How scalp cooling can reduce hair loss in chemotherapy, and how to use and look after cold caps…

If you are having chemotherapy treatment for cancer, it’s very common to experience hair loss. This can often be one of the more challenging side effects to deal with. However, many people find that wearing a cold cap can help. Here we take a look at how scalp cooling can reduce hair loss, and how to wear your cold cap and care for your hair.

What is scalp cooling?

Chemotherapy works by attacking cells that divide quickly, including cancer cells. However, it can also damage other cells that divide quickly, such as hair cells, which are among the fastest-growing cells in the body.

Wearing a cold cap – a special strap-on hat used to cool the scalp – can help to reduce or prevent hair loss by significantly reducing the temperature of the head, slowing the blood flow to the scalp and minimising the amount of chemotherapy drugs reaching your hair follicles, as well as slowing down cell activity to reduce the effects of any chemicals on the cells.

It’s important to note that scalp cooling does not work for all chemotherapy treatments, or all types of cancer. You can talk to your treatment team about whether scalp cooling could be an option for you.

How does a cold cap work?

There are two main methods of scalp cooling. The first uses a cap which is kept in a freezer up until the point of treatment. These types of cold cap effectively work like a large ice pack. They may begin to thaw out during your treatment, so may need to be replaced during treatment.

The second method uses a scalp cooling system, where the cold cap is attached to a refrigerated system which pumps coolant through the cap throughout the period of treatment.

For scalp cooling to be as effective as possible, the cold cap must be worn for a period of time before your treatment, throughout the session, and kept on for a period after your treatment. This can have an impact on the overall length of your chemotherapy sessions.

The exact length of time will depend on your treatment, but commonly you will need to wear the cold cap for at least 30 minutes before your chemotherapy session starts, during your treatment, and then for around another 60-90 minutes after your treatment has finished.

Wearing your cold cap

Prepare your hair
Before you begin, the area of hair that will sit underneath the cold cap must be made damp with lukewarm water. This helps the cap to work more effectively. Some mild conditioner should then be applied to your hair – this will help to protect it from the freezing effects of the cap, and also make it easier to remove the cap after treatment.

Ensure a snug fit
It’s important that the cold cap covers your whole scalp, including the hairline. The cap should fit your head tightly and be secured firmly using the chinstrap. The top of the cap should touch the crown of your head, and the cap should not move around easily.

“If you do try it, make sure it fits and is in total contact with your head, if it’s not it’s likely you will lose hair in that place so spend some time adjusting it” LBW community member

Consider taking pain relief
Some people find that wearing a cold cap can be quite uncomfortable initially, due to the extreme coldness. This normally wears off after 10-15 minutes or so, but taking some painkillers such as paracetamol can help to reduce any headaches or other discomfort – talk to your medical team about pain relief. Placing some fabric or gauze underneath the straps can help to reduce any irritation.

Keep yourself warm
During your scalp cooling treatment, you may feel colder all over. It can help to dress in warm layers. Taking a favourite blanket and drinking hot drinks and herbal teas can also help to keep you warm during your treatment session.

“One thing I found really helpful when using the cold cap was having a hot drink to warm your core.” LBW community member

Try relaxation techniques
Many people who find the initial stages of scalp cooling difficult recommend using relaxation techniques, such as deep breathing or mindfulness, to help them through. Listening to music or a relaxation CD, or talking to other people, can be helpful.

“Take someone with you to distract you. Play games, anything to take your mind off how cold your head is.” LBW community member

After your treatment
When it’s time to remove your cold cap, make sure this is done carefully, without pulling on your hair. As your hair will be damp following treatment, it’s advisable to have a warm hat, beanie or other head covering available.

Looking after your hair during treatment

Chemotherapy can leave your hair dry and brittle, and it’s advisable to take extra care of it while you are undergoing treatment. These tips can help you to keep your hair protected:

  • Try to avoid washing your hair more than twice a week
  • Avoid using hot water or hot implements such as hair straighteners or hot rollers
  • When brushing, approach this gently using a soft hairbrush or a wide-toothed comb
  • Avoid dying your hair until your treatment has completely finished
  • Use mild, chemical-free hair products – there are a range of hair products available which are specially designed to help you look after your hair.

“I used the cooling caps and even though my hair got thinner I still got to keep it which made me very happy. I used a shampoo and a conditioner that are specially designed for use along with a cold cap.” LBW community member

Find recommended Live Better With scalp cooling products here.


It’s important to remember that scalp cooling may not be right for everyone, and that it will only help to protect the hair on your scalp. You may also still experience some patching or thinning of your hair.

However, wearing a cold cap during cancer treatment has been shown to help a significant number of people and can have a real impact on their well-being.

If you have experienced hair loss during cancer treatment, or are looking for tips and advice, why not visit  the Live Better With cancer community here.