What Is Cold Capping
Chemotherapy can cause hair loss by harming the cells that help hair grow. Hair follicles in the growth phase are sensitive to chemotherapy, resulting in hair loss about two weeks after treatment begins.
Cooling caps use intense cold to constrict the blood vessels in the scalp. That keeps the cell-killing chemo away from the hair follicles, where hair is produced.
The whole idea is that when you expose the scalp to cold fluid, the blood vessels in the scalp clamp down, says Dr. Kruse. In doing so, less chemotherapy can be delivered through the blood vessels to where the hair follicles live.
How Do They Work
Cold caps offer scalp cooling therapy that doctors may also refer to as scalp hypothermia. These devices narrow the blood vessels under the scalp to limit the amount of chemotherapy that reaches the hair follicles. Less exposure to chemotherapy can reduce the risk of hair loss.
A 2017 study found that women with breast cancer who received chemotherapy and underwent scalp cooling maintained most of their hair. However, those who did not get scalp cooling experienced substantial hair loss.
A 2017 review found that scalp hypothermia can reduce alopecia and appears to be effective for people receiving chemotherapy for breast cancer and solid tumors.
A more recent 2018 article suggests that cold cap treatment works better in individuals undergoing taxane-based chemotherapy than in those receiving anthracycline. These are two different types of chemotherapy drugs.
Cold Cap Tips From Women Who’ve Tried It
Depending on the type of scalp cooling your hospital offers, the advice may be different. Check with your treatment team for specific guidance.
The following tips from women who have experienced scalp cooling may help:
- Take a warm drink with you to sip during the treatment to help warm you up
- Wear layers and take a blanket to keep warm
- Take earphones to listen to music or a podcast
- The cold cap should cover the whole scalp and fit snugly
- Removing hair extensions, weaves or braids before scalp cooling
- Gently combing back your hair with a wide tooth comb or your fingers so the front hairline is visible
- Take a spray bottle of warm water to apply to your hair before the cap goes on
- Apply a small amount of conditioner to your hair before the cap goes on, this will help remove the cap
- Once the scalp cooling finishes, allow time for the cap to defrost before removing it so it doesnt pull on your hair
If youre struggling with the side effects of the cold cap speak to your chemotherapy nurse or treatment team. They may recommend taking mild pain relief, such as paracetamol, before wearing the cold cap.
Things like water spray bottles, conditioner and extra layers may not be available in the chemotherapy suite so you may want to bring your own.
What Is Scalp Cooling And How Does It Work
Scalp cooling involves wearing a tightly fitted, helmet-like hat filled with a cold liquid or gel before, during and after you receive chemotherapy.
During each chemotherapy session, you wear the cap for 30 minutes before the infusion, during the entire infusion and for about 60 to 90 minutes post chemotherapy, Ortega said. The amount of time you wear the cap can vary depending on the type of chemotherapy youre getting and the type of scalp cooling method you use.
Cold caps and scalp cooling systems work by narrowing the blood vessels beneath the skin of the scalp. By reducing blood flow, this also reduces the amount of medicine that reaches your hair follicles. With less chemotherapy medicine in the follicles, the hair may be less likely to fall out. However, body hair, such as eyelashes, eyebrows and pubic hair may still fall out with chemotherapy.
How Much Does Scalp Cooling Cost
The cost of scalp cooling can range from $1,200 to $4,000 depending on the number of chemo cycles. Unfortunately, most medical insurance companies dont cover the cost of scalp cooling at this time. However, some patients have submitted for reimbursement from their insurance company and received a check for the full benefit amount, Ortega noted. Its worth looking into with your insurance company to see if it is a covered benefit.
You can also reach out to a nonprofit organization called Hair to Stay to see if financial assistance is available.
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How Does Chemotherapy Affect Your Hair
Hair loss occurs because chemotherapy attacks all fast-growing cells in your bodynot just cancer cells. Hair follicles are especially sensitive because those cells multiply rapidly just like cancer cells. This can cause hair loss on your scalp, eyebrows, eyelashes, underarms, legs and pubic hair area.
You may start to notice your hair falling out pretty quickly, sometimes as early as the second or third week after the first cycle of chemotherapy, although it may not happen until after the second cycle of chemotherapy.
When hair starts falling out, it often comes out in clumps rather than an even pattern, Ortega said. Imagine running your fingers through your hair and having it tangle through your fingers and fall out.
Hair loss doesnt occur with all chemotherapies. Whether your hair remains as it is, thins or falls out can depend on the drugs and dosages.
Once your chemotherapy has stopped, your hair should begin to grow back, but the process can test your patience and affect your self-confidence. Thats where cold caps and scalp cooling can help.
What Do Cold Caps Feel Like
As youd expect cold caps worn during scalp cooling are very cold, and they can feel quite heavy. Some women describe having a headache while wearing one, but these usually wear off quickly once the cap is removed.
I did use the cold cap and can only explain the experience as having a severe ice cream headache or brain freeze for 1015 minutes. Once the freezing had taken place I did not feel the cold cap anymore.
It was worse for first half hour then became bearable and, as the time went on, no problem at all.
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Do Chemo Cold Caps Really Work On Natural Hair Trishs Chemo Hair Loss Journey
Naturalista Trish G. was recently diagnosed with cancer and when faced with the inevitable hair loss that is part and parcel of some chemo drugs, she decided to try a chemo cold cap, which is touted as a device that can significantly reduce hair loss during chemotherapy. Trish shared her experience with me.
Dianne: Would you say that the cold cap is really working?
Trish: I would say that the chemo caps worked best they could. I knew it was not 100% guaranteed. I lost a lot of hair but I think when I undo my twist you cant really tell the hair loss due to overall volume. I think it works better on less kinky hair.
Dianne: What were your thoughts when you first learned that you would need to undergo chemo and would lose your hair?
Trish: All I knew was chemo meant hair loss. I kept telling everyone I am ready for that and I wasnt worried. I am the one in my group that consistently cuts my hair really short and I have said that losing my hair was the least of my worries at this point.
Dianne: What made you decide to try the chemo cap and is it worth it?
Dianne: What will you do if you should lose more hair than you anticipated? .
Dianne: What advice would you give other women faced with chemo related hair loss?
Mayo Clinic Q And A: Cold Cap Therapy Can Reduce Hair Loss Caused By Chemotherapy
DEAR MAYO CLINIC: How effective is cold cap therapy in preventing hair loss in people undergoing chemotherapy treatments? Are there any risks?
ANSWER: Using a cold cap can significantly reduce hair loss caused by chemotherapy. Although some minor side effects may occur, no serious side effects have been associated with cold caps. Some have questioned whether cold caps might prevent chemotherapy from reaching cancer cells in the scalp. But that risk appears to be low.
Chemotherapy works by killing rapidly dividing cells, including cancer cells. But chemotherapy cant tell the difference between cancer cells and other normal cells that also divide quickly, such as those in hair follicles. When chemotherapy attacks the hair follicles, it causes the hair to fall out.
In some cases, chemotherapy may only lead to thinning hair. In others, it makes all of a persons 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, its a side effect thats often hard to take. Not only can losing your hair be tough on your self-image, its also a vivid and constant reminder of a cancer diagnosis.
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Whats A Cold Cap For Chemo
Asked by: Mrs. Helen Greenfelder
Cold caps and scalp cooling systems are tightly fitting, helmet-like hats filled with a cold gel or liquid that you wear during chemotherapy infusions. These devices have helped many people keep some or quite a bit of their hair when treated with chemotherapy that can cause hair loss.
Is Cold Cap Therapy Painful
Most patients experience a few minutes of mild discomfort when the first cap is put on. After about 10 minutes the scalp area becomes mostly numb. The most commonly reported side effects include headaches, complaints of coldness or uncomfortable sensations, dizziness and to a lesser degree, claustrophobia.
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Wigs And Head Coverings
You may still want to wear a wig or other hair covering during chemotherapy. If you have any questions or concerns, talk with your healthcare provider.
If you want to wear a wig or hair piece, try to get one before your hair falls out because it will be easier to match your hair color and style. If youve already lost some or all of your hair, bring a photo of your usual hairstyle and, if you can, a lock of your hair to the store. This will help you find a wig or hair piece that looks like your hair did before your treatment started.
When shopping for wigs or hair pieces, you may want to shop around and compare prices. A wig or hair piece should fit properly, be comfortable, and be easy to care for. You may want to start wearing it as soon as your hair begins to thin. As your hair gets thinner, you may need to have your wig or hair piece adjusted to make it fit better.
Many insurance companies will pay for wigs or hair pieces when hair loss is related to medical treatment. Contact your insurance company to find out what your plan offers. If you need help finding a place to buy a wig or hairpiece, talk with your healthcare provider.
Some people choose not to wear any head covering during their chemotherapy. This is your choice.
Cold Caps: Preventing Hair Loss During Chemotherapy
An annoying cowlick, frizzy hair that cant be tamedweve all had bad hair days from time to time. But for those with hair loss, particularly those experiencing hair loss due to chemotherapy, it can be disheartening.
Finding out you have cancer can be one of the most stressful situations a person experiences in their life, then add the fact that their appearance may be different during and after treatment, said Sandra Ortega, a nurse navigator for Banner MD Anderson Cancer Center at Banner Gateway Medical Center in Gilbert, AZ. Hair loss, or alopecia, due to chemotherapy is one of the most upsetting side effects of chemo treatments.
As a way to reduce and prevent hair loss from occurring, some patients are turning to cold caps, or scalp cooling, an approach thats been used in Canada and parts of Europe for years but has grown in use in the U.S. since 2015 when the Food and Drug Administration approved scalp cooling machines.
We spoke with Ortega about what causes hair loss during cancer treatments, how cold caps and scalp cooling work to halt hair loss and costs associated with these devices.
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Cold Caps During Chemotherapy
A cold cap is a hat that is worn during some chemotherapy treatments. Its cooling effect reduces blood flow to the scalp, which also reduces the amount of chemotherapy medication that reaches this area. This helps to prevent hair loss.
It’s usually worn for 15 minutes before each chemotherapy treatment. You can find out about scalp cooling caps on the Macmillan website.
Who Can Use Scalp Cooling
Scalp cooling is currently approved for women and men of any age being treated with chemotherapy for most cancers. However, scalp cooling isnt recommended if you have leukemia or other certain blood-related cancers.
Most people can use it with few side effects. Common side effects are headaches and feeling cold. If cold temperatures really affect you, then the therapy may not be right for you. Talk with your doctor about any questions you may have about hair loss and scalp cooling before and during treatment.
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Thinking About Using The Cold Cap
Before my breast cancer chemo I was desparate to keep my hair. Having only average plain looks and a lumpy scalp I knew that being bald would really not suit me. I also did not want to see a cancer sufferer looking back at me every time I looked in the mirror. So I tried the cold cap and for me it was very successful. I even had to have my hair cut and thinned out during chemo. I reckon I lost less than 10% of my hair but then, not every body loses their hair completely. My body hair everywhere else thinned and seemed to stop growing but strangely, I did lose all my pubes, although when and where they went is still a mystery. It was only after my 6th and final chemo that my eye lashes and eye brows thinned a bit. Another cold cap lady I met at the same time thinks that she lost only about 40% of her hair but she had no bald spots and she looked fine. Although she did lose all her body hair.
Now there are a lot of scare stories about the cap headaches, unbearable pain etc which might put you off even trying it. But my advice is, if you are really desparate to keep your hair then try it.
So here are the facts:
You have to wet your hair and rub conditioner into it at the start of each chemo. This improves the freezing ability of the cap. The nurses will always help you with this.
Best wishes for tomorrow. x
noticing your post was in March so hope your through the worst & doing well.
Cold Caps May Reduce Hair Loss From Chemotherapy
Hester Hill Schnipper, LICSW, OSW-CProgram Manager Emeritus, Oncology, Social Work
Cold caps or scalp cooling is a process designed to help some women lose less hair during chemotherapy. Let us note at the start at this does not work for all chemo drugs, and that the results can be variable. Let us also add some history. Perhaps twenty years ago, there was briefly a lot of hype about cold caps to preserve hair during chemotherapy. The theory, then and now, is that the cold constricts blood vessels that run to the scalp and reduces or stops chemo drugs from going there. These earlier products were only briefly on the market they turned out to be very uncomfortable, not to work very well, and some oncologists expressed concerns about limiting the blood flow to the scalp.
Several studies have found that 59-68% of women treated with taxanes lost less than half their hair if they used a cooling system.
Since, like everything else in Cancer World, there are no guarantees about saving your hair, this can become a tough decision. Remember that it is not irrevocable. If you start out chemo using a cap and decide you dont like it, you can stop. A switch in the other direction is less useful because the damage has already been done.
There is no doubt that it is better, always, to have options and some control. Considering using a scalp cooling system is one way to exercise your choices.
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Hair Loss Related To Chemotherapy
Chemotherapy works by attacking fast-growing cells. Cancer cells are fast growing, but so are other cells, such as hair cells. Chemotherapy can cause hair loss on your scalp, eyebrows, eye lashes, arms, legs, and pubic area. Depending on your chemotherapy, you can lose hair in none, some, or all of these areas.
You may start to see your hair fall out 1 to 4 weeks after your first chemotherapy treatment. How much of your hair falls out depends on the type of chemotherapy and how much and how often you receive it. Talk with your healthcare team about the amount of hair loss you should expect from the chemotherapy you will receive.
How quickly hair falls out also varies from person to person. The first signs of hair loss may be more hair on your pillow in the morning, in the shower, or when you brush your hair.
Once your chemotherapy has stopped, your hair should begin to grow back. It can take 3 to 5 months for your hair to grow back, and it may have a different texture, color, or volume. For most people, hair grows in as fully as it was before chemotherapy.