What is Scalp Cooling?
Scalp cooling, or scalp cooling therapy, is a simple and innovative method to minimize hair loss in patients with cancer undergoing chemotherapy.
This technique involves the use of a special cap filled with a cooling gel or liquid. Patients wear the cap before, during, and after each chemotherapy session.
There are two types of scalp cooling treatments: cold caps and scalp cooling systems.
Chemotherapy drugs target the rapidly growing cells in the body, including those in hair follicles. This results in hair loss, also known as chemotherapy-induced alopecia. A scalp cooling cap for chemo minimizes the toxic effects of chemotherapy drugs on hair follicles.
Patients generally wear the cooling cap for 30 to 45 minutes before chemotherapy, during chemotherapy, and continue to wear it 2 hours after the chemotherapy.
Scalp cooling systems, on the other hand, use a machine-driven cooling cap that is connected to a refrigeration unit and circulates a coolant through the scalp region throughout the chemotherapy infusion. The temperature is maintained between 15 and 20 degrees Celsius throughout the session.
Is Scalp Cooling Therapy Effective for Cancer Patients?
Patients usually ask, “Does scalp cooling work for chemo?”
Multiple studies have been carried out to study the efficacy of scalp cooling therapy in chemotherapy patients.
- A systematic and meta-analysis study from 2024 reported that automated scalp cooling devices led to a 47% reduction in hair loss and non-automated scalp cooling devices led to a 43% reduction in hair loss among chemotherapy patients.
- A 2024 Asian study found that women who underwent anthracycline- and taxane-based treatments for breast and gynecological cancers were 50% more likely to achieve hair preservation and better hair regrowth after treatment.
The scalp cooling technique is safe and has been approved by the US Food and Drug Administration. It promotes a sense of normalcy during cancer treatment for patients, reduces emotional distress, and supports a better quality of life during treatment.
Patients using scalp cooling caps may experience mild side effects, such as headaches and chills. However, these side effects are temporary and wear off after a few hours.
How Does Scalp Cooling Work?
Scalp cooling technology reduces the temperature of the scalp during and after the chemotherapy session.
Scalp cooling causes the blood vessels in the scalp to constrict (vasoconstriction), leading to reduced blood flow to the scalp region, which in turn reduces the amount of chemotherapy drugs reaching the hair follicles.
A lower temperature on the scalp decreases cell division in hair follicles, making them less vulnerable to chemotherapy drugs.
What are the Advantages and Disadvantages of Scalp Cooling Therapy?
Advantages of Scalp Cooling Therapy
Key advantages associated with scalp cooling therapy for chemotherapy patients include:
- Helps Reduce Hair Loss: Scalp cooling lowers the scalp temperature, controlling the amount of chemotherapy drug that reaches the hair follicles. It reduces damage to the hair follicles and improves hair preservation for patients.
- Boosts Confidence and Self-Esteem: Chemotherapy-induced hair loss is a visible reminder of cancer for patients and their caregivers. It also reduces confidence and self-esteem. The scalp cooling technique helps patients maintain a positive self-image.
- Encourages Treatment Acceptance: Chemotherapy-induced alopecia is a barrier to treatment adherence and causes patients to avoid or delay chemotherapy. Scalp cooling eases this fear and improves treatment adherence.
- Supports Mental Well-being: The preservation of hair through the scalp cooling technique reduces depression and anxiety related to cancer treatment.
- Proven and Safe: Scalp cooling therapy is FDA-approved and is used worldwide. Most people tolerate the treatment well, experiencing only minor side effects, such as nausea, chills, and headaches.
Disadvantages of Scalp Cooling Therapy
Some of the disadvantages of scalp cooling therapy for cancer patients include:
- Not Always Effective: Scalp cooling therapy is not effective in all patients. Some patients may experience moderate to severe hair loss even after undergoing scalp cooling during chemotherapy.
- Time-Consuming Process: Scalp cooling therapy is a time-consuming process, as the patient must wear the cooling cap for a considerable period. This makes the treatment more tiring.
- Costly and Unavailability: It is expensive due to the high infrastructure costs. Further, it is not available at all chemotherapy centers. Also, scalp cooling therapy is generally not covered by insurance.
- Discomfort from Cold: Some patients may experience headaches, chills, and discomfort related to cold during scalp cooling therapy. Patients may also experience discomfort as they have to wear the cap for extended periods.
- Not Suitable for All Patients: It is not suitable for all patients. It is contraindicated in patients with cold agglutinin disease, cryofibrinogenemia, cold sensitivity, cryoglobulinemia, and post-traumatic cold dystrophy.
What are the Risk Factors Associated with Scalp Cooling?
The scalp cooling therapy is safe and tolerated by most patients.
The majority of the patients experience only mild side effects. Commonly observed side effects of scalp cooling include:
- Cold Discomfort: It is one of the most frequently reported side effects of scalp cooling therapy. Patients generally experience an intense feeling of cold, especially during the first 15 to 30 minutes of wearing the cap. It may cause chills and shivering in patients.
- Headaches: Patients may also experience headaches triggered by cold temperatures on the scalp. The intensity of headaches may be mild to moderate.
- Scalp and Neck Pain/Discomfort: Patients may also experience discomfort or pain in the forehead or scalp due to prolonged wear of the cap. Patients may also experience nausea and dizziness during scalp cooling therapy.
- Claustrophobia: Wearing a tight-fitting cap for an extended period may induce a feeling of claustrophobia in some individuals.
- Dry Skin/Scalp Irritation: The cold temperature from the cooling cap may cause dryness of the scalp. In rare cases, the patients may also experience mild cold burns, especially when the non-regulated caps are used.
- Scalp Metastasis: Scalp metastasis is also a concern with scalp cooling therapy in certain types of cancer, as it reduces the amount of chemotherapy drugs reaching the scalp. Thus, if microscopic cancer cells are present in the scalp, they may not be effectively killed, which can result in cancer spreading to the scalp.
That said, oncologists will comprehensively examine this risk in patients before recommending the use of scalp cooling technology.
Conclusion
Scalp cooling therapy is a safe and FDA-approved treatment. It helps reduce hair loss in patients with cancer undergoing chemotherapy. It works by lowering the scalp temperature and limiting drug exposure to hair follicles.
The advantages of scalp cooling therapy include improved mental and emotional well-being, increased treatment adherence, and safety. Potential side effects may include nausea, dizziness, chills, headaches, and discomfort.
Those patients with serious concerns related to hair loss due to chemotherapy may speak to their expert team about the possibility of including scalp cooling therapy in their chemotherapy plan.
At HCG Cancer Centre, we offer scalp cooling therapy for certain cases of cancer. We have found this intervention to help reduce hair loss and unnecessary distress for our patients.
