The benefits of scalp cooling with chemotherapy

Losing your hair during chemotherapy treatment for breast cancer is a big worry for many women. While most chemotherapy drugs used for the treatment of early breast cancer do cause hair loss, there are techniques which aim to reduce how much hair is lost when used in conjunction with certain chemotherapy drugs. We explore how scalp cooling works and who may find it most effective.

How scalp cooling for chemotherapy works

Scalp cooling is a technique developed to try and reduce hair loss associated with some chemotherapy drugs. Scalp cooling works by lowering the temperature of the scalp before, during and after each chemotherapy treatment as a means of reducing blood flow to the hair follicles.

Scalp cooling involves wearing a tight-fitting cap during your chemotherapy treatment which is connected to a machine that circulates a cold gel around your scalp. The cold gel restricts blood flow to the hair follicles on the scalp only. Other body hair including eyelashes and eyebrows are still likely to fall out with chemotherapy.

Does scalp cooling really work?

Many factors affect the success of scalp cooling, including the type of chemotherapy you are receiving, the fit of the scalp cooling cap and the type of hair that you have. For reasons that are unclear, scalp cooling does not work as well in people with Asian/African ancestry.

Many people who have scalp cooling with their treatment still experience total or significant hair loss. For many others however, scalp cooling has left them with enough hair so that they don’t feel the need to use a wig or a head covering.

Research, including studies conducted at the Mater Hospital and Patricia Ritchie Centre, has demonstrated that scalp cooling has been shown to prevent around 50% of chemotherapy-induced hair loss in women receiving treatment for breast cancer.

For women having chemotherapy combinations without an anthracycline (e.g. TC), around two thirds have hair loss of 50% or less. For women having a combination including an anthracycline (AC, EC, FEC), around forty percent have hair loss of 50% or less.

I’ve heard that scalp cooling can be painful?

Some people find scalp cooling uncomfortable. It may cause you to develop a headache, feel dizzy or nauseated. You might also feel uncomfortable due to the pressure of the cap. Taking paracetamol 30 minutes before scalp cooling starts might help. Some people who feel the cold also find it helpful to bring a warm socks and jumper, jacket or blanket to help stay warm.

Scalp cooling also adds extra time on to your treatment (~60-90min) due to the need for cooling prior to starting your infusion, as well as for some time afterwards.

Can I still cut and colour my hair?

If you wish to dye your hair, we recommend doing this prior to using scalp cooling and to use a low ammonia or demi-permanent product.

Some women prefer to cut their hair short before treatment to minimise the quantity of hair loss. Other women say that keeping their hair around shoulder length was helpful for styling to cover up bald patches. Either way, how you style your hair while undergoing scalp cooling treatment is entirely your choice.

We do recommend avoiding washing your hair too frequently (once a week may be sufficient), and to use gentle products with a low pH (5.5).

More information on scalp cooling

Scalp cooling at the Mater is generously supported by grants from the Friends of the Mater Foundation so there is no additional cost for this service. Most women find that it’s not too much of a burden however you can stop it at any time.

For more information about scalp cooling at the Mater, visit the Patricia Ritchie Centre website.

An information guide about scalp cooling by the University of Melbourne and Peter MacCallum Cancer Centre is also an excellent resource.