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HOME » SCALP COOLING » Chapter 1 Making a decision

Chapter 1 Making a decision

Chapter 1 Making a decision to try scalp cooling

What is scalp cooling?

Scalp cooling is one of those things that until you are faced with the possibility of losing your hair you probably won’t have heard much about.  It’s a method of cooling the scalp which can be used with some (but not all) forms of chemotherapy to try and help reduce hair loss. You will also hear the term ‘cold cap’ used. This is often the name given to the ‘helmet’ hat that is worn throughout the scalp cooling process. This cold cap is placed onto your head over your hair roots. It is attached to a scalp cooling machine that pumps a liquid solution around the cold cap that will dramatically reduce the temperature at your hair roots. (*Forster Suite - Stevenage manufacturer is Paxman).

To understand the scalp cooling concept it is a good idea to briefly explain the workings of the hair follicle. The root of every hair on our scalp (and body) grows from a hair follicle. Through tiny blood vessels the hair follicle provides the hair root with food and oxygen and processes any waste product. When chemotherapy drugs cause hair loss they do so because they temporarily disrupt this natural process. As a result the individual hair falls out.  It is important to also know that this temporary disruption means that once treatment is complete the hair should start to regrow as normal.

The scalp cooling technique can help to reduce hair loss by shrinking the hair follicle, thus helping to prevent circulation of the chemotherapy drug to the hair follicle (root) and so the natural function can continue. When effective this helps to reduce hair loss.

The scalp cooling process does not guarantee that your hair will be saved but when it is successful it does mean that some people notice very little hair loss at all, others have a fair amount of hair fall but can manage their style and therefore are able to keep their own hair throughout treatment.

Is scalp cooling the right choice for me?

By taking your time to read through the remaining pages in this chapter you should have a good understanding of both the practical and emotional implications of deciding if scalp cooling is the right choice for you.

Are all patients offered scalp cooling?

The short answer is no.

It is important to understand that scalp cooling is not compatible and therefore does not work for every type of chemotherapy drug.  It is also not suitable for haematology patients.  Your oncologist will have made a decision whether or not scalp cooling is appropriate for you and so advised your nursing team to offer you this choice.

At the Forster Suite scalp cooling is offered to every patient it is suitable for - all male and female patients who wish to try it. The team will do their very best to schedule your appointment time around the two available scalp cooling machines.

We understand that hair loss can be a very challenging part of chemotherapy and so the opportunity to try and prevent hair loss is a very important decision for you to make. As the scalp cooling process is not guaranteed to save your hair it’s important to weigh up the various factors involved.  We have consulted with many patients who have gone ahead with the scalp cooling process to come up with some helpful and informative points for you to consider:

Patients experiences of scalp cooling vary. Some say it dramatically reduced hair loss to such a degree that there was very little hair loss at all. For others unfortunately the cold cap wasn’t a success or having tried it they decided it wasn’t for them and didn’t continue. Our aim is not to discourage you but to be open about how the experience may be so that you can make an informed decision.

In deciding whether or not scalp cooling is for you the following main topics are often a factor:

Time Factors:

Having a scalp cooling treatment adds more time onto your total treatment time. This is because in order to make time to prepare your hair, fit the cap, allow the cooling system to do its job and have your chemotherapy treatment. For example if your chemotherapy treatment would normally take 2 hours then an additional 1 to 2 hours will  most likely be needed to also complete the scalp cooling process. Making the total time needed between 3 to 4 hours.  Times do vary – your nurse will be able to provide you with the estimated time for your particular chemotherapy drug.

On arrival at the Lister hospital  (*other hospitals may vary) you will be asked to prepare your hair  with the items you have been asked to provide such as conditioner and water spray (chapter 2 will take you through this in detail). You will need to wear a cold cap for each and every chemotherapy treatment (where the treatment causes hair loss). For most people this is every treatment.

Another time consideration is that you will have to leave the hospital with damp hair as most hospitals do not have a facility for you to wash your hair. You can choose to wear a hat or scarf over your hair if you wish (especially recommended in cold weather). You can wash your hair when you get home if you wish. In the past the advice was to leave the hair unwashed for around 24 hours. However this advice has now been changed – see page 24.

Hair type and style:

The scalp cooling helmet (cold cap) needs to fit very firmly to your head to be successful and so if you are someone with a lot of hair or thick hair type you may need to consider having a change in style. This change in style is aimed at giving you the best possible chance of the cold cap sitting firmly in order to be as close to the hair follicles as possible. Pages 12 -13 go into this in greater detail.

Eye lashes and brows

Does the scalp cooling prevent hair loss of eye lashes and eye brows?

Unfortunately not as the system is designed for the scalp only. Not everyone loses their lashes and brows. Take a look in our directory at the support services that offer you guidance and make-up sessions to help with this. We also have a video online.

How the cold cap feels when on

It’s fair to say that most people will say the cold cap is uncomfortable. It fits very firmly on the head with a chin strap to ensure a tight fit.  The coldness can cause a head-ache and nausea. Some people are able to cope with this and others try it and say it’s not for them.

Most people who stick with the cold cap say that after an initial time of around 10 to 15 minutes they have got used to the feeling and are then able to relax more and manage any discomfort. This is particularly important to bear in mind for your first session. It is only natural to be anxious about both your first chemotherapy and scalp cooling session. With this in mind patients have given us some helpful tips for managing this – see page 22.

During treatment your nursing staff will do all they can to make you feel comfortable such as placing a gauze under your chin strap, giving you a blanket to help warm you up and lots of encouragement to continue.

Remember that there is nothing to stop you from trying the cold cap and stopping at any point you wish. Whilst your nurse will help to encourage you to stick with it they will of course remove it upon request. Do remember that a cold cap must be worn for the duration of every treatment.

Taking short breaks - Toilet breaks

For your comfort you will be able to take toilet breaks as the ‘New Paxman’ system allows the cap to remain on your head but be temporarily disconnected for a short toilet break (this short break will not affect the scalp cooling process).

Managing how you feel

It is only natural and quite normal to feel anxious about hair loss.  Many patients say that they feel embarrassed or vain as their concern around hair loss is just as important as their illness itself.

At Cancer Hair Care we say to our patients ‘it’s not vanity its sanity’ – there is nothing wrong with caring about your appearance. Whilst you may not be able to imagine yourself without hair or how you will cope it is important to remember that you will find ways to cope and support is available. In fact many patients say that once they have decided on their hair care journey they feel empowered in their decision and better able to cope. Many patients also tell us that keeping on top of their image or trying new things helped to give them confidence through treatment.

One option is scalp cooling as when successful it can save your hair and thus mean that you won’t have to deal with the emotional side of hair loss. Many patients tell us that this gave them privacy around their treatment and meant there was not a visible indication to others that they were undergoing cancer treatment. In turn this gave them confidence.

However when considering whether or not scalp cooling is something you want to try it is worth knowing that there are many helpful organisations that are dedicated to supporting you both practically and emotionally through changes with your hair care and hair loss. Whilst hair loss may seem a daunting prospect you will see that with some helpful advice you will discover that looking good is not something you have to give up on. 

Some people find talking through hair loss with their friends and family helpful others find talking to someone removed from their peer group more supportive. It may be helpful to talk through how you feel with your nurse or one of the Cancer Hair Care team. Both are used to discussing hair loss concerns and will be happy to offer you support.

If you are concerned about talking with young children about hair loss Cancer Hair Care can provide fun knitted dollies that will help children to understand hair loss through play.

Being prepared for hair loss – incase scalp cooling doesn’t work for you

Unfortunately the cold cap treatment it is not guaranteed to work. Therefore it is a good idea to ensure that you have made a contingency plan for hair loss. If scalp cooling doesn’t work for you, or having tried it you decide it’s not for you, then having considered your options in advance you won’t be stuck with what to do. We recommend that you consider the following.

1. Ask your nurse for a wig referral to your local NHS wig supplier – go along and take a look. Sometimes people loose some of their hair during scalp cooling but want to continue and want, at times, to cover up. The supplier will make a note of the wig you have selected and will then be able to supply it quickly if needed.

2. Think about alternatives such as specialist head scarves, hats and other options for covering up.

Understanding after care

It is important to know that you will need to treat your hair very gently for the duration of your treatment and for a short time afterwards. This may mean a change in your regular hair care regime. 

Making your decision

Now you have a better understanding of the practical, emotional and actual process of scalp cooling you may find it helpful to answer the questions over the page: 

Making your decision -Is scalp cooling the right choice for me?

Scalp cooling - Helpful key questions for you to answer:

1.         Am I prepared to allow the additional time needed for scalp cooling? 

Yes….              No….   

2.         Am I happy to leave the hospital with damp hair?          

Yes….              No….   

3.         Do I feel able to endure any discomfort/coldness?

Yes….              No….

4.         Am I prepared to alter my current hair style if needed?

5.         Having considered other options for dealing with hair loss do I feel that saving my hair is a priority for my personal confidence and daily quality of life?

Yes….              No….                                                   

6.         And finally - is scalp cooling the right choice for me? Yes….                    No….                               Don’t Know -If you are still unsure then discuss this with your nurse, get in touch with Paxman or Cancer Hair Care.

Yes -If you have decided to give scalp cooling a try the remainder of this booklet will offer you guidance on preparing for scalp cooling treatment and hair care.

 No -If you have decided that scalp cooling isn’t for you may we suggest that you consider other options for covering up. Our directory will help signpost you to organisations that can support you. At support is waiting.

Chapter 2 Preparation and hair care for scalp cooling






  • Putting on eyelashes by Sara

  • Creating eyebrows by Sara

  • Eyebrows & lashes by Sara

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