COOLING DURING CHEMOTHERAPY

Chemotherapy can cause a range of side effects. For many people, hair loss is one of the most visible and emotionally difficult. But did you know that there are methods that can help reduce some of the side effects of treatment?

Scalp cooling with cold caps can reduce the risk of hair loss during certain chemotherapy regimens. There are also cooling gloves and cooling socks, which are used during selected treatments to reduce the impact on the hands and feet.

In this article, you get an overview of how these methods work, what the research shows, and which options you can explore if you are about to start chemotherapy.

WHAT IS SCALP COOLING?

Scalp cooling is a method used during chemotherapy to reduce the risk of hair loss. The scalp is cooled using a specially designed cold cap before, during and after chemotherapy.

When the scalp is cooled, the blood vessels constrict and blood flow to the hair follicles is reduced. At the same time, cell activity decreases. This means that less of the chemotherapy reaches the hair follicles, which may protect them from the effects that would otherwise lead to hair loss.

Scalp cooling cannot guarantee that you will keep your hair. The effect depends on factors such as the type of chemotherapy, the dose and your individual treatment course.

HOW DO COLD CAPS WORK?

Cold caps are designed to keep the scalp cooled at a controlled temperature throughout the treatment.

There are generally two types of systems:

Stationary cooling systems: A cold cap is connected to a machine that circulates cooling fluid and regulates the temperature.

Mobile cold caps: The caps are pre-cooled and changed at fixed intervals during treatment. This makes it possible to use the system without a machine or a fixed installation at the hospital.

Regardless of the type of system, it is important that the cold caps are used correctly and in accordance with the manufacturer’s instructions. Scalp cooling usually needs to start before chemotherapy and continue for a period after the infusion. The total time varies depending on the treatment and the system used.

DOES SCALP COOLING WORK?

Research shows that scalp cooling can reduce hair loss in most patients, but results vary.

The effect is measured by the degree of hair loss. If more than 50% of the hair is retained, the treatment is considered a success.

A systematic review and meta-analysis from 2024 examined scalp cooling in patients receiving taxane-based chemotherapy. About 60% had less than 50% hair loss. The results varied, among other things, depending on the type of chemotherapy.

It is therefore important to have realistic expectations. Some people keep most of their hair, others experience significant shedding, and for some the method does not have a sufficient effect.

At Rapunzel, 3 out of 4 users experience a satisfactory result with our self-managed cold caps. However, the result always depends on the individual’s treatment course and circumstances.

Read more: Frequently asked questions about cold caps

WHAT ARE COOLING GLOVES AND COOLING SOCKS?

While cold caps are used to cool the scalp and protect the hair, cooling gloves and cooling socks are designed to cool the hands and feet during certain chemotherapy treatments.

Some chemotherapy drugs can affect the nails and the peripheral nerves and cause symptoms such as tingling, numbness, pain or altered sensation in the hands and feet. This is called peripheral neuropathy.

Cooling the hands and feet is being studied as a possible way to limit the impact on tissue during chemotherapy. However, the evidence is still limited and not conclusive, and the method cannot be regarded as a reliable way to prevent nerve damage.

If you are considering cooling gloves or cooling socks, you should therefore talk to your treatment centre about whether it is relevant and appropriate for your specific treatment.

WHO CAN USE COLD CAPS?

Scalp cooling is not relevant for all types of cancer or all chemotherapy regimens.

The method is used mainly for solid tumours, such as breast cancer and ovarian cancer, where chemotherapy may cause hair loss. There may be situations where scalp cooling is not recommended, including certain blood and lymphatic cancers or scalp conditions.

It depends on the diagnosis, the treatment and other circumstances. You should therefore always discuss the option with your oncologist or treatment centre before you begin.

RAPUNZEL - MOBILE COLD CAPS THAT GIVE YOUR HAIR A CHANCE

At Rapunzel, we believe that the opportunity to keep your hair during chemotherapy is about more than appearance. Hair can be closely linked to identity, self-esteem and the feeling of recognising yourself in the middle of a cancer journey.

That is why we have developed a mobile solution with CE-marked cold caps that the patient can manage themselves, with help from a relative or another helper.

With Rapunzel’s mobile system, you get:

• A complete cold cap system for use during chemotherapy.
• A flexible solution that does not require a connected cooling machine.
• The option to use the cold caps across different treatment centres.
• Personal guidance and support throughout your treatment.

We help you understand your options and assess whether scalp cooling may be relevant for you.

Read more about Rapunzel’s cold caps or see our frequently asked questions.

FREQUENTLY ASKED QUESTIONS ABOUT SCALP COOLING

CAN YOU AVOID HAIR LOSS WITH COLD CAPS?

Cold caps can reduce the risk of hair loss during certain chemotherapy regimens, but they do not work for everyone. The effect depends on factors such as the type of chemotherapy, the dose and the individual’s circumstances.

WHEN SHOULD YOU START USING COLD CAPS?

Scalp cooling usually needs to start before the first chemotherapy infusion and be used at every treatment. It is important to follow the instructions for the specific system.

HOW LONG DO YOU NEED TO WEAR COLD CAPS?

It depends on the chemotherapy and the cold cap system. Scalp cooling typically takes place before, during and after the infusion, so the total time can be several hours.

CAN ANYONE USE COLD CAPS?

No. It depends on factors such as the cancer diagnosis and the type of treatment. Always talk to your treatment centre about whether scalp cooling is relevant for you.

WHAT IS THE DIFFERENCE BETWEEN COLD CAPS, COOLING GLOVES AND COOLING SOCKS?

Cold caps are used to cool the scalp in order to reduce hair loss. Cooling gloves and cooling socks are used to cool the hands and feet in order to limit certain chemotherapy side effects there.

WHERE CAN I FIND MORE INFORMATION ABOUT COLD CAPS?

You can read more about Rapunzel’s mobile cold caps, how they are used and which options are available at rapunzel.care.