Caps, hats or scarves are common fashion accessories for many cancer patients who have received chemotherapy, since hair loss is a common side effect of the treatment. While hair almost always grow back after treatment is complete, alopecia—as the condition is known in the medical field—may be devastating to patients already going through a difficult journey. Now, some cancer patients may be able to use a different kind of cap during and after chemotherapy—not one that hides their balding scalp, but a cap that may help prevent them from losing their hair, or reduce the amount they lose. To battle hair loss caused specifically by chemotherapy, some hospitals and infusion centers are turning to cooling caps, a novel therapy cleared by the U.S. Food and Drug Administration (FDA) for some patients to protect hair cells from chemotherapy drugs.
How do cooling caps work?
While chemotherapy drugs are designed to attack rapidly growing cancer cells, some drugs may also damage fast-growing healthy cells, such as those found in the digestive system, bone marrow and hair follicles. As a result, some patients receiving chemotherapy may experience digestive issues, a suppressed immune system and hair loss. The degree of hair loss may vary widely from patient to patient, even among those using the same drugs or undergoing similar treatment regimens. If hair loss does occur, it usually begins within two weeks of starting chemotherapy and may increase one to two months after the start of treatment.
Theoretically, cooling caps work two ways to protect hair cells from damage from chemotherapy drugs. First, the lower temperature of the scalp constricts cells, making it more difficult for the drugs to penetrate. Second, the cooler temperature reduces the cellular activity in the follicles, making them a less likely target for chemotherapy drugs seeking out fast-growing cells. According to a study published in 2017 in the Journal of the American Medical Association, 66 percent of women with breast cancer who used cooling caps during chemotherapy treatments saw 50 percent less hair loss than patients who didn’t use the product.
Some cooling caps are connected to cooling systems during therapy. Other types of caps are stored in a freezer at very low temperatures until they are ready to use. The FDA first cleared the caps in 2015 for chemotherapy patients with breast cancer, then cleared their use for patients with other cancers in 2019.
"The good news about oncology care in this millennium is that we not only focus on treating the cancer, but our hopes are to treat and manage some the side effects,” says Anita Johnson, MD, FACS, Director of Breast Surgical Oncology at our Atlanta hospital, which offers DigniCap® cooling cap services. “With cooling caps, our goal is to provide a possible preventable measure of chemotherapy-induced alopecia."
Alopecia advice
Here are some other ways patients may deal with or potentially reduce the amount of hair loss:
- If you decide on a wig or hairpiece, have it ready in advance before hair loss occurs. This way, you can match it to your natural hair color, style and texture.
- Try scarves, caps, turbans or hats as an alternative to wigs and hairpieces.
- Use a soft bristle brush and avoid too much brushing or pulling of hair.
- Use mild, gentle shampoos and conditioners. Rinse your hair thoroughly and gently pat dry to avoid damaging your hair.
- Avoid coloring, perming or relaxing the hair.
- Avoid using hair dryers, electric rollers or curling irons.
- Limit the use of hair clips, barrettes, elastic bands, bobby pins and hair sprays. Avoid braiding or placing hair in a ponytail.
- Hair usually regrows six to eight weeks after therapy, but be prepared for it to grow back a slightly different color and texture at first.
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