The importance of hair management when cold capping

Published: August 15, 2022

If you are considering using Penguin Cold Caps to save your hair on chemo, it’s important to understand that success relies as much on how you manage your hair throughout your treatment as it does on the caps themselves.

For many people, the thought of losing their hair on chemo is one of the more distressing side effects of cancer treatment. According to an observatory study by the UCHealth Cancer Centre at Highlands Ranch Hospital, 65% of patients undergoing chemo experience hair loss, and 40% are still experiencing permanent chemo-induced alopecia or partial regrowth three years after treatment.

The study found that, for many women diagnosed with breast cancer, losing their hair is more traumatic than a breast mastectomy and can cause patients to refuse treatment. They felt that hair loss would have a negative impact on their body image, sexuality, self-esteem, and quality of life and be a constant and visible reminder of their cancer diagnosis.

We can attest to that observation based on the feedback we receive from many of the thousands of women that have cold capped with Penguin:

“I wanted to wake up every morning and see myself reflected in the mirror. I didn’t want to look at a sick person”

Read Sophie’s Story


“Choosing to save my hair made me feel empowered in a situation that I had absolutely no control over”

Read Josie’s Story

Find out more from our patients about their experience of cold capping, and the results they achieved – Patient Stories


Haircare recommendations

No matter which cold cap system you choose to use, hair maintenance advice is relatively universal. The cold capping does its job by cooling your hair follicles to the point at which they enter a hibernated state, this effectively stops them from absorbing the damaging chemo drugs that make your hair fall out. But your hair will still be weakened and needs to be handled with care.

For more detailed information, see What is cold capping?

Your Penguin Cold Cap rep will give you comprehensive instructions on how to treat your hair while undergoing treatment and beyond, until the point at which your hair is stronger.

The aim is to keep as much of your hair on your head as possible and reduce shedding. Most people will experience some shedding, but by following the recommendations, you can dramatically help reduce the amount you shed.

The main recommendations are:

  1. Avoid hair pulling and catching
    You should avoid anything that pulls on your hair or puts pressure on your scalp, including hair bands, grips, and tight-fitting headbands or hats. Your Penguin rep will recommend you go one step further and buy a silk pillowcase at night to protect your hair from pulling when you naturally toss and turn in your sleep
  2. Avoid hair chemicals
    Do not use chemicals such as peroxide, parabens, or sulfates on your hair. These chemicals are in some shampoos, conditioners, styling products, and hair color – so check the before you buy.
  3. Comb with care
    Reduce the number of times you comb your hair to twice a day, and take extra care when using your fingers, a detangling brush or a wide-tooth comb. If you have long hair, hold your hair when brushing or combing to avoid pulling on the roots. If you have curly hair, you may find it helps to apply a detangling spray before you start. Avoid spraying or wetting your roots.
  4. Manage hair matting
    The chemo is likely to make your hair dryer and coarser, and as a result, you may find it begins to matt. To deal with this, lightly spray your hair with water, apply conditioner, but not too close to your scalp. Carefully work through the matted hair with a wide-tooth comb or your fingers, but avoid pulling on the roots.
  5. Limit hair washing
    This is the one that people struggle with the most. The recommendations are that you wash your hair a maximum of twice a week, using lukewarm water and turning your shower head to a low-pressure setting. Gently use your fingers to work the shampoo and conditioner into your hair before rinsing, taking care not to scrub your scalp with your nails. Avoid applying conditioner too close to your scalp – it can leave a residue that clogs up your hair follicles.
  6. Avoid hair styling tools
    Even with cold capping, your hair will not be as lustrous and healthy as usual. Avoid using heated styling tools such as a hair dryer, curling irons, or hot rollers to keep your hair as soft as possible. Leave hair to dry naturally, avoid direct sunlight on your scalp and use hair oils to lock in as much moisture as possible.

For more information, see Tips for managing your hair when using cold caps

Success depends on patient motivations

Many people find these recommendations challenging to follow, especially over an extended period of time. But most of the patients involved in the UCHealth Cancer Centre study did adhere to the rules.

The study concluded that this was because the patients who choose to cold cap are highly motivated. They placed a high value on their hair, physical appearance, and privacy, regardless of the inconvenience to them.

The patients realized and accepted that a degree of effort and perseverance is required to achieve a successful outcome. This realization empowered them to feel a sense of control, making them more likely to stick to the rules. Instead of viewing the haircare recommendations as onerous or difficult, they enjoyed taking on the challenge of managing their symptoms tangibly.

Some people are not motivated in this way. It’s not a negative; it’s just that their priorities may fall elsewhere. If you fall into this camp, you may find you won’t persevere with the required hair maintenance and, as a result, may not be as successful.

Should you cold cap, or not?

Cold capping with Penguin does work, as our many patient success stories prove. But success, in part, does come down to the individual. You need to ask yourself:

  • How important is it for me to save my hair?
  • Am I willing to make the necessary sacrifices?
  • Am I likely to follow the hair care recommendations for as long as necessary?

If the answer is YES, and you are highly motivated to save your hair, you are more likely to follow your Penguin Cold Cap rep’s instructions, and you will have a greater chance of success.

If you have any questions about cold capping, or anything else related to your chemo treatment, why not join the Facebook Chemotherapy Support Group – with thousands of members reaching out to each other, someone will no doubt be able to offer you first hand advice.