Scalp Cooling for Chemotherapy-Induced Hair Loss

What is chemotherapy-induced hair loss?

Chemotherapy works by targeting all rapidly dividing cells in the body. Hair is the second fastest dividing cell, and this is the reason why many chemotherapy drugs cause alopecia. The hair follicles in the growth phase are attacked, resulting in hair loss approximately two weeks after the commencement of the chemotherapy treatment.

The damage that chemotherapy causes to the hair follicle can be alleviated by using the scalp cooling treatment; also known as the ‘cold cap.’ It works by reducing the temperature of the scalp by a few degrees immediately before, during and after the administration of chemotherapy.

What is scalp cooling?

Scalp cooling is a non-drug therapy used during certain chemotherapy treatments to help reduce hair loss. The Paxman Scalp Cooling System works by lowering the temperature of the scalp before, during, and after chemotherapy infusion. Cooling causes blood vessels in the scalp to constrict and reduces the amount of chemotherapy that reaches the hair follicles, helping protect them from damage.

While scalp cooling can significantly reduce hair loss for many patients, results vary depending on the chemotherapy regimen, dosage, and individual factors.

How does scalp cooling work?

The Paxman system uses a soft silicone cooling cap connected to a refrigeration unit that circulates coolant at a controlled temperature. The cap is worn:

Before chemotherapy begins
Throughout the infusion
For a period after treatment is completed

The cooling process helps protect hair follicles by:

Reducing blood flow to the scalp
Slowing cellular activity within the hair follicles
Decreasing the amount of chemotherapy drugs delivered to the scalp

Together, these effects help minimize damage to hair follicles and reduce chemotherapy-induced hair loss.

How effective is scalp cooling?

Scalp cooling has been shown to be effective for many patients receiving chemotherapy, particularly those receiving treatment for breast cancer. However, no scalp cooling system can guarantee complete hair retention. Results vary based on:

The specific chemotherapy drugs being used
Drug dosage and treatment schedule
Hair type and thickness
Individual response to treatment

Many patients experience significant hair preservation, while others may still experience partial hair loss or thinning. Even when some shedding occurs, patients often retain enough hair to avoid needing a wig or head covering.

Your oncology team can discuss whether your specific treatment regimen is generally associated with good scalp cooling outcomes.

Who is a candidate for scalp cooling?

Many patients receiving chemotherapy may be candidates for scalp cooling. Eligibility depends on:

Cancer diagnosis
Chemotherapy regimen
Treating physician recommendations
Availability of scalp cooling equipment at the treatment center

Not all chemotherapy drugs respond equally to scalp cooling, so patients should discuss expectations with their care team before starting treatment.

Does scalp cooling hurt?

Patients commonly describe the initial cooling period as the most challenging part of treatment. During the first 10 to 15 minutes, it is common to experience:

Cold sensations
Headaches
Scalp discomfort
Chills

Most patients report that these symptoms lessen as they adjust to the temperature. Warm blankets, layered clothing, and relaxation techniques can help increase comfort during treatment.

Is scalp cooling safe?

The Paxman Scalp Cooling System is FDA-cleared for use in the United States and is considered a safe, non-invasive treatment option. It has been used worldwide by thousands of cancer patients.

As with any supportive care intervention, patients should consult their oncology team to determine whether scalp cooling is appropriate for their individual situation.

What are the financial considerations of scalp cooling?

Coverage for scalp cooling varies by insurance plan and payer.

Patients should consider:

Equipment fees
Per-treatment charges (if applicable)
Insurance benefits and reimbursement policies
Flexible spending account (FSA) or health savings account (HSA) eligibility

Many insurance plans now provide some level of coverage for scalp cooling, but benefits can differ significantly. Patients should contact their insurance provider before treatment to verify coverage and expected out-of-pocket costs.

Paxman also provides patient support resources and information regarding reimbursement options. Patients may wish to ask:

Is scalp cooling covered under my plan?
Do I need prior authorization?
What documentation is required for reimbursement?
Are payment plans or financial assistance programs available?

Financial Support for Paxman Scalp Cooling

Hair To Stay is a national non-profit subsidizing scalp cooling patients in the US. Patients may apply for a subsidy. A case manager will guide you through the eligibility process. Visit www.hairtostay.org.

Questions to Ask Your Care Team about Scalp Cooling

Before starting scalp cooling, consider asking:

Is scalp cooling available at my treatment location?
Is my chemotherapy regimen compatible with scalp cooling?
What level of hair preservation can I realistically expect?
How much additional time will scalp cooling add to each treatment visit?
What will my out-of-pocket costs be?
Does my insurance cover scalp cooling?

Learn More about Scalp Cooling

Patients can learn more about scalp cooling and search for participating treatment centers using Paxman's official resources:

Paxman Scalp Cooling System Locator:Paxman Locations
Patient FAQ and Educational Resources:ColdCap by Paxman

Related Treatment Areas & Resources

Ready to Make an Appointment?

If you have questions about whether this treatment or service may be right for you, make an appointment with the Virginia Cancer Specialists team.