Overview

Scalp cooling is a process intended to help reduce hair loss from chemotherapy. It is only effective with some types of chemotherapy treatment that cause hair loss as a side effect. Any type of hair is suitable for scalp cooling. 

If you have scalp cooling, you will wear a cap on top of your head during your chemotherapy treatment. This is often called a cold cap. It:

• lowers the temperature of the skin on your head (your scalp)
• helps to protect the hair follicles by limiting blood flow to the scalp
• reduces the amount of chemotherapy medicine that reaches the hair follicles

We can teach you to apply the cold cap yourself. This can help you to:

• feel fully part of the scalp cooling process
• have control over an aspect of your care

We have prepared step-by-step instructions for applying the cold cap.

The aim of this information is to help you make an informed decision about whether to self-apply the scalp cooling.

Types of chemotherapy suitable for scalp cooling

Scalp cooling is suitable for some types of chemotherapy that cause hair loss. We currently offer scalp cooling for chemotherapy treatment with these medicines (this is not a complete list):

• cabazitaxel (also called Jevtana®)
• cyclophosphamide (also called Cytophosphane®)
• docetaxel (also called Taxotere®)
• doxorubicin (also called Adriamycin®)
• epirubicin (also called Pharmorubicin®)
• eribulin (also called Halaven®)
• etoposide (also called Etopophos® or Vepesid®): scalp cooling is only available if you have all doses (recommended amounts) of the medicine through a vein rather than as tablets
• nab-paclitaxel (also called Abraxane®)
• paclitaxel (also called Taxol®)
• pegylated liposomal doxorubicin (also called Caelyx®)
• sacituzumab govitecan (also called Trodelvy®)
• trastuzumab deruxtecan (also called Enhertu®)
• topotecan (Hycamtin®): scalp cooling is only available if you have all doses of the medicine through a vein rather than as tablets

Who is not eligible for scalp cooling

Scalp cooling is not suitable if any of the following apply to you:

• You have a blood (haematological) cancer, such as myeloma, leukaemia or lymphoma, or brain (neurological) cancer. This is due to the increased risk of cancer cells surviving in the blood vessels of the scalp.
• You get severe headaches or migraines. Scalp cooling can sometimes cause headaches. If you regularly get headaches, we recommend that you do not increase your chance of having one by using the cold cap.
• You have a head wound. This is because scalp cooling is likely to slow down the healing process and increase the chance of an infection within the wound.
• You have been diagnosed with the condition total alopecia (which causes complete loss of hair on the scalp) or already have hair loss. 
• After you leave our Chemotherapy Village, you continue taking a chemotherapy tablet or using a chemotherapy pump attached to you at home. Scalp cooling is only effective when done at the time that the chemotherapy enters the body.

Benefits of scalp cooling and doing it yourself

If you decide to scalp cool, there is a greater chance of reducing hair loss from chemotherapy. Depending on the chemotherapy treatment that you are having, there is research available to confirm the success rates. You can find this information online.

We can teach you to apply the cold cap yourself. Our aim is for you to feel empowered to be part of the process. By choosing to do this, you can take your time to make sure that:

• the cold cap fits properly
• you are happy with the fit

Risks of scalp cooling

Research has shown that scalp cooling sometimes causes side effects, such as:

• headaches
• feeling sick (nausea)
• dizziness
• scalp pain

A large percentage of our patients do not get any side effects. Please tell us if you do and we can then help you.

It is common to feel cold during the scalp cooling process. However, when your body has adapted after about 10 to 15 minutes, you often do not feel as cold.

Please wear warm clothes and cover yourself with a blanket to make the experience as comfortable as possible.