For many women who undergo chemotherapy for breast cancer, hair loss can be a devastating side effect. But research is mounting in favor of devices called "cooling caps," which are aimed at helping to minimize hair loss.
The Food and Drug Administration cleared the DigniCap scalp cooling system in 2015, a device designed to reduce temporary hair loss while female patients undergo the potent cancer treatment.
The FDA made its decision after reviewing results of a study of 122 women undergoing chemotherapy for early-stage breast cancer. Sixty-six percent of the women who used the cooling cap reported losing less than half their hair.
Since the FDA clearance, additional research has shown the potential benefits of cooling systems to halt hair loss. Two separate studies appearing in a February 2017 issue of JAMA noted that women who used such devices were significantly more likely to keep some hair during chemotherapy treatment.
In the first study, conducted at five U.S. medical centers, 122 women with stage 1 or stage 2 (considered early stage) breast cancer underwent chemotherapy. One hundred and six women wore the DigniCap while 16 did not. By the end of treatment those who didn’t use the caps lost most or all of their hair. But of those who did use the caps, two-thirds were able to keep 50 percent or more of their hair.
The second study, part of the SCALP randomized clinical trial, focused on 142 women with early stage breast cancer who were undergoing a broad range of chemotherapy. Those women used the Paxman Scalp Cooling system, which has not yet received FDA clearance in the United States. Half of the women who used the Paxman device kept 50 percent or more of their hair compared with a control group that did not use the device.
How cooling systems work
The devices resemble tight-fitting caps that are placed on the head. During chemotherapy, a liquid coolant is circulated throughout the caps to constrict blood vessels, which may lessen the amount of chemotherapy drugs that reach the hair follicles and cause hair loss. The cooling caps’ temperatures may also slow the hair follicles’ activity and therefore reduce the chemotherapy hair-loss effect.
Scalp hypothermia has been used in Europe for years. Reported side effects in clinical trials included headaches, neck and shoulder discomfort, chills, and pain after wearing the cap for an extended period. Some experts have expressed concern that the cap may prevent chemotherapy drugs from reaching cancer cells that may be present in the scalp.
It’s important to note that the cooling cap’s success may be related to the type and dosages of chemotherapy given, as well as the patient’s ability to tolerate the cold.
According to some reports, the cost of using the cap could be $1,500 to $3,000, and insurance typically doesn’t cover it. However, financial assistance is available from organizations such as Hair To Stay.
(Originally published July 22, 2016; updated March 6, 2017)