Scalp Cooling
A Way to Help Keep Hair During Chemo
Hair loss is one of the most visible and emotional side effects of chemotherapy. For many young patients, it’s more than cosmetic — it can impact your confidence, identity, and sense of normalcy.
If you’re concerned about losing your hair, you’re not alone, and you may have options. One medical approach that sometimes helps reduce hair loss is called scalp cooling.
What Is Scalp Cooling?
Scalp cooling is a treatment designed to help protect hair during chemotherapy. It works by lowering the temperature of your scalp, which reduces blood flow to the hair follicles. This helps shield them from chemo’s effects, potentially preventing or reducing hair loss.
How Does It Work?
Chemotherapy attacks fast-dividing cells — that’s how it fights cancer. But hair follicles also divide quickly, which is why hair loss is so common. Scalp cooling involves wearing a specially designed cold cap that chills the scalp before, during, and after chemo. This cooling slows down the activity of the hair follicle cells and makes it harder for the chemo to reach them. Scalp cooling works better for some chemotherapy drugs than others, so bring this up with your care team if this is important to you.
What to Expect at Each Appointment
If you are a candidate for scalp cooling, it will start at your very first chemo session and continue at every treatment. Here’s how it typically works:
Lightly dampen your hair and apply a small amount of conditioner.
A nurse helps fit the cooling cap system, which includes a snug silicone inner cap, a secure outer cover, and a forehead pad or headband for comfort
The cap is attached to a machine that circulates cold liquid through the system.
You’ll wear the cap 30 minutes before chemo, during the infusion, and for 90 minutes afterward. You can briefly disconnect the cap to use the bathroom or grab a snack during treatment.
How It Feels
Most people feel cold and a little uncomfortable during the first 10–15 minutes. After that, many adjust to the sensation. You may feel:
- Cold, heavy pressure on your scalp
- Headaches or neck discomfort
- Itching or tingling
- Lightheadedness (less common)
Let your care team know how you’re feeling. They can offer meds, warm blankets, or tips like guided breathing to help you stay more comfortable.
Is It Right for You?
Scalp cooling only works with certain types of chemotherapy. It’s not the best solution for everyone, but many young patients who have the option find it empowering.
Here’s what you should know:
- You’ll need to be fitted for your cap before your first chemo — this takes a few days to arrange
- A proper fit is crucial for the treatment to work well
- You’ll need to bring your cap to each appointment
- Cold capping is usually not covered by insurance and can be pricey. Access to cold capping also varies by treatment location
Talk to your oncology team about whether scalp cooling is a good match for your treatment plan and goals.
Resources For Scalp Cooling Treatment
For people hoping to reduce hair loss during chemotherapy, cost can be a major barrier. Hair to Stay helps make scalp cooling more accessible by offering financial assistance to low-income patients. Their subsidy program supports individuals who want to pursue scalp cooling as part of treatment but may not have insurance coverage or the means to pay out of pocket.
