Scalp cooling during Chemotherapy: Cancer treatment does not always mean hair loss

14 Feb, 2023

A majority of cancer patients find their journey to be terrifying, not just because of the disease itself but also the impact of its treatment. In the past, cancer management often meant facing aggressive treatments that came with unavoidable side effects. Most of the side effects are temporary; they disappear over time, and the patients start to feel better. Nevertheless, some of these side effects, although temporary, can cause psychological distress among cancer patients, and one of the most common ones to do so is hair loss. 

Hair loss that occurs due to chemotherapy can cause hair loss in patches, not just on the scalp but on other parts of the body, too. This can not only affect the patients’ confidence but may also affect their will to complete the treatment.  

Over the years, we have discovered a few promising approaches that help reduce hair loss during chemotherapy. However, before learning about the ways to reduce hair loss during chemotherapy, it is important to understand why chemotherapy causes hair loss. 


Why Does Chemotherapy Cause Hair Loss? 

Chemotherapy causes hair loss because it targets rapidly dividing cells in the body. Hair follicle cells are some of the fastest-growing cells in the body, making them a target for chemotherapy drugs. The hair follicles are responsible for hair growth, and when they are affected by chemotherapy drugs, they stop producing new hair, and existing hair falls out. This hair loss is usually temporary, and the hair usually starts growing back a few months after the chemotherapy has ended. 

It is important to note that not all chemotherapy drugs cause hair loss, and the extent of hair loss can vary from person to person, depending on factors like the type of chemotherapy drugs being used, the dose, and the patients overall health. 

In recent times, scalp cooling therapy, also known as scalp hypothermia or cooling cap therapy, has shown promising results in reducing hair loss during chemotherapy. 


What is the Scalp Cooling Technique? 

Scalp cooling is a process where a cold cap or a cooling device is placed on the head during chemotherapy to reduce the blood flow to the scalp. Reduced blood flow brings down the amount of chemotherapy drugs that reach the hair follicles, which aids in reducing hair loss. 

Scalp cooling is a simple and non-invasive method that has proven to be effective in reducing hair loss in many patients. It is important to note that not all patients will be eligible for scalp cooling, as some factors like the type of chemotherapy drugs being used, the dose, and the patients overall health will determine the effectiveness of the procedure. 

Scalp cooling is induced during the time of infusion. Patients are made to wear the cooling caps or scalp cooling devices for a certain duration of time before, during, and after each cycle of chemotherapy. 


Is Scalp Cooling Therapy Effective? 

Several studies have been carried out to study the efficacy of scalp cooling therapy in patients with different types of cancer: 

A study conducted in 2015 showed that the use of scalp cooling with cold caps appeared to be effective in preventing chemotherapy-induced alopecia in breast cancer patients undergoing adjuvant docetaxel and cyclophosphamide chemotherapy. [1] 

A 2017 research study found that female breast cancer patients in stages I to II who underwent chemotherapy using taxane, anthracycline, or a combination of both and used scalp cooling experienced a higher likelihood of retaining more than 50% of their hair after the fourth chemotherapy cycle compared to those who did not use scalp cooling.[2] 

A research experiment conducted in 2019 found that utilizing a scalp-cooling device was effective in avoiding hair loss and was considered safe among Japanese patients. Additionally, the scalp cooling technique resulted in a quicker return of hair volume after chemotherapy, even in cases where it did not prevent hair loss caused by chemotherapy. [3] 


Different Techniques of Scalp Cooling 

During chemotherapy, the expert team may use various techniques to administer scalp cooling therapy, including: 

Cold Caps or Cooling Caps: During the infusion, the patient is asked to wear a tight-fitting cap filled with cooling gel or refrigerant to slow down blood flow to the scalp, reducing the amount of chemotherapy drugs reaching the hair follicles. 

Ice Pack Application: This technique involves applying cold packs or a refrigerant to the scalp during chemotherapy, lowering the temperature of the scalp to reduce the blood flow and, thereby, hair loss. 

Scalp Cooling Device: The process involves wearing a two-layer cap that is connected to a cooling machine. The machine delivers coolant to the cap, which is regulated by sensors to maintain a constant temperature. This is done during the chemotherapy treatment and for a period of time after the treatment has finished. Scalp cooling also reduces the temperature of the scalp and stops the chemotherapy drugs from reaching there. 


Is Scalp Cooling Helpful for All Chemotherapy Patients? 

Scalp cooling is not effective for all patients. The effectiveness of scalp cooling can depend on various factors, such as the type and stage of cancer, the type and dose of chemotherapy, the patients hair type, and the patients overall health.  

Some studies have shown that scalp cooling can be effective in reducing hair loss in certain patients, while others have shown limited effectiveness. To know if you are the right candidate for scalp cooling therapy during your chemotherapy, you should talk to your expert team before the treatment. 


Side Effects Associated with Scalp Cooling 

Like every other treatment, scalp cooling is associated with a few side effects. However, these are temporary and can be managed successfully. 

Headaches, chills, neck and scalp discomfort, pain, or itching of the scalp are some of the common side effects caused by scalp cooling. Dizziness or drowsiness may also be seen. On rare occasions, patients may also experience blistering, skin redness, and irritation, and these adverse effects can be managed effectively.  

Not all patients may experience these side effects, and the intensity of the side effects may vary from one patient to another. For more information on the side effects of scalp cooling and its management, you may talk to your expert team. 


Scalp Cooling Therapy at HCG  

The advent of scalp cooling therapy has brought a glimmer of hope for cancer patients who previously had to suffer hair loss as a side effect of chemotherapy. This innovative technique has been proven to be effective in preventing hair loss for many patients, and HCG – the Specialist in Cancer Care, one of the leading cancer hospitals in India, is at the forefront of offering this game-changing therapy to its patients. With a commitment to using technology to improve the cancer journey, HCG is dedicated to making a difference in the lives of those affected by cancer. So, if you are undergoing chemotherapy and dreading hair loss, scalp cooling therapy could be something you may think of. 

[1] Cigler T, Isseroff D, Fiederlein B, Schneider S, Chuang E, Vahdat L, Moore A. Efficacy of Scalp Cooling in Preventing Chemotherapy-Induced Alopecia in Breast Cancer Patients Receiving Adjuvant Docetaxel and Cyclophosphamide Chemotherapy. Clin Breast Cancer. 2015 Oct;15(5):332-4. doi: 10.1016/j.clbc.2015.01.003. Epub 2015 Jan 26. PMID: 25749072. 

[2] Nangia J, Wang T, Osborne C, Niravath P, Otte K, Papish S, Holmes F, Abraham J, Lacouture M, Courtright J, Paxman R, Rude M, Hilsenbeck S, Osborne CK, Rimawi M. Effect of a Scalp Cooling Device on Alopecia in Women Undergoing Chemotherapy for Breast Cancer: The SCALP Randomized Clinical Trial. JAMA. 2017 Feb 14;317(6):596-605. doi: 10.1001/jama.2016.20939. PMID: 28196254.  

[3] Kinoshita T, Nakayama T, Fukuma E, Inokuchi M, Ishiguro H, Ogo E, Kikuchi M, Jinno H, Yamazaki N, Toi M. Efficacy of Scalp Cooling in Preventing and Recovering From Chemotherapy-Induced Alopecia in Breast Cancer Patients: The HOPE Study. Front Oncol. 2019 Aug 6;9:733. doi: 10.3389/fonc.2019.00733. PMID: 31448235; PMCID: PMC6691158. 

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