Learn how cold capping works with chemotherapy

Published: June 19, 2024

Facing a cancer diagnosis and the subsequent treatment journey is challenging.

As you research your prescribed chemotherapy regimen, you might have encountered the concept of cold capping or scalp cooling, a method to help prevent hair loss during chemotherapy. This article aims to provide you with an understanding of how cold capping works with chemotherapy to help you retain your hair.


Learn how cold capping works with chemotherapy

What is chemotherapy?

Chemotherapy is a type of cancer treatment that uses powerful drugs to kill rapidly growing cancer cells in the body. These drugs are systemic, meaning they travel throughout the body to target cancer cells wherever they may be. Unfortunately, because they are not selective, chemotherapy drugs also affect other rapidly dividing cells, such as those in the hair follicles, leading to hair loss.

How does it work?

Chemotherapy drugs work by targeting cells at different stages of their growth cycle. Some drugs damage the DNA of cancer cells, preventing them from dividing and growing. Others interfere with the cell division process or disrupt the internal functions of the cells. The specific regimen you are prescribed will depend on the type of cancer you have, its stage, and other individual factors. Your oncologist will tailor your chemotherapy regimen based on the type and stage of your cancer, your overall health, and your treatment goals.

Common chemotherapy drugs you may be prescribed may include:

  • Adriamycin (Doxorubicin): Often used in breast cancer treatment, this drug can cause hair loss, nausea, and heart damage at high doses.
  • Cytoxan (Cyclophosphamide): Used for various cancers, including breast cancer, lymphoma, and leukemia. Side effects include hair loss, nausea, and bladder irritation.
  • Taxol (Paclitaxel): Commonly used for breast and ovarian cancer, it can cause hair loss, neuropathy, and low blood counts.
  • Carboplatin and Cisplatin: Used for ovarian, lung, and other cancers, these drugs can cause hair loss, kidney damage, and hearing loss.

Side effects of chemotherapy

Chemotherapy drugs can cause a wide range of side effects, some of which can be managed with medications and lifestyle changes. Understanding these side effects can help you prepare for treatment and improve your quality of life during therapy.

  • Hair Loss (Alopecia): One of the most distressing side effects for many patients, hair loss occurs because chemotherapy drugs target rapidly dividing cells, including those in the hair follicles.
  • Nausea and Vomiting: Chemotherapy can irritate the stomach lining and affect the brain’s vomiting center.
  • Fatigue: A common side effect due to the body’s efforts to repair the damage caused by chemotherapy.
  • Neutropenia: A decrease in white blood cells, increasing the risk of infection.
  • Anemia: Reduced red blood cells can cause fatigue and shortness of breath.
  • Peripheral Neuropathy: Nerve damage can cause tingling, numbness, and pain in the hands and feet.
  • Mouth Sores: Inflammation and sores in the mouth can make eating and drinking painful.

Managing side effects
  • Medications: Antiemetics can help control nausea and vomiting, while growth factors can boost white blood cell counts.
  • Diet and Nutrition: Eating small, frequent meals and staying hydrated can help manage nausea and fatigue.
  • Rest and Exercise: Balancing rest with light exercise can improve energy levels and mood.
  • Infection Prevention: Practicing good hygiene and avoiding large crowds can reduce the risk of infection.

Introducing cold capping

Cold capping, also known as scalp cooling, is a technique used to reduce hair loss during chemotherapy. It involves wearing a specially designed cap that cools the scalp before, during, and after chemotherapy sessions. The cooling effect constricts blood vessels in the scalp, reducing the amount of chemotherapy drugs that reach the hair follicles.


How cold capping works

Cold capping works on the principle of vasoconstriction, which reduces blood flow to the scalp. By lowering the scalp temperature, the cap minimizes the exposure of hair follicles to chemotherapy drugs. This helps preserve hair and can significantly reduce the extent of hair loss.


The two types of cold caps:
Manual Cold Caps

These are gel-filled caps that are cooled in a freezer or dry ice and changed every 20-30 minutes during the chemotherapy session. They require careful timing and assistance from a caregiver but tend to give a closer fit to the scalp, plus can continue to be worn for several hours post chemo increasing the success rate.

Machine-based cooling systems

These systems circulate a coolant through a cap worn by the patient. The temperature is maintained automatically, providing a more consistent cooling effect. Because they cap doesn’t fit so tightly to the scalp, many patients report bald patches. 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.

Benefits of cold capping
  • Hair Retention: Many patients experience reduced hair loss, allowing them to maintain their appearance and self-esteem during treatment.
  • Psychological Well-Being: Retaining hair can help patients feel more in control and less anxious about their treatment.
  • Normalcy: Keeping your hair can help you maintain a sense of normalcy and privacy, as hair loss is often a visible sign of cancer treatment.

Effectiveness of cold capping

The effectiveness of cold capping can vary depending on several factors, including the type of chemotherapy drugs used, the dosage, and individual patient characteristics. Studies have shown that cold capping can be effective for many patients, with success rates ranging from 50% to 95%.

Penguin Cold Caps patients achieve a high rate of success – your can read their stories here.


Factors affecting success
  • Chemotherapy Regimen: Certain chemotherapy drugs are more likely to cause hair loss than others. More on the different drug regimens that respond to cold cap therapy.
  • Consistency: Adhering to the cold capping schedule and maintaining the required scalp temperature throughout the treatment can improve effectiveness.
  • Individual Variability: Each patient’s response to cold capping can differ, so it is essential to have realistic expectations and be prepared for varying results.


Potential side effects of cold capping

While cold capping is generally well-tolerated, some patients may experience side effects, including:

  • Cold Discomfort: The cold sensation can be uncomfortable, especially during the initial stages of treatment.
  • Headaches: Some patients report headaches or scalp pain due to the cold temperature.
  • Scalp Skin Conditions: In rare cases, scalp skin can become dry or irritated.

Preparing for cold capping

If you decide to try cold capping, it is essential to prepare adequately to maximize its effectiveness and manage any potential discomfort.

Steps to prepare:

  1. Consult Your Oncologist: Discuss your interest in cold capping with your oncologist to ensure it is suitable for your chemotherapy regimen.
  2. Choose the Right Cap: Research different cold cap systems and choose one that fits your needs and budget.
  3. Arrange for Assistance: If using manual cold caps, arrange for a caregiver to help with cap changes during your chemotherapy sessions.
  4. Follow Instructions: Adhere to the manufacturer’s instructions for using the cold cap, including pre-cooling the caps and timing the changes.
  5. Prepare for Comfort: Wear warm clothing and bring blankets to stay comfortable during the cold capping process.

For more on what to take to your cold capping chemo session, here’s some recommendation from Penguin users.

During cold capping

Stay Relaxed: Practice relaxation techniques to help manage the discomfort of the cold.

Monitor the Cap: Ensure the cap fits snugly and covers the entire scalp for even cooling.

Communicate with Your Care Team: Inform your healthcare team of any discomfort or issues during the process

Aftercare and maintenance

After completing your chemotherapy sessions, continue to care for your hair and scalp to support regrowth and health.

Hair Care Tips:

  • Gentle Handling: Avoid harsh brushing or styling to prevent hair breakage.
  • Mild Shampoos: Use gentle, sulfate-free shampoos and conditioners.
  • Limit Heat Styling: Avoid using hairdryers, curling irons, or straighteners until your hair regains strength.

Hair regrowth can begin within a few weeks to months after completing chemotherapy. The new hair may have a different texture or color initially, but it usually returns to its pre-treatment state over time.

Cold capping with Penguin Cold Caps

Chemotherapy is a challenging but crucial part of cancer treatment, and its side effects, including hair loss, can significantly impact your emotional well-being. Cold capping offers a promising option for many patients to retain their hair and maintain a sense of normalcy during treatment. By understanding your chemotherapy regimen, managing side effects, and exploring scalp cooling, you can take proactive steps to support your physical and emotional health throughout your cancer journey. Always consult with your healthcare team to make informed decisions about your treatment options and care strategies.

Request a call with a Penguin representative in your area.