What Happens When I Wear a Cooling Cap?

Scalp cooling is a treatment aimed at preventing or reducing hair loss during chemotherapy. It involves placing a tight, cooled cap on the head before, during, and after each infusion. The cooling cap is attached to a machine that circulates a liquid coolant through the cap. This cooling process reduces blood flow to the cells that produce hair and may protect them from chemotherapy.

Scalp cooling is only effective with certain types of chemotherapy. At Dana-Farber, the treatment is currently only offered in the Susan F. Smith Center for Women’s Cancers for early stage breast cancer patients who need chemotherapy.

To be most effective, scalp cooling needs to be followed at each chemotherapy treatment. It is a relatively straightforward process:

  1. Your hair is lightly dampened and a small amount of conditioner is applied.
  2. You will wear a tight-fitting, silicone cooling cap attached to a refrigeration system that circulates a liquid coolant through the cap, gradually lowering the temperature of your scalp. You will need to wear the cap for 30 minutes before chemotherapy, during infusion, and for 90 minutes after each infusion.
  3. You can disconnect the cooling cap from the machine for short periods of time if you need to take a quick break to use the bathroom or get a snack.

You should start the scalp-cooling process at your first chemotherapy infusion and continue it at all subsequent treatments. You will need to be fitted for your cap before your first chemotherapy appointment, and getting a correct fit is very important for success. At Dana-Farber, fittings take place at the Friends’ Place shop on the first floor of Dana-Farber’s Yawkey Center.

You need to bring your cooling cap to each chemotherapy appointment. Depending on the facility where you get chemotherapy, your appointments may be scheduled later in the day due to the length of time required for the cooling process.

Clinical trials have shown scalp cooling to be safe, but long-term follow-up studies are ongoing. You may feel intense discomfort for the first 10-15 minutes of cap use, largely due to the cold temperature. This should decrease as your body adjusts to the cold. Deep breathing and relaxation techniques may be helpful.

Patients using cooling caps also report side effects including headaches, itching, feeling cold, and discomfort. You may have a heavy feeling on your head or forehead. You may feel neck pain or lightheadedness during cooling and after you remove the cap.

If you are considering whether to use scalp cooling, be sure to first talk with your care team about its pros and cons. The cost of this treatment is expensive and not usually covered by insurance. Some nonprofit organizations, such as Hair to Stay and The Rapunzel Project, provide financial support to help pay for scalp-cooling supplies.