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Cold Caps To Prevent Hair Loss During Breast Cancer Treatment

Posted on June 08, 2022
Medically reviewed by
Richard LoCicero, M.D.
Article written by
Sarah Winfrey

Many people diagnosed with breast cancer worry about experiencing hair loss during chemotherapy treatment (chemo) or other cancer treatments. Hair loss is a common side effect of some cancer treatments. People who undergo such treatments may worry about how they’ll look, what others will think, and whether their hair will grow back after treatment has ended.

Some people with breast cancer use cold caps to help limit or prevent hair loss during chemotherapy. These caps deliver cooling to the head and have proved effective in helping to lessen hair loss.

Here, we will examine how cold caps may be used to help prevent hair loss during chemotherapy for breast cancer, including how they work and how to cover the cost of these caps during treatment. As always, it’s best to consult your oncologist or health care team before trying any new hair loss therapies during cancer treatment.

Why Do People Lose Their Hair With Breast Cancer?

Chemotherapy targets cells that multiply and grow rapidly. Cancer cells fall into this category, but so do hair cells. Because of this, chemotherapy drugs kill cancerous cells as well as hair cells, leading to hair loss.

Other types of breast cancer treatment cause hair loss for similar reasons. Although hair loss most commonly happens during chemotherapy, it can also happen with radiation therapy, hormonal therapy, immunotherapy, and targeted therapy.

Some cancer treatments cause hair thinning, which you may not even notice. Others may cause hair to fall out quickly in large clumps. Note that although hair loss on the scalp is a common side effect of treatment, body hair loss (such as eyelashes, eyebrows, and pubic hair) can also occur.

What Are Cold Caps?

Also known as cooling caps, cold caps are exactly what the name implies: caps that fit tightly over the skull and function to make the head cold.

There are two types of cold caps. The first type, sometimes referred to as the “old cold caps,” are like ice packs — they need to be stored in a freezer between uses. You’ll likely need more than one, as you’ll want to wear them before, during, and after chemotherapy and replace them every 20 to 30 minutes during this process.

People with breast cancer usually rent these caps, then bring them to their chemo treatments packed in dry ice. Storing them and replacing them usually requires having a family member or another person present at the treatment session. You could also coordinate with the chemo center ahead of time.

The second type of cold caps, also referred to as the “new cold caps,” are fitted caps. They’re automated in that they attach to a refrigeration unit by a hose. The hose pumps refrigerated liquid through the cap when the machine is turned on, delivering cooling to the head.

Many cancer care centers have these types of caps available for use during chemotherapy sessions. Some people choose to rent one or buy one so that they know they have their own cap available whenever they need it.

Most people wear cold caps for at least 30 minutes before chemotherapy starts, throughout the chemo session, and then for anywhere from 20 minutes to five hours afterward, depending on the type of chemotherapy they’re receiving.

How Do Cold Caps Prevent Hair Loss?

In theory, cold caps work in a couple of ways. First, they slow down activity in the hair cells, making them less likely to be targeted by chemotherapy medications. This means that the medications may pass them by, rather than attacking them in the same way they attack fast-growing cancer cells.

Cold also acts to narrow the blood vessels around hair cells, slowing blood flow to the area. Even if chemotherapy drugs are still attracted to the hair cells, slowed blood flow means that they will not be able to reach the hair follicles in as large quantities as usual. This can help save some hair cells, meaning less hair loss during chemotherapy treatments.

Although a cold cap can’t prevent hair loss completely, it can significantly limit the loss. One oncologist told Cleveland Clinic that people who use cold caps during chemotherapy treatment keep 50 percent to 70 percent of their hair. A study published in the journal Clinical Breast Cancer found that among 20 study participants who used cold caps during chemo, 13 (65 percent) kept at least 75 percent of their hair. Four others (25 percent) keep at least half of their hair.

FDA-approved Cold Caps and Other Scalp-cooling Methods

The U.S. Food and Drug Administration (FDA) has approved two models of automated cold caps for hair loss prevention during cancer treatment: the DigniCap Scalp Cooling System and the Paxman Scalp Cooling System.

There are also several brands of the old type of cold caps, though these are not FDA-approved. These include Chemo Cold Caps, Polar Cold Caps, and Arctic Cold Caps.

Some people try to mimic the effects of a cold cap with ice packs held or bound to the head. While these may serve the same purpose, getting them in place and keeping them there during a chemotherapy session can be difficult. Most people find it worthwhile to instead use caps designed for this purpose.

How To Cover the Costs of a Cold Cap

Cold caps can be expensive. Depending on the type of cap and how long you will need it, costs can run from $380 to $450 per month. In addition, some cancer centers will charge you for the cap every time you use it.

Many insurance companies do not cover the cost of cold cap use, regardless of type. However, it is worthwhile to ask your insurance company if they will cover a cap and to have your health care team or an oncology specialist support your request in writing. This may help you get the insurance coverage you need.

Both DigniCap and Paxman report that some of the people who use their caps have been able to get reimbursement from their insurance companies. This means that you would pay for the cap, then submit your bills to your insurance company, along with a request that they pay. If they decide it is legitimate, they will reimburse you all or part of what you spend on the caps.

If insurance is not a good option for you, talk to your cancer treatment center about how to get your costs covered. They may be able to offer you options that you would not have known about otherwise.

Finally, organizations like The Rapunzel Project and HairToStay might be able to help you out. These are nonprofits that are dedicated to helping people diagnosed with cancer keep their hair or get access to other quality options.

Find Your Team

MyBCTeam is the online social network for people diagnosed with breast cancer and those who love and care for them. Here, you can also share your story, participate in ongoing conversations, and get to know other people from around the world who will understand your journey with breast cancer.

Have you tried cold caps to prevent or limit hair loss during breast cancer treatment? Share your experience in the comments below or by posting on MyBCTeam.

All updates must be accompanied by text or a picture.
Richard LoCicero, M.D. has a private practice specializing in hematology and medical oncology at the Longstreet Clinic Cancer Center, in Gainesville, Georgia. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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