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Does cold capping reduce the risk of permanent hair loss after chemo?

Published: May 9, 2025

Permanent hair loss is a real risk for many chemotherapy patients. Which is one of the reasons why thousands of people turn to cold capping to retain their hair during treatment and eliminate the chances of permanent hair loss.

If you’re about to start chemotherapy, you might have concerns about hair loss, a common side effect of this treatment. While most chemo patients experience temporary hair loss, you should be aware of something called Permanent Chemotherapy-Induced Alopecia (PCIA). It’s a less common but more distressing condition where hair never returns to its original state.

What causes permanent hair loss?

The exact reasons behind change or permanent hair loss are still being studied, but damage to the hair bulb and follicular stem cells is thought to play a significant role. Hormonal therapies alongside chemotherapy might also contribute. Permanent hair loss typically affects the scalp but can also impact eyebrows, eyelashes, and body hair in some cases.

“ Cold capping may reduce the risk of permanent hair loss ”

The rate of permanent hair loss isn’t the same in everyone. You might experience thinning across the scalp, or have patterns like androgenetic alopecia, or appear in patches similar to alopecia areata. Biopsies often show a mix of miniaturized hairs, increased telogen hairs, and sometimes inflammation around hair follicles.

How common is change to your hair or permanent hair loss?

For many, the change is short-lived, but for others it’s a permanent change. There is no way to predict whose hair will change texture or grow back after chemotherapy, or indeed, whether the change is permanent. However, studies have show that if you’re regimen includes Taxotere or busulfan (Myleran), the chance of hair loss being permanent is higher than other chemo drugs.

Although permanent hair loss is relatively uncommon, when it does grow back most chemo patients say their hair is different than before – in many cases much thinner and sparser.

Doctors still don’t fully understand why hair texture sometimes changes after chemotherapy. It could be that the treatment damages hair follicles or affects the genes that control hair growth.

A study by PLOS ONE of 1478 breast cancer patients revealed that 58% of respondents said that their hair grew back thinner, 63% of respondents their hair grew wavier or curlier, 38% said that their hair grew back more white or grey, and 4% of patients reported that regrowth was still less than 30 percent five years after chemo.

Another study conducted by Clatterbridge Cancer Centre and The Christie NHS Foundation Trusts surveyed 383 breast cancer patients who had received taxane chemotherapy. It found that 23.3% of patients treated with docetaxel and 10.1% with paclitaxel reported permanent hair loss. The condition was more common in post-menopausal women, especially those who received docetaxel.

Can I reduce the chances of permanent hair loss?

Here’s where cold capping comes into play. The idea is that by cooling the scalp during chemotherapy, you can reduce the amount of chemotherapy drugs reaching the hair follicles, potentially minimizing hair loss. Penguin Cold Caps, for instance, are designed to maintain the scalp at a low temperature before, during, and after treatment, with the primary intention of saving the patient’s hair. The unintended bonus is that the hair follicle remains undamaged, reducing the long-term chance of permanent hair loss.

While it’s not a guaranteed solution, growing evidence suggests that cold capping could reduce the likelihood of permanent hair loss. The logic is simple: if permanent hair loss is caused by damage to the hair follicles, protecting these follicles by cooling them might help. Clinicians increasingly recommend cold capping as a precautionary measure for patients undergoing taxane chemotherapy.

Taking an active role in your treatment

As you prepare for chemotherapy, making sure you’re informed about all potential side effects, including permanent hair loss, is crucial. Understanding your options, like cold capping, empowers you to participate in your treatment actively. While no one can predict how your body will respond, taking steps to minimize risks can offer peace of mind.

At this current time, innovations like cold capping present the best approach to combating permanent hair loss. As research continues, the goal is to find more effective ways to prevent and manage this long-term side effect of chemotherapy. In the meantime, discussing all available options with your healthcare team, including Penguin Cold Caps, can help you make informed decisions about your treatment and care.

Book a call with our Penguin Cold Cap rep

If you’re considering cold capping, request a call from your local Penguin Cold Cap rep. They can help you weigh the pros and cons, considering your chemotherapy regimen and personal health.

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Your FAQs

We have created a dry ice locator here to help you find the cheapest locations for dry ice. If there is not a location near you try searching using the tips on that page.

It makes no difference whether you choose a Dry-Ice Freezer kit, which is when the caps are cooled in a cool box with dry ice, or a Bio-medical Freezer kit, when the caps are cooled in a special freezer at the clinic. As long as the caps have cooled to the correct temperature, the results will be exactly the same.

There are a number of reasons why Penguin Cold Caps achieve better results than other systems. The main factor is that Penguin is a manual Cold Cap Therapy treatment. This means patients can continue to cool their scalp for the recommended time after the chemotherapy infusion has ended. Patients using a machine-based system are often asked to leave the clinic within one hour after treatment. This leads to the scalp warming up too soon, allowing the chemo toxins to attack the hair follicles, leading to hair loss.

Patients on some of the harshest drug regimens have had success with Penguin Cold Caps. Your Penguin Rep will be able to offer more advice on your specific treatment plan. You will find more information on our Success Rates page and read our user stories. 

Yes – 57% of our customers are referred by their medical team because of the success they’ve seen with other patients.

  • Penguin Crylon Gel Cold Caps.
  • The Penguin Crylon Gel-filled headbands (adds an additional source of cold along the hairline.)
  • Velcro elastic straps that help secure the caps in place.
  • Comprehensive Users Guide and Hair Care Guide.
  • Personalized Schedule of Use.
  • Cooler if ordered.

There are several foundations providing help to those with financial difficulties.

It is a non-invasive, drug-free way of reducing chemotherapy-induced hair loss by the application of cold to the scalp. For more information read our post here.

Chemotherapy drugs are designed to damage or kill cells with a ‘fast division rate’, such as cancer cells. Unfortunately, other cells in the body also have a fast-dividing rate, including your hair. This similarity makes these cells susceptible to the chemotherapy drugs and causes hair loss.

If your hair is snapping or breaking midway through treatment, I know it can be frustrating, but don’t give up on cold capping just yet! Even though your hair may be weaker right now, you’re still protecting your follicles, which is crucial for keeping as much hair as possible and ensuring it grows back healthier and faster after treatment. Here’s what’s happening and why your hair is breaking:
  1. Your hair is getting weaker, but your follicles are still alive – The treatment affects the hair follicles, making new growth more fragile. This weakens the hair shaft, so instead of shedding from the root, some strands may break in the middle. But because you’re cold capping, your follicles are staying active, meaning your hair is still growing even during this process.
  2. Your hair’s growth cycle has been disrupted, but it hasn’t stopped – Normally, your hair cycles through growing, resting, and shedding phases. The treatment can push it into a resting phase, which may cause uneven thinning or breakage. But thanks to cold capping, many of your follicles are still functioning, which will help you bounce back more quickly afterward.
  3. Your hair texture and strength are changing, making it more fragile – You may notice your hair feeling drier, frizzier, or finer than before. This is because the process temporarily alters how your body produces hair, making it more prone to breakage. But since you’re still protecting your follicles, your hair will start to regain its strength once you’re finished with treatment.
  4. Your body isn’t producing as much keratin right now – Keratin is the protein that keeps your hair strong and elastic. With less keratin, your hair can become brittle and more likely to snap. The good news? Cold capping helps maintain follicle health, so as your body recovers, your hair will grow back stronger and healthier.
  5. Your scalp may be more sensitive – Some medications cause dryness or irritation, which can make your hair even more fragile. Keeping your scalp hydrated and using gentle hair care can help reduce breakage.
  6. Everyday friction can cause breakage – Brushing, towel-drying, or even tying your hair back too tightly can lead to more snapping. Try to be as gentle as possible to protect what you have.
Even though it might feel discouraging right now, remember that cold capping is still working! You’re protecting your follicles, your hair is continuing to grow, and once treatment is over, you’ll have a much quicker recovery. Stick with it—your patience will pay off!

We recommend to wait 6 months after your last infusion as this is how long it takes for you hair follicles to recover. However if you want to color sooner, wait 3 months and try a natural/organic hair dye with no ammonia or peroxide in. But always remember to do a patch test first. Even if you’ve used the same color dye in the past, chemotherapy can make your skin more sensitive than before.

We recommend you have a trim to remove any split ends (1-2 inches max)  before your first cold capping session. This will help prevent any knots from forming further down the line. It’s very easy to catch hair knots when brushing, pulling on clothes, or even on your pillow as you sleep.  You need to be careful to avoid catching your hair so not to pull on already weakened hair follicles.  There is no need to have a drastic haircut!

Depending on availability, dry ice can be purchased either the night before or on the day of therapy. Purchase 45-50 lbs. (20-23kg) of dry ice in ‘slab form’ on the day of your treatment. If the dry ice supplier only has pellets, ask the dry ice supplier to put the pellets into 10 lbs. bags. If you are purchasing your dry ice the night before, order 60 lbs. (27kg).

No – Unlike some other cold cap providers, you do not need to dampen your hair whilst using Penguin Cold Caps. We don’t recommend it because our caps fit very snuggly to your head, transferring the cold far more efficiently than other providers. There are now studies showing there is  “no convincing evidence was found whether wetting hair prior to scalp cooling contributes to better prevention of CIA” – It also shows that it leads to a 200% increase of discontinuation due to intolerance.

Depending on your hair type and treatment regimen and few other factors Your Penguin Rep will provide you with a personalized schedule. You will need to put your first cap on at least 50 minutes before your chemo infusion begins and continue to wear them for the recommended time after your treatment. It is essential to follow your schedule to achieve the best results.

While cold, many patients tell us they expected them to be far worse. They will never be comfortable, but most people find the cold bearable. The first couple of caps are the worst – but as your scalp cools, the nerve endings numb, and you won’t notice the cold as much.

When the Penguin Cold Caps arrive, you will also receive full instructions for use and a hair care guide via email. But if you have any questions, one of our experienced representatives is just a call away to help you.

  • 3 Penguin Cold Caps
  • 3 Penguin Gel Headbands
  • 2 Black Straps
  • 1 Yellow Strap (if supplied)
  • 1 Thermometer
  • 1  Cooler (If supplied)
  • 1 Timer (if supplied)
  • 1 Pair of Gloves.

Yes -Penguin Cold Cap therapy is a manual cold capping system, which means you have the flexibility to cold cap anywhere.  Unlike machine capping, you do not need to be connected to a machine to keep the caps cold. You are free to move around.

  • Penguin Crylon Gel Cold Caps.
  • The Penguin Crylon Gel-filled headbands (adds an additional source of cold along the hairline.)
  • Velcro elastic straps that help secure the caps in place.
  • Comprehensive User Guide and Hair Care Guide. (Emailed)
  • Personalized Schedule of Use. (Emailed)
  • Cooler if ordered.

We can arrange next-day delivery within the USA. For Europe it’s normally 1-2 days. For the rest of the world it is 2-3 days. Use our shipping calculator or contact us for a delivery time frame.

Although not standard across all insurers, some accept claims for a percentage of the cost. You will need to contact your insurer to see whether you can make a claim. You can find more information here: Are Cold Caps covered by insurance?

Although not standard across all insurers, some accept claims for a percentage of the cost. You will need to contact your insurer to see whether you can make a claim. You can find more information here: Are Cold Caps covered by insurance?

We accept all major providers. VISA, Mastercard, American Express, JCB and more. We also accept HSA & FSA cards, however you may need to call them up for approval.

Penguin Cold Caps, 7328 Lakeshore Rd, Lexington, Michigan, 48450, USA

Penguin Cold Caps are only available to rent.

Order online here. Contact one of our representatives here or Request a call-back.

You will be charged a monthly rental fee for the time you have them.

Penguin Cold Caps’ rental price is Array (USD) per month. With a refundable security deposit is ArrayArray (USD).