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Scalp Cooling Hair Retention for Chemotherapy Treatment

Patient Care > Treatments > Supportive Treatment

Scalp Cooling Hair Retention for Chemotherapy Treatment

“Am I going to lose my hair?”

It's the first question people generally ask when they initially discover they need chemotherapy. 

The majority of cancer patients who undergo chemotherapy will experience hair loss. Cancer cells cannot be distinguished from other cells, like hair follicles, by chemotherapy drugs, which target fast-growing cells in the body. As hair is the second fastest-dividing cell, many chemotherapy drugs cause hair loss. Chemotherapy damages hair follicles (at the root of the hair), resulting in hair loss within 7 to 21 days after the start of treatment. 

It begins to regrow after treatment is complete. It is not uncommon for people to start growing their hair during treatment. It takes some time for the hair to re-grow, ranging from three to twelve months. There may be a difference in the texture or colour of the newly grown hair. 

Alopecia (hair loss) is consistently ranked in the top 3 most distressing side effects of cancer chemotherapy. It is a well-known side effect of many chemotherapy regimens, with both men and women reporting it as the most traumatic and intense aspect of their cancer treatment. It is estimated that I out of 12 patients refuse chemotherapy because they do not want to lose their hair. 

What is scalp cooling?

Scalp cooling is a simple treatment that lowers the scalp's temperature to 18-20 degrees Celsius. A scalp cooling machine circulates a cold gel around a tight-fitting cap worn during chemotherapy treatments. The cold gel constricts the blood vessels on the scalp, resulting in less blood flowing through them. This results in less hair being exposed to chemotherapy drugs. 

Scalp cooling has been clinically proven to safely and effectively prevent or reduce chemotherapy-induced hair loss in many cases, resulting in a high level of hair retention or even complete hair preservation, which has a significant positive impact on the confidence, strength and hope of the patients who choose to use it.  

For patients, this means the opportunity to regain control, maintain their privacy and encourage a positive attitude towards treatment.  

Additionally, scalp cooling helps in faster recovery of hair volume after chemotherapy, even in patients for whom scalp cooling failed to prevent chemotherapy-induced hair loss. 

The FDA-approved Paxman Scalp Cooling System

Paxman has been pioneering and leading scalp-cooling technology worldwide for over 25 years. Today it is a global hair retention solution expert for chemotherapy patients.  

The Paxman Scalp Cooling System offers a comfortable and tolerable option over other scalp cooling methods due to its superior heat extraction technology. Tested and developed for over a quarter of a century, the system features the highest levels of clinical efficacy, hospital safety and patient comfort. It has been approved by the US. Food and Drug Administration (FDA) for breast and solid tumour cancer patients. 

How does it work?

Commonly known as a cooling cap, the Paxman Scalp Cooling System is a device placed on patients' heads, similar to a hat, which reduces the scalp’s temperature by a few degrees immediately before, during and after the administration of chemotherapy. Liquid coolant passes through the cap, extracting heat from the patient's scalp and thereby constricting blood vessels in the scalp. This reduces the flow of chemotherapy to hair follicles in the scalp, interfering with its side effect of causing hair loss without impacting the effectiveness of treatment and ensuring the scalp remains at an even, constant temperature to minimise hair loss. Scalp cooling is also thought to reduce metabolism in the hair follicle cell, which may help protect the cell from the toxic effects of chemotherapy.  

The clinically proven cold cap system has helped over 100,000 cancer patients in more than 25 countries to retain their hair during chemotherapy. By preventing or decreasing hair loss, the system helps improve the quality of life for many patients burdened by chemotherapy-related hair loss. 

How long does it take?

Patients undergo scalp cooling each time they receive chemotherapy. The average cooling time is 2.5 hours, including 30 minutes pre-infusion, cooling during infusion, and 90 minutes post-infusion.

Is the cooling tolerable?

Most Paxman scalp cooling patients were comfortable while wearing the device, with less than 5% of participants discontinuing the treatment because of intolerance. The most intense discomfort is felt in the first 10 to 15 minutes of treatment and subsides as patients become accustomed to the cold. The cooling system brings the scalp's temperature to roughly 66°F (20°C).

How can patients minimise discomfort?

Deep breathing can help at the initial stages by increasing relaxation and improving stress management. Patients should dress warmly and in layers, even in warm weather. Hot drinks and blankets are another excellent way to alleviate the coldness some patients experience. If the cold is still hard to bear after the first 20 minutes of scalp cooling, patients can consult their healthcare professional about taking a mild pain reliever, which may reduce the discomfort.

Who should avoid scalp cooling?

It is not recommended to use scalp cooling in the following circumstances:

  • Your haematological cancer is myeloma, leukaemia, or lymphoma. This is due to the possibility that cancer cells may survive in the scalp’s blood vessels. In other words, cancer may return in the future. 
  • Your first chemotherapy treatment without scalp cooling has already been completed. 
  • The dose of chemotherapy you require is very high. With high-dose chemotherapy, scalp cooling is less likely to be effective. 
  • Chemotherapy is administered continuously through a pump over several days. 
  • Your liver is not functioning as it should. Chemotherapy drugs may remain in the body for a longer period than usual. Keeping the scalp cold for an extended period may not be possible. 
  • The migraines you are experiencing are severe. 
  • Patients with cold sensitivity, cold agglutinin disease, cryoglobulinemia, cryofibrinogenemia, and post-traumatic cold dystrophy 
  • Scalp cooling is contraindicated for paediatric patients. 

Patients may experience hair loss and overall thinning of the hair whilst using scalp cooling, and the regular shedding cycle of the hair will continue. If some hair loss is experienced, patients are encouraged to persevere with the process - many patients report hair growth during their chemotherapy treatment whilst using scalp cooling, as new hair growth is also protected from the chemotherapy. Whilst using scalp cooling, it is not advisable to go to the hairdresser. This is to ensure your hair is under the least amount of stress possible. 

Depending on the type of chemotherapy being used and the type of hair of the patient, scalp cooling results may vary from patient to patient. The effectiveness of chemotherapy depends on several factors, including the chemotherapy regimen, dose, duration, drug metabolism, and concomitant comorbidities. It is effective if you do not require a hair wig/head cover throughout your chemotherapy treatment or if you suffer grade 1 hair loss (hair loss of up to 50%, no need for a wig). 

You may experience risks or side effects from scalp cooling treatment. As a result of scalp cooling, the following side effects have been reported most frequently: 

  • Mild to severe headaches (following cooling of the scalp) 
  • A feeling of discomfort 
  • Feeling of heaviness in the head 
  • Feeling light-headed (during scalp cooling or after removing the cooling cap after scalp cooling) 
  • Cold-related discomfort (while cooling the scalp) 
  • Pain in the forehead (due to pressure and tightness from the cap during scalp cooling). 
  • There may be cold injuries, such as frostbite or cold urticaria (hives or a rash at the site of the cold cap). 
  • Nausea 
  • Sinus pain 
  • Chills 
  • Dry skin 
  • Scalp pain