Scalp cooling

Scalp cooling can reduce hair loss caused by chemotherapy. It works by reducing the amount of chemotherapy drugs reaching the hair follicles. Scalp cooling does not work with all chemotherapy drugs and it is not always possible to know how effective it will be.

You will need to keep your head cold before, during and after your chemotherapy treatment.

There are two methods of scalp cooling:

  • Cold cap - a special cap filled with cold gel.
  • Refrigerated cooling system - this pumps liquid coolant through a cap.

You might feel cold during your treatment, but the chemotherapy staff will try to make you as comfortable as possible. Your hospital may not have the facilities for scalp cooling. Your doctor or nurse can tell you if it is available and whether it is suitable for you.

If you don’t lose all your hair, but it thins or becomes dry or brittle, it is important to treat your hair carefully. This can help to reduce hair loss.

How scalp cooling works

Some chemotherapy drugs can cause temporary hair loss. Scalp cooling can help to prevent hair loss from your head. There is no known way to prevent hair loss that might happen as a result of radiotherapy, hormonal therapies or biological therapies.

Scalp cooling works by reducing the temperature of the scalp by a few degrees immediately before, during and after having chemotherapy. This aims to reduce the amount of chemotherapy that reaches the hair follicles on your scalp, which may lessen hair loss. In some cases, it may prevent the hair from falling out. Unfortunately, some people who have scalp cooling may still lose their hair.

There are two widely available methods for scalp cooling:

Cold cap

This method uses a special cap that is filled with cold gel. It can be fitted easily to your head and kept in place with Velcro®. The cap can often be uncomfortable and heavy, as well as being very cold. This can give some people a headache. Let your doctor or nurse know if this happens. They can give you painkillers.

The cap also needs to be changed every 20 to 40 minutes to keep your scalp cool.

Refrigerated cooling system

A refrigerated cooling system pumps liquid coolant through a cap. This type of cap generally feels lighter than a gel-filled cap. You need to sit next to the machine while the cap is in place, so you can’t walk about freely. However, the cap can be disconnected for short periods if necessary, for example if you need to use the toilet.

Things to consider

Both types of scalp cooling need to be worn for 30 to 40 minutes before you have your chemotherapy drugs, and for some time afterwards. You may have the cap on for a few hours in total. You may feel cold during the treatment. The chemotherapy staff will do everything they can to make you as comfortable as possible, but some people find the discomfort too much. If the cold cap is too uncomfortable it can be removed at any stage.

Scalp cooling is only effective when used with certain chemotherapy drugs and it is not always possible to know how effective it will be until you try it. The main drugs that scalp cooling can be used with are, epirubicin, paclitaxel and doxorubicin.

Scalp cooling can only protect the hair on your scalp. Some chemotherapy drugs can cause loss of body hair (including eyelashes, eyebrows, chest hair and pubic hair).

Any hair loss caused by chemotherapy is usually temporary, and once the treatment is over, your hair will grow back.

Scalp cooling is not advised when treating some types of cancer, such as blood cancers.

Some hospitals do not have facilities for scalp cooling. Your doctor or chemotherapy nurse can tell you if it is available and if it’s suitable for you.

Hair thinning

Some people find they do not lose all their hair. It may thin or become very dry and brittle instead. If this happens, it is important to treat your hair carefully, such as using a wide toothed comb or baby brush to gently brush it. This may prevent damage to your hair and may help to reduce any further hair loss. We have tips on caring for your hair during treatment.

Back to Hair loss

After treatment

Your hair may grow back after treatment but it might have changed. It’s important to care for your new hair.