Scalp cooling reduces hair loss during breast cancer chemotherapy

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For many women with breast cancer, hair loss is the most distressing side effect of chemotherapy. Although cooling the scalp with ice packs has been tested, the technique has had limited success. However, a newer approach — wearing a cap connected to a cooling system that gradually reduces scalp temperature — has been more successful, according to two reports in the Feb. 14, 2017, Journal of the American Medical Association.

In one study, 67 of 106 women with stage I or stage II breast cancer who used the FDA-approved DigniCap during their treatment with taxane (Taxol and others) lost less than half of their hair. In comparison, 16 women who underwent the same treatment but did not wear the cooling cap lost all of their hair.

The other study evaluated another approach, the Paxman scalp-cooling system, which hasn't yet received FDA approval. In that study, 48 women wore the cooling cap during treatment with taxane plus anthracycline (Doxorubicin and others) and 47 women didn't wear the cap. Half of the women who wore the cap lost less than half of their hair, while all of those who didn't lost all of their hair.

Both scalp-cooling treatments begin 30 minutes before chemotherapy infusion starts, last throughout the infusion, and continue for 90 to 120 minutes afterward. They are expensive — an estimated $1,000 to $3,000 for a full course of therapy — and whether they will be covered by insurance remains to be seen.