A cancer diagnosis is often fraught with fear and anxiety, and for many women that includes major apprehension about losing their hair during chemotherapy.
The use of cold capping and scalp cooling during chemotherapy is growing as a way to help patients minimize hair loss related to chemotherapy. Endeavor Health oncologist Sonia Baweja, MD, breaks down the basics and potential benefits of scalp cooling.
There are two different cold cap options—automated scalp cooling devices at cancer treatment centers like Endeavor Health that are regulated by the FDA, and manual frozen gel caps that some patients rent and bring with them to use during chemotherapy. The manual gel caps are not regulated by the FDA.
Both cold cap options lower the temperature of the scalp, temporarily decreasing blood flow to that area and reducing the amount of chemotherapy drugs that reach hair follicle cells.
Cold capping does not completely eliminate hair loss and works better for certain drug regimens than others, explained Dr. Baweja. On average, women who use cold capping see a 60-70% decrease in hair loss, she added.
Cold capping has been approved for solid tumors and is most frequently used by young women with early breast cancer, said Dr. Baweja. It is not recommended for patients with brain tumors or blood cancers including leukemia and lymphomas.
The process of cold capping can be challenging as the cold caps must be worn for 30 minutes before treatment, during the chemotherapy treatment and for another one and a half to three hours post-treatment.
For patients who choose to rent manual cold caps, they must bring a cooler with dry ice, two caps and someone to help them change the caps back and forth every 30 minutes throughout treatment sessions.
Every person reacts differently but patients can experience discomfort with cold capping including headaches, dry skin or almost frost bite on the scalp, shoulder tension and pain, said Dr. Baweja.
“It’s not super easy or comfortable, but it’s wonderful that we have this option and the choice to try it is there,” said Dr. Baweja.
“For many patients who lose their hair every time they look in the mirror or others look at them it’s a reminder of what they are going through and a message that they are not well. Maintaining their hair is a way to help them feel like life is normal and protect their personal information and feel in charge. It’s about far more than vanity.”
Importantly, there is no evidence that cold capping negatively impacts cancer treatment or makes chemotherapy less effective, said Dr. Baweja. Unfortunately, the process is quite expensive and is not covered by insurance.
Dr. Baweja is hopeful that the cold capping technology will continue to improve and more patients will be afforded this option. “It makes the idea of chemotherapy more palatable for some women; I hope we will continue to become more creative and efficient in bringing it to more patients,” said Dr. Baweja.
Nonprofit organizations like The Rapunzel Project help provide information on available resources for patients who are unable to pay for scalp cooling.
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