair. Stay away from hairspray relaxers. Don’t use permanents (perms).

• Don’t use blow dryers or curling irons.

• Use soft-bristle brushes.