Hair loss is one of the most distressing side-effects of chemotherapy for women who battle breast cancer. Not only do you experience nausea, lack of appetite and fatigue but your appearance is changing as well – from dry skin and frail nails to hair loss. And sure, some lucky women don’t experience side effects and chemo drugs are constantly improving to make sure patients get the best possible care with the fewest side effects manageable. In fact, many new options are now in clinical trials and it’s only a matter of time before they become widely available. 

In the meantime, however, dealing with chemo side effects can be daunting. Some can be minimized by switching treatment if you and your treatment team find a better option for you. Others can be managed with additional therapies and lifestyle changes. Hair loss, on the other hand, can be prevented to an extent by including scalp cooling in your chemo procedures. Today on the FindMeCure blog we’ll introduce you to scalp cooling and present the pros and cons, so you can make an informed decision about your treatment. 

What is scalp cooling and how does it help?

Scalp cooling is an additional treatment that makes the blood vessels in your scalp shrink in order to stop chemotherapy from targeting your hair follicles. This prevents important cells from dying and when these cells stay alive and healthy, so does your hair. 

There are three main ways to cool your scalp to the required temperature (which is between -15 and -40 F): ice packs, cooling caps and a scalp cooling system. 20 to 50 minutes before, during and up to an hour and a half after chemo treatment one of these three cooling methods is applied to preserve your hair. 

Ice packs need to be frequently changed when they’re no longer at the needed temperature and cooling caps work much the same way – they’re filled with frozen material and when the temperature rises, they have to be replaced. Scalp cooling systems are more efficient because what they do is connect a cap at room temperature to a cooling machine in order to sustain the optimal temperature without replacing the cap.

If scalp cooling fits your chemo treatment you have a good chance of preserving your hair. In a study done on the effects of scalp cooling for women with breast cancer more than half the women preserved most or all of their hair. More research is needed in order to find out when scalp cooling is the most effective and which chemo treatments it’s best suited for but for now, it seems this non-invasive treatment can help some women avoid one of the most upsetting side effects of chemotherapy.

What should I know in advance?

Scalp cooling may not be the best option for people with cold sensitivity. Applying a low-temperature cap to the scalp can also lower your body temperature and even cause hypothermia – discuss with your treatment team the kind of clothes you should be wearing and whether or not to bring blankets. 

If you have thick full hair the cooling cap may not make secure contact with your scalp, so losing patches of hair is still possible. This is more likely if you opt for ice packs instead of a cooling cap so ask your treatment team to help you pick the best option for you. 

Increased risk of scalp metastases is a common concern among researchers who want to make sure that scalp cooling doesn’t prevent the treatment of cancerous growths in the scalp. However, if you don’t already have scalp metastases that need to be treated with chemo research suggests scalp cooling does not increase the risk of developing them. Of course, if cancer cells are present in the scalp preventing hair loss may not be possible as the treatment takes precedence. 

What is the cost of scalp cooling? 

Some patients say that the overall cost of scalp cooling is comparable to the price of a high-quality wig. However, keep in mind that how much scalp cooling is going to cost you depends on things like:

  • Your insurance – your insurance could cover only one type of scalp cooling and you might end up opting for another or your insurance could cover all three types of treatment and then you can choose with no worry.
  • Your chemo schedule – how many cycles of chemotherapy you need will affect the cost of scalp cooling that goes with it.
  • The brand of scalp cooling – different brands of scalp cooling treatments come with different price tags. 
  • The type of scalp cooling – depending on whether you’ll decide to go with ice packs, cooling caps or scalp cooling system the cost will change. 

The average price range you’re looking at, according to the National Cancer Institute is $1,500 $3,000 but again, that number depends on different factors and in certain cases – for example, if you join a clinical trial testing scalp cooling therapy – the price for you maybe $0,000. 

What brands can I choose from? 

In 2015 the FDA approved the DigniCap for the treatment of breast cancer patients undergoing chemo. In 2017 the scalp cooling system was cleared for all cancer patients treated with chemo drugs commonly associated with hair loss. The Paxman scalp cooling system also received FDA approval. 

Manual cold caps on the other hand still await FDA clearance which means that treatment centres don’t stock them and patients often bring their own. Based on patients’ recommendations the Rapunzel Projects endorses the following brands: Penguin Cold Caps, Chemo Cold Caps, Arctic Cold Caps, Wishcaps and Warrior Caps. Talk to your treatment team about different opportunities as they will be in a position to help you make the best choice based on your particular circumstances. 

Can I join a clinical trial?

As we mentioned earlier, if you join a trial testing the effects of scalp cooling during chemo, all associated medical costs will be covered by the trial sponsors. This is a general rule whatever treatment in research you want to access. 

FindMeCure comes up with 3 trials for scalp cooling worldwide. A recruiting trial in Singapore is testing the effects of scalp cooling combined with cooling of the limbs to prevent peripheral neuropathy (numbness) – researchers want to know whether simultaneous use of these supportive treatments is a good idea or it’s going to result in a reduction of core body temperature. 

Another recruiting trial, this time in the Netherlands, is testing the beneficial effects of shortening post-infusion cooling time (PICT) for paclitaxel-treated patients. Previous research has suggested that shortening the PICT from 90 to 45-20 minutes leads to a higher percentage of hair preservation in docetaxel-treated patients.

A recruiting trial in Beijing, China is comparing the effects of a scalp cooling system vs. the effects of a cooling cap in breast cancer patients. If you live near any of these areas you can join a clinical trial for a scalp cooling treatment today. Either way, the results of clinical trials help further research and ultimately benefit everyone – even patients who did not participate in the study.


  1. This was a fascinating read as I had no idea there was a way to possible reduce the hair loss that is caused by chemo therapy. This definitely seems like an option that everyone should at least know about. I will have to send this article to my sister-in-law, since she may be dealing with cancer soon so this info could help her.

  2. Really this topic of my interests thank you.

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