For many people, their first question after learning they have cancer is not, “Am I going to Live?” but, “Am I going to lose my hair?”
It’s a big deal. There are so many women and children (and men!) who have bravely borne the loss of their hair. Some have learned to embrace their new look, and others have become impressively imaginative in their use of hats, wigs, bandanas, and even beautiful henna tattoos. Cancer patients regularly face hair loss with bravery and creativity, and that’s always a good look!
But the reality is that many would choose to keep their hair if they could. With increasing options for cooling systems (both portable cold caps and cooling systems connected to machines), more cancer patients may be able to keep their hair, or at least enough of it so that no one can tell they’re going through chemo.
How do cooling systems and cold caps work?
The idea is pretty simple: keep your head so cold that the blood vessels constrict and less of your chemo drugs reach your scalp. The caps are filled with a gel that’s cooled to between -15 and -40 degrees Fahrenheit. Brrrr!
In addition to narrowing the blood vessels, the cold temperature also decreases the activity of the hair follicles and makes them less likely to be affected by chemotherapy. With less chemo reaching your scalp and less activity in your hair follicles, your hair is less likely to to fall out. Caps are worn before, during, and after a chemotherapy session.
What’s the difference between a machine-based cooling system and a cold cap?
Both options work based on the same principles and will get your head properly chilled. A cold cap is pretty simple in that it’s kept in a special freezer and packed in dry ice. Cold cap systems are usually rented by the patient, and, because they do thaw a bit while on the head, they need to be replaced about every 30 minutes.
Machine-based cooling systems are a bit more convenient, because they are kept in-house at the cancer treatment center, and patients just pay a fee to use them (hopefully both options will be covered by insurance soon). A machine circulates coolant through the cap while the patient goes through therapy so that the cap does not need to be switched out.
The side effects? You may have guessed: your head gets really cold. Some people get headaches while wearing the caps, and you’ll want to dress warmly before using one. Some users also experienced dizziness and nausea. In one study, a woman decided to stop using the cooling system because it was simply too cold.
Are they effective?
Unfortunately, the caps are not effective 100% of the time. In trials, they were deemed to be between 50 and 65% effective, but results vary based on the type of treatment prescribed—cold caps and cooling systems were more effective when used with taxane chemotherapy than anthracycline chemotherapy. Several cold caps and cooling systems have been approved by the FDA and are currently available at many cancer care centers.
Hair Care While Using a Cooling System or Cold Cap
Even the hair that is saved by using a cap will need to be treated with tender loving care while going through treatment. Breastcancer.org recommends that women not do any heat styling (not even blow drying), wash hair with cool water and gentle shampoo no more than every third day, avoid coloring their hair until at least three months after treatment, and brush and comb their hair gently.
Currently, it looks like most patients interested in using a cooling system or cold cap will need to pay out of pocket, but, of course, check with your insurance. As the systems become more popular, costs may go down and insurance companies may start to cover them. The Paxman Scalp Cooling System, for example, would cost about $1,500 to $3,000 over the course of chemotherapy, but the company hopes to make using the system more affordable.
The Rapunzel Project and Hair to Stay Foundation are nonprofits dedicated to helping patients afford scalp-cooling technology. Patients interested in using a cap may want to contact these organizations for possible assistance.
For patients like Brynn, being able to keep some of her hair was empowering. She says she felt like she was able to recognize herself in the mirror each morning. And Brynn was able to decide who she wanted to share her diagnosis with—it wasn’t obvious from her hair loss. Scalp cooling systems help to protect patient privacy as well as their hair. We think that’s pretty cool!
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.