Scalp Cooling: A Way To Combat Hair-Loss During Chemotherapy

A trademark side effect of cancer is hair loss, but that may no longer have to be the case. The effectiveness of scalp cooling, a method to prevent chemotherapy induced hair loss, has been outlined in several recent studies conducted at University of California, San Francisco and University of Baylor College of Medicine.

According to an article by the American Cancer Society, “Cooling Caps to Reduce Hair Loss”, scalp hypothermia, or scalp cooling, is a method of cooling the scalp with ice packs or cooling caps during, before and after each chemotherapy treatment to reduce the effects of chemotherapy on hair loss cells. We have previously written about how this treatment is already widely used in Europe and is gaining ground in the U.S.

Chemotherapy uses cytostatic drugs, or drugs that prevent cell growth and division, to stop cancer cells from rapidly dividing by attacking the body’s cells. While chemotherapy attacks cancer cells, it also attacks healthy cells, such as hair cells, which will result in hair loss.

In an article released by Cornell Weill Medical, “Scalp Cooling Can Help Some Breast Cancer Patients Retain Hair”, Dr. Hope S. Rugo, a UCSF professor that led the study, explains the theory behind scalp cooling. Dr. Rugo says the cold temperatures slow hair follicle cell division, and therefore creates a less susceptible environment for the damaging effects of chemotherapy.

Blood vessels dilate when the body is exposed to heat and constrict when the body is exposed to cold. When the body becomes too hot, the blood vessels will dilate so that the blood can flow closer to the surface of the skin so heat can be released from the body. When the body is exposed to cold the blood vessels will constrict to conserve heat in the body.

According to the aforementioned American Cancer Society article, when cooling constricts the blood vessels in the scalp, the amount of chemotherapy that is able to reach the cells of the hair follicles reduces; therefore, the effect of chemotherapy on the follicle cells reduces and as a result there is less hair loss from the scalp.

According to a study in JAMA by the University of California, San Francisco, scalp cooling has proved to be an effective method to combat chemotherapy induced hair loss. The study aimed to answer whether or not scalp cooling associated with a lower risk of hair loss when used by women receiving chemotherapy for early-stage breast cancer. There were 122 patients in the study receiving non anthacycline-based chemotherapy and 50% or less was found in 66.3% of the patients using scalp-cooling group vs. hair loss of 50% or less was found in 0% of patients in the control group after four weeks of chemotherapy.

Baylor College of Medicine conducted a similar study with 182 breast cancer patients receiving chemotherapy with a taxane, anthracycline, or both. This study found that the women who underwent scalp cooling were significantly more likely to have less than 50% hair loss compared with no scalp cooling.

There are a variety of different ways in which scalp cooling is practiced, ranging from simple bags of crushed ice to continually cooling machines that are placed on the head. Some companies that create these cold caps are ChemoCap, Elasto-Gel, and Penguin Cap. Paxman, a UK company, created a technologically advanced scalp cooling system that circulates a non-viscous coolant through the helmet to keep the scalp cool. We have previously written about the product DigniCap, made by Swedish company Dignitana. While the technology isn’t widely obtainable in the United States, DigniCap, an FDA cleared device, is available in the United States. Around 50 medical centers across 17 states have access to DigniCap but the expensive device, which costs between $1,500-$3,000 per patient is not covered by most insurance. While this is expensive, a non-profit organization called HairToStay offers subsidies for patients that cannot afford the technology.