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HOME » SCALP COOLING » Chapter 2 Preparation

Chapter 2 Preparation

Getting prepared for your first scalp cooling & chemotherapy treatment.

This section will help you to get prepared for your first experience of scalp cooling alongside your first chemotherapy treatment.  It is only natural to feel anxious about your first treatment but we hope that, by sharing experiences from other patients and offering some hints and tips about what to expect, you will feel more prepared and better able to manage how you feel.

Your hair style

Many people ask if they need to change their current hair style in preparation for scalp cooling.  This is entirely a personal choice. However because the cold cap needs to fit very snugly to your scalp you may find the guidelines below helpful:

Hair thickness

In our experience the ideal style would allow your hair to be combed flat when wet without any area bulging out that feels thicker than 1cm in thickness diameter from the scalp. If the hair is 1cm or more in thickness (not length) in any area then we recommend you consider a change in style such as a layered haircut to help reduce this bulk. Remember you want the cooling effect to reach the hair follicles – thick hair may prevent this being as effective as possible.

Hair length

It is our opinion that the ideal length of hair would be no longer than shoulder length. This is because the hair can become matted putting additional tension on the hair. Long lengths of hair will hang below the cap – this is normal and not a problem. It is the hair follicle (root) of the hair that needs to be protected. There is nothing to stop you from trying the process with long hair but patient feed-back tells us that longer lengths (shoulder and below) can be problematic.

Chemical processes:

In relation to colour/perm/relaxing/chemical straightening please see our guidelines on page 28 and the Paxman after care leaflet.

An overview of your first scalp cooling treatment

The day of first treatment Forster Suite, Lister Hospital. Other hospitals may vary.

Patients have told us that it helps to reduce anxiety when they have a better understanding of what to expect in relation to scalp cooling.  Below is an overview:

You will be asked to arrive 20 minutes prior to your scheduled appointment time to allow enough time for you to prepare your hair.

 Let reception know you have arrived

Ask at the nurses’ station if you should prepare your hair

Prepare your hair (see guide - page 19)

Once your hair is prepared please take a seat back in the waiting room

A member of the team will call you into the treatment room

A member of the team will try on different sized cold caps to ensure a good fit (after your first treatment they will continue to use this size unless a change is needed). For your information there are 4 different sizes ranging from extra-small to extra-large.

The majority of the time a fabric-elasticated band is placed over your forehead and ears to protect them from the cold cap and help with comfort. If you don’t have one we recommend you ask your nurse to use gauze.

On selection and fitting of the suitable cold cap the scalp cooling machine will be started - approximately 30 minutes prior to your chemotherapy treatment.

Once your pre cooling time is complete your nurse will start your chemotherapy

Once your chemotherapy treatment is complete your cold cap will remain on for the recommended time.

When the time is complete you can undo the chin strap but must wait for a further 10 minutes (approx.) until a team member is satisfied that your head is warm enough to take the cap off.

Initial hair loss due to chemotherapy normally starts around 10 days to 14 days after your first treatment. With this in mind you won’t be able to tell if scalp cooling is successful until after this period. Hair loss can then continue throughout the duration of chemotherapy treatment. In order to prevent hair loss you must wear the cold cap during each and every treatment until the end of your chemotherapy cycle.

Ensuring a good cold cap fit

Your nursing assistant/nurse will do their very best to ensure the best possible fit of your cold cap. It is helpful for you to interact with the fitting:

Here are some tips:

The cold cap won’t necessarily feel very tight until your chin strap has been fastened. The chin strap can often feel uncomfortable at the beginning.  It may be helpful for you to pull the chin strap down yourself and allow sometime to get used to the tight and pressurised feeling you may experience.

If you can slip your hand up the back of the cold cap it is too big – a smaller size is recommended.See the next few pages for detailed information on how to prepare your hair.

Preparing your hair for scalp cooling – in detail:

At The Lister Hospital, Forster Suite you are kindly asked to supply your own items needed to prepare your hair for the cold cap treatment. Other hospitals may vary. Please bring your kit to each and every treatment. In Chapter 5 we have made some recommendations on where to buy your items from.

At most hospitals there is not a facility for you to wash your hair at the and so it is recommended that you wash your hair prior to treatment.  This does not necessarily need to be on the day of treatment. Our recommendation is to have clean hair that has been washed within any time 48hours prior to treatment.  (You may choose to arrive with freshly washed damp hair. But do keep your head warm).

Your kit:

You will need to have the following to hand:

o          Water spray

o          Conditioner

o          Wide tooth comb (and section clips if needed)

o          A fabric hair band (or your nurse can supply gauze)

o          A towel (can be provided for you if you don’t have one- please ask a member of staff).

Arrive 20 minutes prior to your appointment time

Please arrive 20 minutes prior to your chemotherapy appointment to allow sufficient time to prepare your hair for the cold cap treatment. On arrival at the unit please check with your nurse if you should go ahead and prepare your hair for your planned appointment time.

Please take your items to the washroom (or as directed by your hospital) and prepare your hair  - follow our step by step guide

Step 1

Using your water spray damp down your hair -wet well throughout.      

Step 2 

Use sufficient conditioner to ensure good coverage. This helps the cold cap to be more easily removed.

Step 3

Apply the conditioner to all layers of your hair – do not use to much a fine layer is enough

Step 4

Comb conditioner through using a wide tooth comb. For now comb into your parting (nurse may change this).

Step 5

You are ready. Please go to the treatment room.

Where to buy your kit:

You can buy your kit items from any supplier you wish. You do not need to use a specific conditioner but it is recommended to use something mild (for those with sensitive scalps you may wish to consider avoiding products with artificial perfumes –this is because highly perfumed products can cause irritation to sensitive scalps). However naturally perfumed PH balanced products are fine to use. There is also no absolute rule. See page 24 for more about this.

At The Lister Hospital, Stevenage, Cancer Hair Care have put together ‘Scalp Cooling Kits’ that are available for a recommended donation of £7.00 (or free of charge). Your nurse can supply you with one upon request.

Alternatively you can buy all of the items needed from local stores and on-line. Of our directory  in this booklet will offer you some details of recommended brands and suppliers.

Top tips during treatment

Other patients have said that they found the following helpful:

If you feel panicked by the coldness/ tightness of the cold cap try closing your eyes and taking a few deep breaths

Remember that after around 10 minutes you will start to get used to the feeling and the intensity will lessen

For added comfort ask to have gauze under your chin strap, by your ears, cheeks

Have a blanket handy to feel warmer

Drink a hot drink

Read a magazine or book for distraction

Do remember that the cold cap can be unclipped for a short time to go to the toilet or stretch your legs

The scalp cooling machine does sometimes flash and bleep – don’t panic or remove your cold cap simply alert your nurse

Remember your nursing team are here to support you. You are not bothering them by asking for their help so do call upon them –they care about you but won’t know if you need support unless you ask. Contact Cancer Hair Care, we are here to help you.

At the end of each treatment

Once treatment is complete take your time to gently remove the cold cap with the help of your nurse. Don’t rush to get up – take your time as you may feel a slight rush (dizziness) as the warm air starts to recirculate around your head.

As your hair will be damp you may like to cover up in a hat, cap or scarf. You can gently wash your hair after treatment if you wish – see page 24, additionally our aftercare guide will offer you some tips on caring for your hair.

Please remember to take home your kit and bring it to your next appointment.

Chapter 3 Aftercare Caring for your hair





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  • Cat Deeley & Cancer Hair Care

  • Putting on a wig by Emma

  • Eyebrows & lashes by Sara

  • Black head scarf by Emma

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