Cold caps: do they work?

PUBLISHED ON: 25 May 2017

A nurse showing a woman a cold cap

Can wearing a cold cap during chemotherapy stop you losing your hair?

Hair loss can be an extremely distressing side effect of chemotherapy. ‘Should I use a cold cap?’ is one of the most common questions about chemotherapy asked by women on Breast Cancer Care’s Forum. Cold caps, or scalp cooling, offer the possibility of preventing or reducing hair loss from certain chemotherapy drugs.

But what is scalp cooling and does it work?

We asked several women who’ve used cold caps to share their experiences and tips.

What is a cold cap?

A cold cap is a special hat that’s worn during chemotherapy. There are two main types of scalp cooling.

The first type uses a cap filled with a cold gel. It needs to be changed every 20–40 minutes to keep the scalp cool.

The second type uses a refrigerated cooling machine to pump a liquid coolant through the cap throughout the treatment.

Both types need to be worn for some time before, during and after chemotherapy is given.  

What do cold caps feel like?

As you’d expect cold caps are very cold, and they can be quite heavy. Some women describe having a headache while wearing one.

I did use the cold cap and can only explain the experience as having a severe ice cream headache or brain freeze for 10–15 minutes. Once the freezing had taken place I did not feel the cold cap anymore.

Amanda

I found it very uncomfortable, heavy and unpleasant. It gave me a bad headache.

Karen

It was worse for first half hour then became bearable and, as the time went on, no problem at all.

Niki

Because the cap is worn before and after treatment, it means you’ll probably be at the hospital for longer.

Do cold caps work?

Scalp cooling is thought to reduce blood flow to the hair follicles. This in turn may reduce the amount of chemotherapy drugs reaching the follicles. But how effective is it at preventing or reducing hair loss?

The truth is that scalp cooling doesn’t work for all chemotherapy drugs and its effectiveness varies from person to person.

My hair thinned on the first chemo regime but this last regime of chemo, which I was on for 13 months, I have kept a full head of hair. To keep as much hair as possible and look as much like you when you look in that mirror makes such a difference, and for me has been worth every hour I have spent wearing the cap.

Mandy

I'm so pleased I persevered with the cold cap. I kept a good covering of hair throughout treatment, which helped keep me much more positive.

Amanda

Some women have little success with scalp cooling.

I was told there were no guarantees with the cold cap. In the end I cold capped but I still lost a significant amount of hair. I wore a wig for about four months as despite cold capping I did have a fair bit of hair loss.

Christine

I only had two cold cap sessions as my hair started to fall out after one round of chemo. My consultant hinted at the fact that it was unlikely to work for me but I still gave it a go.

Karen

To improve the chances of the cold cap being effective, it’s important the cap covers the whole scalp and fits snugly.

I wore the cold cap and on my first wearing it was not tight up the back of my head or right hand side. I lost all my hair on the back of my head up to half way. I also lost most of my hair on my right hand side, over my ear, and also patches on the top.

Amanda

If you do keep your hair, you may find that it’s patchy or thinner.

My hair did definitely thin out, and towards the end of treatment I did wonder if it had been worth the cold cap. People who knew me could see the difference but those that didn’t know me before just thought I had thin hair. I never used a scarf, bandana or wig.

Niki

Scalp cooling is often less effective on African and Caribbean hair, so increased cooling times may be recommended.

Cold cap tips from women who’ve tried it

Ask your specialist or chemotherapy nurse if scalp cooling is available and suitable for you.

Many women describe the first half hour of wearing the cap as being the most uncomfortable.

Niki’s tips

  • I took in a flask of hot herbal tea which I sipped constantly through a straw and the steam reduced the headache for sure.
  • I had earphones and listened to either music or mindfulness recordings to distract me.
  • I wrapped in layers and was given an electric heat pad which was brilliant.

Amanda’s tips

  • To get through the first part I used to put on a big cosy woollen poncho.
  • I would sit quietly with my eyes shut, just thinking happy thoughts.
  • I used to take a water spray bottle and conditioner to every chemo session. Just before the cap went on I wet my hair thoroughly, applied lots of conditioner then carefully combed my hair flat against my head.

Mandy’s tips

  • Make sure the hair is as wet with the conditioning treatment supplied as possible.
  • You need to feel the cap on your scalp, especially the crown area, so I have the cap as tight as I can.
  • Once the scalp cooling finishes, allow plenty of time (I find about 20 minutes) for the cap to defrost so you don't pull the hair out when you remove it. You will know when it's ready as it will lift off easily with no tugging to the hair.

Looking after your hair

Even if scalp cooling works and you keep your hair, chemotherapy may make your hair brittle, dry or straw-like, so it’s a good idea to treat your hair as gently as possible.

  • Try not to wash your hair for about two days after chemotherapy.
  • Use a mild, unperfumed shampoo and conditioner.
  • Try not to wash your hair more than twice a week and use warm, rather than hot, water.
  • Pat your hair dry, rather than rubbing it.
  • Brush your hair gently with a soft hairbrush or wide-toothed plastic comb.

Connect with other people having chemotherapy on our Forum

You might be interested in:

» Ten tips for getting through chemo

» Hair regrowth after cancer and why I ditched the wigs

» When hair grows back after chemotherapy

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