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Sometimes, chemotherapies used to treat certain cancers can cause alopecia, or hair loss.

Cold caps are medical devices promoted to prevent this. Also known as scalp hypothermia, cold caps rely on cold temperatures to help offset damage to the hair follicles.

While there’s evidence that scalp hypothermia could benefit some people undergoing chemo, it’s not suitable for everyone.

This article introduces how cold caps work, where to get one, price, and how to go about getting started.

Cold caps are frozen devices intended to decrease the risk of hair loss from chemo treatments. The cold temperatures may decrease blood flow to your scalp, thereby preventing chemotherapy drugs from affecting your hair follicles.

In theory, by preserving your hair follicles, you may be able to thwart significant subsequent hair loss. However, it’s still possible that you’ll shed some hair. The purpose isn’t to prevent all hair loss — rather, it’s to prevent more noticeable, widespread hair loss.

How effective are cold caps against hair loss?

The efficacy of cold caps is believed to range from 10 to 100 percent.

While the technology has been used in some form since the 1970s, researchers are still determining when cold caps might work best.

For example, research from 2016 found that using cold caps effectively minimized some hair loss in women with breast cancer.

Here are a few considerations about traditional cold caps and scalp cooling for chemo:

  • Type of cancer. This treatment option is intended for solid tumors only. It isn’t recommended for leukemias or lymphomas.
  • Location of tumors. You shouldn’t use this method if you have tumors in your brain or scalp area.
  • Hair thickness. Cold caps may not work as well if you have thick hair.
  • Hair loss location. Cold caps don’t address hair loss in other areas of the body that may occur with chemotherapy, such as your arms, lashes, and eyebrows.
  • Computerized alternatives. Traditional cold caps may be effective, but research shows that computer-assisted scalp cooling systems could work even better.
  • Type of chemotherapy. Cold caps aren’t effective with all types of chemo. Research from 2018 found that patients undergoing taxane-based chemo had a greater response to scalp cooling than those undergoing other types of chemo.

Common side effects of cold caps for chemo include:

  • scalp and forehead irritation
  • numbness
  • chills
  • headaches
  • pain
  • nausea
  • discomfort that extends to your neck and shoulders
  • dizziness

Side effects are more severe in some people, potentially making cold caps too uncomfortable to use.

There are no known long-term risks associated with these devices.

Although cold caps may be effective at preventing hair loss, they’re not suited for everyone. Talk with your doctor about your options, potential side effects, alternatives, and more before getting started.

If your oncologist gives the go-ahead, you’ll need to bring your cold cap with you for each chemo session. To gain the most of its potential benefits, you’ll also need to wear it before and after your appointment.

Allow yourself extra time for use and preparation. Overall, you may spend anywhere from 20 minutes to 2 hours during each use. If you’re using a cap that requires a cooling machine, you’ll need to finish the process at a medical facility.

It’s also a good idea to bring more than one cold cap if your treatment sessions last more than 20 minutes. This way, you can switch out your cold cap for another if it defrosts during use.

Note that the tighter, or closer to the skin, the cold cap is, the more effective it is.

You’ll need assistance with changing out your cold caps during chemo treatments. A friend, family member, or trained caregiver (sometimes called a “capper”) may be able to assist.

Consider dressing in layers and bringing blankets with you to help offset the cold sensations from your scalp hypothermia treatment.

When looking for a cold cap for chemo, consider the following elements to help you make the best decision:

  • customer reviews
  • price
  • additional features, such as coolers
  • ease of use
  • access to a medical professional for assistance
  • any FDA clearance or clinical backing

The prices of cold caps vary among companies.

It’s common to rent them. While renting may be cheaper in the short run, it could lead to more long-term expenses should you need more chemo in the future.

Below are some estimated rental costs, provided by the manufacturers:

It’s also important to consider the following factors when thinking about the total cost:

  • if cold cap treatment services include help with cap transfers during treatment sessions
  • if the initial cost of the cap is included or separate from other fees
  • any security deposits
  • ongoing rental fees
  • how many chemo treatments you need
  • portable coolers and dry ice for transporting the cold caps to your appointments
  • the possibility of needing multiple caps for longer chemo sessions
  • facility fees, if you need to use cooling machines

Medical insurance typically doesn’t cover cold caps for chemotherapy, although it may be possible to obtain a partial reimbursement from your insurance company. Contact your insurance company ahead of time to ask about possible coverage.

There are several brands of cold caps to consider, with varying features and price points.

Arctic Cold Caps

Arctic Cold Caps offers a complete system that includes eight caps, a cooler, a timer, and more.

If you have questions about the treatment, the company provides free access to a registered nurse.

Chemo Cold Caps

Like Arctic Cold Caps, Chemo Cold Caps offers a complete system.

One key difference is that you receive six caps instead of eight. This is possible because of a steel-infused cooling system that refreezes them during your treatments.

Penguin Cold Caps

Also sold as portable kits, Penguin Cold Caps is one of the first companies to provide these products for chemo treatment.

The caps come with chin straps for a tighter fit to make sure your scalp receives a uniform treatment.

Penguin Cold Caps are offered as rentals only. To get started, you must visit the company website to find your closest sales representative.

When considering cold caps, it’s important to also consider computerized scalp cooling systems and any lifestyle changes that may minimize hair loss. Discuss the following information with your doctor.

Scalp cooling systems

While sometimes confused with traditional cold caps for chemo, scalp cooling systems work with computers and are offered directly at cancer treatment centers.

There are two types of FDA-cleared scalp cooling system: DigniCap and Paxman.

DigniCap

DigniCap is provided by your oncologist during each chemo round. The average cost of this system is $1,500 to $2,000, charged by the treatment center for each full course of chemotherapy.

You can learn more about the DigniCap systems through the manufacturer’s website and see if your cancer treatment center offers this option.

Paxman

Paxman is another scalp cooling system. It may minimize hair loss from chemo and prevent thinning hair. If you’re interested in this option, your doctor can prescribe the device. You obtain it from a medical supply store or pharmacy.

Lifestyle changes

Certain lifestyle changes may also help minimize hair loss during chemo. Consider the following tips:

  • Cut your hair shorter before starting treatment.
  • Avoid tight hairstyles like braids and ponytails.
  • Refrain from using heated styling tools like hair dryers and straighteners.
  • Extend the amount of time between washes.
  • Pat your hair dry gently after washing.
  • Use a wide-tooth comb to gently remove tangles from wet hair, starting at the ends.
  • Avoid using chemical-based hair products like perms, relaxers, and dyes.

Cold caps may help minimize hair loss during chemo treatments for cancer. The majority of cold caps are available as monthly rentals that you bring with you to the treatment center.

Clinical studies have shown that for some individuals, cold caps can indeed reduce hair loss and thinning hair. Still, they’re not guaranteed to work, and possible discomfort may make these caps unfeasible for longer usage.

Talk with your oncologist about cold caps, including their potential benefits and risks. You may then consider the above roundup of cold cap options, any alternatives, and whether your insurance company might cover the associated costs.