Cooling Caps to Reduce Hair Loss during Chemotherapy
Some types of chemotherapy can cause hair on the scalp—as well as on other parts of the body—to fall out. Although hair loss caused by chemotherapy is usually temporary, many patients with cancer consider it one of the most distressing side effects of treatment. Cooling the scalp causes blood vessels to constrict, which may limit the amount of chemotherapy drug that reaches hair follicles. The idea of cooling the scalp to prevent hair loss has been around since the 1970s. Early efforts involved putting ice packs on the scalps of patients undergoing chemotherapy. More recent approaches have used cooling caps that are chilled and need replacing periodically during a session to maintain cold.
The FDA approved DigniCap system uses a tightly fitted cap in which cold liquid circulates to cool the scalp before, during, and after chemotherapy. This cap, which is connected to a machine that regulates the cooling process, is covered by an outer cap, made of neoprene, that acts as an insulator. FDA’s expanded clearance of this device/treatment in 2017 was based in part on a study involving 226 patients with various types of solid cancer who received different types of chemotherapy. Of this group, 146 (65%) had no hair loss or mild hair loss, and only 63 (28%) opted for a wig, according to the study results. The researchers reported that the effectiveness of scalp cooling depended on various factors, including the chemotherapy regimen received. Although there has been some concern that scalp cooling could trigger increased metastases to the scalp, the researchers saw no evidence of that—a finding that was supported by a recent review of studies on scalp cooling and the risk of scalp metastases. The most common side effects of the scalp cooling system included headaches induced by the cold, neck and shoulder discomfort, and pain associated with wearing the cooling cap for extended periods.