Cold Caps

cold caps

The Quest to Prevent Hair Loss: Cold Caps

A Cold Cap is exactly what the name suggests – it is a hat which can be worn during chemotherapy to cool down the scalp and prevent hair loss.

Cold caps are now available in most chemo therapy units. There are two types –

The first type uses a machine which pumps liquid coolant through the cap for the duration of the treatment.

The second uses a cap filled with cold gel which needs to be changed every half an hour or so to keep the cap cool.

Should I Cold Cap?

There are, as with a lot of things pluses and minuses to cold capping.

The main aim with the cold cap is to try and prevent you losing your hair.  It is important to realise this is not guaranteed and is also not really going to prevent 100 per cent hair loss in the majority of cases.

This is obviously a huge plus – see To Wig or Not to Wig  but there are down sides.

The Cold Cap needs to be warn prior to the start of the treatment and after the treatment has finished.  The length of time varies with the chemotherapy drug being used and you will be guided by your oncology unit. This means that for some chemotherapy agents you need to be ready to spend several hours longer with the cold cap on than the treatment takes in order to gain benefit.

Cold Capping can be a painful experience. The cooling of the scalp to a low temperature can cause an intense headache, sometimes this feels like a migraine.  The closest description I have heard is that of a severe ice cream headache (without the pleasure of the ice cream!).

The headache doesn’t last for the whole duration of treatment and is thought to subside after the first 8 minutes but this can seem like a very long time. Relaxation techniques and yoga breathing can help to get you through.  It is also worth taking some paracetamol before putting the cold cap on.

Unsurprisingly Cold Capping can make you feel really cold so it is best to be prepared. See Your First Chemo for a list of things to take with you. Have a hot drink and try to relax (believe me, I know this is easier said than done, especially at the beginning).

What does Science say?

There have been studies over the last few years looking at the benefits of cold caps in terms of reducing hair loss and the rough conclusion is that cooling the scalp seems to prevent hair loss in at least half the women studied who were having chemotherapy for breast cancer.  The effect is, however, dependent on the chemotherapy drugs used and the doses at which they are used.

Cold Capping was not found to improve the quality of life of the women studied. (Hope S, Rugo MD JAMA 2017;317(6)) 

At the end of the day the decision is Yours.  If you are not happy using the cold cap then don’t.  Nobody else should persuade you or give it the hard sell   Don’t feel guilty or bad if you’d prefer not to use it.



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