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This information is about scalp cooling, a method of reducing hair loss| (alopecia) caused by chemotherapy|. Chemotherapy commonly causes hair to fall out, which can be distressing even though the hair grows back once the treatment has ended.
Scalp cooling is a method of reducing hair loss from the head that occurs during treatment with some chemotherapy drugs. Chemotherapy is the use of anti‑cancer (cytotoxic) drugs to destroy cancer cells.
Every hair on the body grows out of a hair follicle. Small blood vessels in the scalp supply the cells of the hair follicles with food and oxygen, and carry away waste products. Any chemotherapy drugs in the bloodstream will also be carried to the hair follicles.
When blood vessels in the scalp are cooled they become smaller, so less blood flows through them. Cooling the scalp during chemotherapy means that less of the chemotherapy drug reaches the hair follicles, so the hair is less likely to fall out.
There are two widely available methods of scalp cooling. One method uses a hat known as a 'cold cap', which is filled with a gel that can be chilled. The hat must be fitted snugly around the head to work properly. The other method of scalp cooling uses a small refrigerated cooling system to pump a liquid coolant through a cap that is attached to a specially designed refrigerator.
Scalp cooling is not suitable for everyone.
It isn't suitable:
Some doctors worry about using scalp cooling with any treatment that aims to cure the cancer. They are concerned that cancer cells that may have spread to the scalp may be more likely to survive the chemotherapy if scalp cooling is used. However, secondary cancers in the scalp are not common.
Clinical trials| have shown that the risk of these developing as a result of scalp cooling is very small, except in some more aggressive haematological cancers. Some people may prefer not to have scalp cooling because of this, but others are happy to try it. If you're interested, talk it through with your doctor.
Scalp cooling is most likely to be effective with:
For scalp cooling to work, your scalp needs to be cold for up to 30–40 minutes before your chemotherapy drugs are given and for some time afterwards. Your scalp temperature needs to be kept low for the whole time the drugs are circulating in your blood.
If you are having your chemotherapy as an outpatient, you may need to spend up to one and a half hours longer at the hospital for each treatment.
You may find that the ice pack and gel-filled hats feel heavy to wear. When using this type of hat, you are usually free to walk about once your chemotherapy has been given. However, your hat will need to be changed every 20–40 minutes to keep your scalp cool, so you cannot go too far from the chemotherapy department.
Caps attached to the cooling machines generally feel lighter than the frozen caps. You will need to sit by the machine while the cap is in place, so you can't walk about freely with this method. However, the cap can be disconnected for short periods of time if necessary – for example, if you need to use the toilet. These caps do not need to be changed, as the machine is continuously cooling the liquid circulating round your scalp.
You will probably feel chilly when having scalp cooling and may need to wear a warm jumper. Hot drinks will help you feel warmer. You may get a headache during scalp cooling, especially in hot weather.
Scalp cooling can be very effective in preventing or reducing the loss of your hair, but you won't know how well it will work for you until you try it. It may help not to wash your hair for at least 24 hours after having scalp cooling.
Despite scalp cooling, you may find that your hair thins slightly. Unfortunately, some people who have scalp cooling will still lose their hair.
Scalp cooling protects only the hair on your scalp. Body hair – including eyelashes, eyebrows, beards and moustaches, chest hair and pubic hair| – may be lost.
Any hair loss caused by chemotherapy is almost always temporary, and once the treatment is over, your hair will start to grow back. At first, the hair is very fine, but you will probably have a full head of hair after 3–6 months. You may find that your new hair is curlier or more coarse than it was before, or it may be a slightly different colour.
If you are interested in scalp cooling, discuss this with your doctor or nurse, who can advise whether it is suitable for you.
This information has been compiled using information from a number of reliable sources including:
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