Cancer Treatment Chemotherapy An Overview of Scalp Cooling An effective way to prevent hair loss from chemotherapy By Colleen Travers Colleen Travers Facebook LinkedIn Twitter Colleen Travers writes about health, fitness, travel, parenting, and women’s lifestyle for various publications and brands. Learn about our editorial process Updated on May 13, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Douglas A. Nelson, MD Medically reviewed by Douglas A. Nelson, MD LinkedIn Douglas A. Nelson, MD, is a board-certified oncologist and hematologist who previously served for 13 years as a physician in the US Air Force. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Chemo and Hair Loss How Scalp Cooling Works Frequency The Cost Effectiveness Side Effects Scalp cooling (also referred to as scalp hypothermia) involves using ice packs or a cooling cap before, during, and after a chemotherapy to prevent or drastically reduce hair loss. Certain chemotherapy drugs are known for inducing hair loss, and this treatment may be a solution for some patients. zneb076 / Getty Images Why Chemo Causes Hair Loss Chemotherapy drugs target cells that multiply and divide very quickly, as these are the traits of cancer cells. While useful for this purpose, the treatment is not targeted. In other words, it acts on the whole body, not just the tumor site. In addition, because chemotherapy targets all dividing cells without discretion, it can affect cells that are healthy—not just those that are malignant. Hair cells fall into this group, which means that their destruction—and hair loss—ends up being an unwanted consequence of chemotherapy treatment. How Scalp Cooling Works There are two ways to approach scalp cooling. The first is a cooling cap, which is a snug, helmet-style hat that is filled with a gel coolant and chilled to between -15 and -40 degrees F. The cooling cap will narrow the blood vessels under the scalp, which helps reduce the amount of chemotherapy medication that reaches hair follicles and cells. The cold temperature slows down the rate at which hair cells divide, making them less of a target for chemotherapy medication. Similar to an ice pack, cooling caps gradually thaw during treatment as they are being worn by the patient. As a result, roughly every 30 minutes, the cap needs to be replaced. The second way to approach scalp cooling is by using a scalp cooling system, which became available in 2016. There are currently two scalp cooling systems approved by the U.S. Food and Drug Administration (FDA): the DigniCap Scalp Cooling System and the Paxman Scalp Cooling System. These systems work the same way a cooling cap does, but they offer the benefit of a cap that is attached to a refrigeration unit. This delivers coolant to the scalp continuously; there’s no need to change the cap once it’s on. Frequency If you and your healthcare provider decide that scalp cooling is an option for you, you’ll wear a cooling cap or connect to a scalp cooling system beginning 20 to 50 minutes before chemotherapy treatment, during the entirety of the chemotherapy session, as well as for roughly 20 to 50 minutes after treatment. One of the benefits of using a cooling cap versus a system is that it’s portable, so you’ll be able to leave the treatment center and finish up your scalp cooling on the drive home. The Cost Most insurances don’t cover scalp cooling, though, depending on your specific plan, you may be able to be reimbursed for the cost. You can, however, use a flexible savings account or health savings account to help pay for scalp cooling treatment. Cooling cap prices depend on the manufacturer and can be found by visiting their website. (Just keep in mind you’ll need more than one cap to swap out during treatments.) If you use a scalp cooling system, the price will depend on how many treatments you need and may range from $1,500 to $3,000. Since you’ll likely be using a facility's cooling system, you will also be charged a facility fee, which is around $60 to $70 per treatment and not covered by insurance. There are also a few nonprofits dedicated to help cancer patients receive scalp cooling treatments, such as The Rapunzel Project and the Hair to Stay Foundation. Effectiveness Research published in the March 2018 edition of the Journal of Oncology Practice found that, depending on the type of chemotherapy drugs used, scalp cooling could be extremely beneficial. For example, one study reports that women using a Paxman cooling system who had different types of chemotherapy (from taxane-based to an anthracycline) kept anywhere from 16% to 59% of their hair. Women who were treated with Taxol kept 100% of their hair. Researchers also looked into the DigniCap system and found that those treated with taxane-based chemotherapy kept 66% of their hair, and 100% if their treatment was weekly Taxol. In the instance of cooling caps, taxane-based chemotherapy had a success rate of 50% to 84% of hair retained, while women with anthracycline-based chemotherapy kept 20% to 43% of their hair. Side Effects Side effects of scalp cooling include headaches, dizziness, and nausea. Those using scalp cooling should make sure to take extra care of their hair, which means gentle brushing, alternating days of shampoo, avoiding hair color, skipping blow-drying, and avoiding hot tools like hair straighteners to help keep hair strong and prevent breakage. There’s also been concern that scalp cooling can cause any stray cancer cells that may have spread into the scalp to not be adequately treated, allowing them to grow and metastasize in the scalp. Though reports of this have been rare, it’s best to discuss scalp cooling with your healthcare provider first so you can determine if it’s the best course of treatment for you. When Will I Lose My Hair After Chemo? Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Breastcancer.org.Scalp Cooling Is Safe, Effective for Reducing Hair Loss Due to Chemotherapy, Study Finds. Memorial Sloan Kettering Cancer Center. Managing Hair Loss with Scalp Cooling During Chemotherapy for Solid Tumors. Breastcancer.org. Cold Caps and Scalp Cooling Systems. U.S. Food and Drug Administration. FDA clears expanded use of cooling cap to reduce hair loss during chemotherapy. July 23, 2017. Kruse M, Jame A. Management of Chemotherapy-Induced Alopecia With Scalp Cooling. Journal of Oncology Practice 14, no. 3 (March 1 2018) 149-154. doi:10.1200/JOP.17.00038