When I received my diagnosis, one of my biggest worries was losing my hair. It felt a bit trivial to be concerned about my appearance at such a critical time but, like many women, my hair is a big part of my identity. My big, curly, silver-threaded mop is my crowning glory. Losing it felt like losing a part of myself. So, I was open to any option that might help me keep it.
During my initial consultation, the cold cap was briefly mentioned but I didn’t really understand what it was. There’s a lot of misinformation and confusion about scalp cooling, and it wasn’t explained well. Once I knew chemotherapy was on the cards, I did a lot of self-research on hair loss and scalp cooling. I asked questions and spoke to other women who had been through it. Getting clear answers was tough.
I talked to two women who had used the cold cap (one was an old friend) and both said it had helped them keep about 50% of their hair. Those seemed like decent odds to me. So, at my first chemo appointment, when asked if I wanted to do scalp cooling, I said yes, even though I was nervous. The chemo nurse saw my anxiety and let me check out the machine and try on the cap, which helped a lot. Most people I spoke to said the cold cap was “not great but doable,” and I agree. It’s not pleasant or comfortable, and it’s extremely cold, but it’s tolerable. It doesn’t freeze your scalp (no brain freeze!). We’re resilient and do acclimatize, though.
For my first chemo session, they set me up in a chair and brought over a Paxman scalp cooling machine. The nurse sprayed my hair with water, applied some cheap, awful-smelling conditioner, and put the cap on. It was heavy and felt wet and cold. She adjusted it so it wasn’t over my eyebrows (that I’d just had microbladed so couldn’t get wet!), and then they turned on the machine. It takes about 30 minutes to reach peak coldness, and those first 30 minutes are the toughest. After that, the cold evens out. Once the cap has been on for about 30 minutes, they start the chemo infusion. You have to keep the cap on for about an hour after the infusion ends.
After my first cycle, I gently washed out the horrible conditioner at home. I did everything right: used a bamboo cotton sleep cap, washed my hair gently once a week and combed it carefully. But I was still losing a lot of hair. By the second week, I lost about 70% of my hair in one go and decided to shave it all off.
By my second cycle, I was confused and conflicted about continuing with the cold cap. I was distressed and in floods of tears at the chemo unit. A kind nurse comforted me and explained that while the cold cap only preserves hair in about 50% of cases, its main function is to protect the hair follicles. She said it was worth continuing because it would help my hair grow back faster. I was so grateful for this information, which I hadn’t been told before. I decided to keep using the cold cap and wore a bamboo cotton hat under the cold cap to protect my shaved head. I’m delighted to say my hair has grown back quickly, and I credit the cold cap for that.
Key Takeaways:
- The cold cap isn’t pleasant or glamorous, but it’s manageable and effective.
- If you’re going to use the cold cap, you have to do it from cycle one of chemo (you can’t, for example, start using it from cycle 3)
- It might not save all your hair, but it will protect your hair follicles.
- Bring your own conditioner to use (the smell of it will be a comfort).
- If you wear glasses, keep them on while fitting the cap because you won’t be able to put them on afterward.
- Scalp cooling will extend your time in the chemo unit.
- If you do lose your hair, it’s temporary and will grow back for most people.
Scalp Cooling Science: How It Works
1. Cooling Cap: You wear a special cap that’s chilled before, during, and after your chemo treatment. It’s designed to keep your scalp cool.
2. Blood Flow Reduction: The cold temperature makes the blood vessels in your scalp constrict, which means less blood (and chemo) reaches your hair follicles.
3. Hair Protection: With less chemo getting to your hair follicles, there’s a better chance your hair won’t fall out.
4. Slowed Metabolism: The cooling also slows down the activity in your hair follicles, making them less likely to be affected by the chemo.
