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How To Prevent Hair Loss During Chemo

What To Look For When Choosing A Cold Cap

Preventing Hair Loss During Chemotherapy

Some factors can serve as a guide to help people choose the right supplier. These factors include:

  • Cost: Most cold caps are available for rent for a monthly fee. There may also be an extra charge to cover shipping.
  • Financial assistance: A person should check whether their insurance company covers the costs of cold caps. There are also nonprofit organizations that offer financial assistance.
  • Company services: It is important to check what features a cold cap supplier is offering. For example, some manufacturers offer phone support, instructional videos, and satin pillowcases.

The Memorial Sloan Kettering Cancer Center provides some tips to help individuals prepare for their scalp cooling treatment. It recommends:

  • washing the hair with a fragrance-free shampoo
  • brushing the hair gently using a soft-bristle brush or comb
  • keeping the hair short before beginning treatment
  • using products that help cover bald spots or thinning areas

Some things to avoid using during chemotherapy include:

  • swimming caps

How Is Scalp Cooling Done

Scalp cooling is done by wearing a special cap on your head. There are 2 different ways to cool your scalp: using frozen cooling caps or by using a machine that continuously cools the cap.

Frozen cooling caps

There are many well-known brands of cooling caps:

You can rent the Chemo Cold Cap and the Penguin cap through the companies that make them. Your healthcare provider can give you more information about these products.

Its important for the caps to stay at the same cold temperature before, during, and after your treatment. To do this, you will need to have multiple frozen caps during each chemotherapy treatment and change them as they get warm. Follow each caps guidelines for how many caps you will need and how long you should wear each one.

All caps need to be frozen ahead of time and brought to your chemotherapy appointment in a portable cooler with dry ice. You will need to plan ahead to bring a caregiver, friend, family member, or a hired trained capper to help you change your cold cap during your treatment.

Cap attached to a cooling machine

Memorial Sloan Kettering offers the Paxman Scalp Cooling System. This system works by attaching a cooling cap to a cooling machine. The machine pushes cold liquid through the cap while youre wearing it.

How Do They Work

Cold caps offer scalp cooling therapy that doctors may also refer to as scalp hypothermia. These devices narrow the blood vessels under the scalp to limit the amount of chemotherapy that reaches the hair follicles. Less exposure to chemotherapy can reduce the risk of hair loss.

A 2017 study found that women with breast cancer who received chemotherapy and underwent scalp cooling maintained most of their hair. However, those who did not get scalp cooling experienced substantial hair loss.

A 2017 review found that scalp hypothermia can reduce alopecia and appears to be effective for people receiving chemotherapy for breast cancer and solid tumors.

A more recent 2018 article suggests that cold cap treatment works better in individuals undergoing taxane-based chemotherapy than in those receiving anthracycline. These are two different types of chemotherapy drugs.

Cold caps are available at various prices, which depend on the manufacturer, the number of chemotherapy sessions, and the duration of the scalp cooling therapy.

Most cold caps cost $380450 per month , but there may also be additional costs for shipping and refundable security deposits.

A scalp cooling system can cost $2,0002,200 for a full course of treatment. People who opt for this method may also have to pay a fee to the facility.

Aetna is a health insurance company that may provide coverage for scalp cooling to prevent hair loss.

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Managing Your Hair Loss

Losing your hair can cause more than a change in your physical appearance. It can be an emotional challenge that affects your self-image and quality of life. It is important to be kind to yourself during this stressful time.

People cope with hair loss in different ways. Thinking about how you feel most comfortable in managing hair loss before, during, and after treatment may help. And, your choices may change over time.

Cold cap therapy

Wearing a cap that cools the scalp can help prevent hair loss from drugs given through a vein. This treatment is called scalp cryotherapy. You wear the cap before, during, and after chemotherapy.

The cold makes the blood vessels in the skin of your head narrower. Less blood and less of the chemotherapy drug reaches your hair follicles through the blood vessels. Keeping your scalp very cold also helps prevent damage to the hair follicles. Talk with your health care team to learn if cold cap therapy is available and might work for you.


An over-the-counter medication called minoxidil may help thinning hair from hormonal therapy or targeted therapy. It may also help if your hair does not grow back completely after chemotherapy, radiation therapy, or a stem cell/bone marrow transplant.

There are also other medications you can take by mouth. These include spironolactone and finasteride .

What Causes Hair Loss In Cancer Patients


Chemotherapy targets cancer cells that divide rapidly. But some healthy cells in the body also divide rapidly, like those lining the mouth and stomach, and in the hair follicles. When cancer treatments, especially certain chemotherapy drugs, damage the healthy, fast-growing cells responsible for hair growth, alopecia may result. Radiation therapy may also cause hair loss in the specific area of the body being treated.

Although hair loss does not always happen right away, it usually begins within two weeks of starting chemotherapy treatment and progresses over the following two months. Hair loss in the area being treated with radiation treatment usually begins up to three weeks after the first treatment. Hair loss may continue throughout treatment and up to a few weeks afterward.

Hair loss may occur on the head and/or elsewhere on the body, including the face , hair on the arms, underarms and legs, and pubic hair.

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Cold Caps And Scalp Cooling Systems

Cold caps and scalp cooling systems are tightly fitting, helmet-like hats filled with a cold gel or liquid that you wear during chemotherapy infusions. These devices have helped many people keep some or quite a bit of their hair during chemotherapy that can cause hair loss.

Cold caps and scalp cooling systems work by narrowing the blood vessels beneath the skin of the scalp, which reduces the amount of chemotherapy medicine that reaches the hair follicles. With less chemotherapy medicine in the follicles, the hair may be less likely to fall out. The cold also decreases the hair follicles metabolic activity, which makes the cells divide more slowly and protects the follicles from the chemotherapy.

During each chemotherapy session, you wear the cap for 30 to 50 minutes before the infusion, during the infusion, and for a certain amount of time after the infusion. The amount of time you wear the cap after the chemotherapy infusion can vary from 20 minutes to 4 or 5 hours, depending on the type of chemotherapy youre getting and the type of scalp cooling method you use.

How Long Does Scalp Cooling Take During Treatment

Scalp cooling will add time before and after each of your chemotherapy treatments. How long you need to cool before and after your treatment depends on the type of cooling cap youre using and your chemotherapy. It can range from 20 minutes to 2 hours. If youre using frozen caps, you can go back home with your cold cap on to finish your cooling.

Once you finish each chemotherapy treatment, you may be asked to finish your cooling in a separate area outside the chemotherapy infusion unit so that other patients can get treatment during the day.

Your healthcare team will answer your questions about how long cooling will take after treatments.

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Everyone Is Very Surprised At How Quickly How Thick How Fast My Hair Is Growing Back

Like many cancer patients facing chemotherapy, Jessica Heline of Tinton Falls was concerned about side effects, including a telltale one: hair loss. So, when an oncology nurse at Monmouth Medical Center mentioned that a scalp cooling system could help counteract that problem, Jessica figured it was worth a try.

It appealed to me because I learned I might keep my hairand if I did lose it, it would likely grow back faster afterward, says Jessica, 31, an engineer and mother of a 3-year-old boy.

Jessica was diagnosed with stage 2B invasive ductal carcinoma in her left breast in April 2019. Since cancer had spread to a few of her lymph nodes, her doctors recommended chemotherapy before surgery. While Jessica was primarily concerned with surviving the disease, she wanted to look as normal as possible.

Treatment Helps Many Chemotherapy Patients Prevent Hair Loss

Preventing hair loss during chemotherapy

Hair loss can have an emotional impact on all people during cancer treatments. But now, there’s a procedure that helps most patients.

When Alana Doctor discovered a lump in her breast she was seven months pregnant with her third child.

“And I sort of felt something in the shower one day. And, you know I panicked, as one does,” she said. Within days, a biopsy confirmed she had breast cancer.

“I had a mastectomy, which was at 34 weeks pregnant,” Doctor said. “So, you know, having the surgery when you’re pregnant, that was pretty scary.”

“You know, I want to see my kids grow up. I felt a little bit like i was in survival mode.”

Hair loss is often seen as an inevitable, but emotionally devastating, side effect of chemotherapy. Doctor worried how her two small sons, 5 and 8 years old, might react. Then, her oncologist, Dr. Philomena McAndrew, said she could possibly save some of her hair by freezing her head.

“We want the patient to have their dignity and quality of life throughout the treatment,” McAndrew said.

The process starts with a patient putting on a tight frozen cap before chemo. They then leave it on during the treatment and for 30 minutes after, freezing the scalp in an attempt to stop the chemo from traveling to the hair follicles.

“When you first put them on, it is a bit of a shock to the system,” Doctor said.

Many insurance policies have begun to help pay for ice caps.

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Chemo Hair Fall Timeline

Patients undergoing a chemotherapy treatment will notice different levels of hair loss depending on the pattern of medication, dosage and type of cancer.

  • A lot of patients experience hair fall within the first 1 or 2 weeks of treatment itself.
  • Hair loss usually tends to begin from the side of the ears and top of the head. However, it varies for each individual.
  • By about 3 months, complete balding may occur.
  • Patients tend to notice their hair regrowing after 1 to 3 months. A change in hair color and texture may be evident but are usually not permanent.
  • 60 percent of patients have reported a change in their color and hair type.

Did You Know?

  • About 65 percent of patients undergoing chemotherapy experience alopecia .

Be Gentle To Your Hair

Be gentle to yourself generally, especially during this period of your life. Treat your hair gently by following a couple of simple advice, like washing it with a mild shampoo, avoiding excessive combing, staying away from curlers, fans, and other heat sources, using a brush with sparse teeth, avoiding aggressive hairstyles.

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Coping With Hair Loss During Chemotherapy

Casey Gallagher, MD, is board-certified in dermatology. He is a clinical professor at the University of Colorado in Denver, and co-founder and practicing dermatologist at the Boulder Valley Center for Dermatology in Colorado.

One of the most distressing side effects of chemotherapy is hair loss . For many of us, our hair is part of our image, the way the public sees us when we step outside. Understanding the reasons for hair loss, and ways to cope emotionally and physically with hair loss ahead of time may ease some of this distress on your journey through chemotherapy.

A Short Haircut Might Make A Difference

Cold caps tested to prevent hair loss during chemo

Shorter hair often looks fuller than longer hair. As a result, hair loss might be less noticeable if you have a short hairstyle. If you typically wear your hair long, consider cutting it before you begin chemotherapy.

After you start chemo, hair loss might make your scalp feel itchy, irritated, or sensitive. Shaving your head can help ease the discomfort. Many people also prefer the look of a cleanly shaved head to partial hair loss.

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How To Use The Paxman Scalp Cooling System

If youre interested in using the Paxman Scalp Cooling System, talk with your healthcare provider before your first chemotherapy treatment. They will sign you up and Paxman will send you your cooling cap and kit. You will receive it in 3 to 4 days.

Its important that you get ready for your scalp cooling treatment before your first appointment. Your nurse will connect your cap to the cooling machine, but you will need to prepare your hair and fit your cap on your head.

To learn how to get ready for your Paxman scalp cooling treatment, watch the videos on the Paxman website at

After you watch the videos, practice getting your hair ready and fitting your cap. You may need some help from a caregiver, friend, or family member. You may also bring someone to your appointment with you.

Remember to bring your cap and kit with you to your appointment.

Be Gentle To Your Head Skin Too

Treating the scalp skin is just as important as being gentle to your hair. There are methods you can use additionally to make sure there is no itch or bruises caused by scratching.

Also, ask your doctors about scalp hypothermia it involves placing ice packs or similar cooling items on your head before, during, and after chemotherapy. The consequences are a feeling of coldness which influences blood vessels to narrow down and take in less medicine. According to some experiences, this reduces hair loss.

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Hair Loss Related To Chemotherapy

Chemotherapy works by attacking fast-growing cells. Cancer cells are fast growing, but so are other cells, such as hair cells. Chemotherapy can cause hair loss on your scalp, eyebrows, eye lashes, arms, legs, and pubic area. Depending on your chemotherapy, you can lose hair in none, some, or all of these areas.

You may start to see your hair fall out 1 to 4 weeks after your first chemotherapy treatment. How much of your hair falls out depends on the type of chemotherapy and how much and how often you receive it. Talk with your healthcare team about the amount of hair loss you should expect from the chemotherapy you will receive.

How quickly hair falls out also varies from person to person. The first signs of hair loss may be more hair on your pillow in the morning, in the shower, or when you brush your hair.

Once your chemotherapy has stopped, your hair should begin to grow back. It can take 3 to 5 months for your hair to grow back, and it may have a different texture, color, or volume. For most people, hair grows in as fully as it was before chemotherapy.


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