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What to Know About Cold Caps

What to Know About Cold Caps

Reviewed by Jasper Clinical Board

Last updated 5/24/21


Hair loss is a common side effect of some types of chemotherapy. And for many people, it can be a very difficult part of having cancer. After all, your physical appearance affects how others treat you, and how you see yourself. It’s also a constant reminder of your condition, which can be challenging.
The good news is that there are some ways to help minimize chemo-related hair loss. That includes cold caps—aka scalp cooling.

What are cold caps?

Cold caps are essentially freezable gel-pack hats. They fit your head tightly, like a helmet, and are typically made of a rubbery material like neoprene. They’re sold under several brand names (like Penguin and ElastoGel) but all work on the same basic principle: chilling your scalp during chemotherapy treatments can help prevent hair loss.
Old-fashioned cold caps work just like ice packs: They’re stored in the freezer before use, and your care team may swap them out for fresh ones as they warm up during a chemo session. There are also new, FDA-approved devices (like DigniCap and Paxman) that make the scalp cooling process easier. They run a chilled liquid through the cap to ensure it remains a steady, ice-cold temperature.

Do cold caps really work?

Although there’s no guaranteed way to prevent hair loss, cold caps do have a helpful impact for many people. Research has found that breast cancer patients who received scalp cooling had less hair loss four weeks after chemo and showed faster recovery of hair volume afterward.
It’s important to understand that these are not black-and-white results. If you get chemotherapy, you will probably still have some hair loss—but using a cold cap may help you have less. For some people, that’s a win. For others, it’s not worth the time, energy, and money (more on that shortly).
There are some mild side effects, but most people don’t find scalp cooling too uncomfortable. The possible side effects include headache, neck and shoulder discomfort, scalp pain, dizziness, and (no surprise!) feeling cold. 

How do cold caps work?

To understand how scalp cooling works, we need to step back and consider why chemo causes hair loss in the first place. 
Chemotherapy drugs are powerful chemicals that circulate through your body and kill the fast-dividing cells. This is key to stopping cancer in its tracks, but it unfortunately kills off some healthy cells in the process. That includes cells in your mouth, stomach, and blood, as well as hair follicles. The good news is that these healthy cells will eventually recover. But in the meantime, you’ll probably have side effects in these areas, including hair loss.
So how does scalp cooling protect your hair follicles from chemotherapy? There are actually two beneficial effects: First, cooling your scalp slows down the metabolism in your hair follicles. That makes them more resistant to the damage caused by chemotherapy drugs. Second, cooling your scalp causes the blood vessels to constrict. This prevents the medication from reaching your hair follicles, thus keeping them safe.
Typically, you’ll wear a cold cap for 30 minutes or so before your chemo session begins, as well as during the treatment and for up to three hours afterwards.

Is scalp cooling right for me?

Not everyone can safely use a cold cap. People with blood cancer, for instance, need the chemotherapy drugs to reach every part of their body, including the scalp. Using a cold cap could actually prevent the treatment from doing its work. There are also some differences in efficacy based on the type of chemotherapy you’re getting. For instance, research has shown that patients who received taxane treatments had significantly better results than those who had anthracycline treatments.
Finally, there are some concerns that scalp cooling could allow stray cancer cells to survive in your scalp, leading to a recurrence of cancer in the future. So far, studies have suggested that this is probably not a risk and scalp cooling is safe. Even so, it’s a fairly new treatment, and some doctors are waiting for more research to fully embrace it.
Ultimately, of course, this is a very personal decision that you should make with your healthcare team.

How much does scalp cooling cost?

The price of a cold cap varies, depending on which manufacturer you choose and how many courses of chemotherapy you need. But roughly speaking, you can expect to spend $1,500 to $2,000 total on your scalp cooling treatment. 
Generally, insurance will not help you cover the cost of scalp cooling treatment. That means you’ll have to pay the costs entirely out of pocket. If you’re worried about paying for treatment, nonprofit groups like the Rapunzel Project and Hair to Stay may be able to help.
For some people, a bigger issue than cost is the effort required for scalp cooling. Keep reading for more on that subject.

Does every treatment center offer scalp cooling?

No. The level of support you’ll get varies a great deal between treatment centers. Some have all the equipment you need and train their staff in scalp cooling treatments. Others don’t offer scalp cooling services at all. 
If your treatment center doesn’t offer this service, you’ll need to do a lot of the work yourself. That could mean contacting the cold cap manufacturer, learning how to prepare and wear a cold cap, bringing an ice chest and other supplies to your treatments, monitoring scalp temperature during your session, changing out your cap periodically, and so on.
For some people, this is all too much work. For others, it’s a small price to pay. It all depends on your personal preferences.

I want to get scalp cooling. What’s the first step?

As always, the first step is talking with your healthcare team! Your doctor can help determine whether you’re a good candidate for a cold cap and may be able to facilitate your treatment. They may also connect you to a therapist or counselor who can help you adjust to your changing appearance and feel good in your daily life.

The content on this website is intended to provide the best possible information for you, but should not be considered—or used as a substitute for—medical advice. If you have questions about your diagnosis or treatment, please contact your health care provider(s). For questions or comments about this content, please email us at support@jasperhealth.com.