Instructions for applying the cold cap

Scalp cooling is a process intended to help reduce hair loss from chemotherapy.

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

We have prepared step-by-step instructions to teach you how 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

Step 1: Preparing yourself

The first step is to prepare yourself for having scalp cooling. Make sure that you have a:

• water spray bottle
• pot filled with hair conditioner
• towel
• headband

You need to sit in a comfortable position at the styling station.

Step 2: Finding the right sized cold cap

The second step is to try the cold caps available and find the most suitable size for you. Our cold caps range in size from extra small to extra large.

We recommend that you remove any hair ties, plaits or braids to create the best possible fit. Please tell the nursing team if this is a challenge for you. We can then talk about it in more detail.

When trying the cold caps, you need to find one that:

• has a snug fit (the cold cap should not rise after you have put it on)
• touches the crown at the back of your head

The cold caps are a standard shape. As everyone's head is a different shape and size, we often see small gaps between the cap and the scalp in certain areas.

Step 3: Getting your hair ready

You need to comb your hair before you start to make sure that there are no tangles. Then follow this process:

1. Use the water spray bottle that we have given you to dampen your hair slightly. You need to do this all over to flatten your hair and make it easier for the cold cap to fit.
2. Put on a small amount of conditioner (the size of a 50p coin) and cover your hair with a thin layer.
3. Pull your hair back to keep it away from your face.
4. Put on the headband but avoid covering the hair at the front of your head. The front of the headband should sit on your forehead.

Step 4: Fitting the cold cap

It is time to fit the cold cap by following this process:

1. Fit the outer cap over the inner cap.
2. Apply the cold cap onto your head.
3. Bring the chin strap down and put it under your chin.
4. Fasten the tightening straps until they feel secure but make sure that you can still open your mouth.

Step 5: Connecting to the machine

You can now go to your treatment chair. One of the health professionals connects the cold cap to the scalp cooling machine.

Your cold cap is connected: 

• for 30 to 45 minutes before your chemotherapy session
• during the chemotherapy session
• for 20 to 90 minutes afterwards

It is recommended that you avoid disconnecting the cold cap from the machine during the 30 to 45-minute period before your chemotherapy starts. When this part of the process has passed, you can disconnect the cap. However, the cap should not be disconnected for more than 10 to 15 minutes.

The time that you need to wear the cold cap depends on your hair type and chemotherapy medicine:

• How long you wear the cold cap before your chemotherapy session depends on your hair type. If you have Afro-Caribbean hair, you will need to wear the cold cap for 45 minutes in advance. For all other hair types, you will need to wear the cold cap for 30 minutes before having chemotherapy.
• How long you wear the cold cap after your chemotherapy session depends on the chemotherapy medicine. The recommended time ranges from 20 minutes to 90 minutes.

Step 6: Removing the cold cap

When the scalp cooling is finished, we recommend that you wait up to 10 minutes before removing the cold cap. This defrosting period:

• allows your hair to reach room temperature before you remove the cold cap
• protects your hair and prevents you from pulling it

You then need to use the towel that we have given you to pat your hair dry gently.

You are now ready to go home.