One of the common side effects of chemotherapy treatment is hair loss, also known as chemotherapy-induced alopecia. Hair loss can happen anywhere that hair grows on your body, but hair loss on the scalp is often a concern for many.  

According to the American Cancer Society, a lower dose of chemotherapy every week is less likely to result in hair loss, as compared to higher doses of chemo administered every 3 weeks. But for those who are worried regardless of their regimen, scalp cooling may be an option if your cancer care team recommends the process and says you’re qualified to try it.

What is scalp cooling?

Scalp cooling, also known as scalp hypothermia, reduces the temperature of your scalp to help reduce hair loss during chemotherapy. Scalp cooling can be administered with two main methods: automated scalp cooling systems and manual scalp cooling devices.

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Automated scalp cooling systems vs. manual scalp cooling devices

Automated scalp cooling systems are FDA-regulated and approved methods of lowering your scalp to a lower temperature to help prevent chemotherapy-related hair loss. Currently, there are three FDA-approved systems (DigniCap, Paxman, Amma) that work by attaching a cooling cap to a cooling machine. The system circulates a cold gel or liquid through the cap to cool the scalp.

Manual scalp cooling devices are frozen cooling caps that are portable and must be frozen ahead of time. You can rent frozen cooling caps and transport them to your treatments with dry ice to maintain the proper temperature. With this method, you’ll need multiple frozen cooling caps since they warm up as you wear them. Make sure you have someone who can help you change the frozen cooling caps during your treatment. Manual scalp cooling devices aren’t regulated by the FDA.

The purpose of both methods is to cool your scalp to reduce bloodflow to hair follicles so that they become less susceptible to the damaging effects of chemotherapy.

Can anyone use scalp cooling?

No, scalp cooling isn’t recommended for everyone. It’s only approved for those receiving chemotherapy related to solid cancer tumors that’s not lymphoma or leukemia. If you have blood cancer, you should not pursue this method and talk to your doctor about alternatives. Additionally, patients under 18 years of age don’t qualify for scalp cooling. 

Below is a list of some conditions that aren’t qualified for scalp cooling:

• Skin cancer, blood cancer, head and neck cancer 
• Squamous cell carcinoma of the lung or small cell lung cancer
• Cancer that affects your central nervous system
• Scalp metastasis or cancer that’s spread to your scalp
• Severe liver or kidney disease
• Sensitivity to cold temperature or cold agglutinin disease
• Radiation therapy on your skull
• Bone marrow ablation chemotherapy 

How effective is scalp cooling?

Scalp cooling doesn’t always prevent hair loss, but it can reduce the amount you may lose during chemotherapy by up to 50%. This all depends on factors like chemotherapy type, length of treatment, overall health, age, and hair type. 

Are there side effects from scalp cooling?

There can be, but the side effects are usually tolerable. They can include headaches, nausea, dry skin, claustrophobia, burning sensation, sinus pain, and an overall discomfort with being cold. 

If you’re looking for methods to reduce chemo-related hair loss, be sure to ask your care team if scalp cooling is right for you.

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