Can Scalp Cooling Devices Prevent Chemo-Related Hair Loss in Breast Cancer?

Losing your hair during chemotherapy can be one of the most emotional and visible parts of breast cancer treatment. That’s partly why scalp cooling devices, or cold caps, have gotten so much attention online.

But are these devices truly effective or an overhyped trend?

TikTok creators, breast cancer influencers, and support communities frequently tout scalp cooling devices as game changers for keeping enough hair to avoid wigs and feel more like yourself during chemotherapy.

Many posts frame scalp cooling or cold caps as:

• A way to “save your hair” during chemotherapy
• A must-have part of breast cancer treatment prep
• An empowering tool that helps people feel more like themselves

At the same time, there’s also skepticism and frustration online, as some people report that scalp cooling:

• Causes headaches, discomfort, or intense cold sensations
• Doesn’t work as well as they’d hoped
• Is expensive or difficult to access through insurance

“Scalp cooling is the only [U.S. Food and Drug Administration]-cleared method to reduce chemotherapy-related hair loss,” says Jame Abraham, MD, a breast medical oncologist at Cleveland Clinic Cancer Institute and member of the National Comprehensive Cancer Network Guidelines panel for breast cancer.

What Are the Drawbacks?

• The type of chemotherapy drugs used
• The dose and schedule of treatment
• The fit of the cooling cap
• The consistency of scalp cooling usage
• The thickness, type, texture, and style of hair

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• Headache
• Scalp pain
• Dizziness
• Nausea
• Neck pain
• Skin rash

Additionally, access and insurance coverage vary significantly, and out-of-pocket costs can add up quickly.

• Follow the manufacturer’s instructions. Make sure you’re following directions on cooling times before, during, and after chemotherapy, as well as how often to replace the cap.
• Check that the cap fits properly. The cap should fit snugly and come in contact with your entire scalp.
• Practice gentle hair care. Avoid dyes and other chemical treatments; wash it less often; use mild, fragrance-free shampoos and conditioners; detangle gently; and let your hair air-dry.
• Consider specific guidance for your hair type. For example, your care team may recommend removing hair extensions or protective styles, such as braids. They may also suggest straightening curly hair or even wetting hair down before scalp cooling. This can help the cap work more effectively.

And don’t be discouraged if you still experience some shedding. “Some thinning is common, even with successful cooling,” says Abraham.

Scalp cooling devices for breast cancer appear to be a trend that largely lives up to the hype — as long as you have realistic expectations. The evidence suggests cool caps can meaningfully reduce chemotherapy-related hair loss for some people with breast cancer.

And most people who try it are happy with the results. “About 80 to 90 percent of users say they would recommend it to others,” says Abraham.

The biggest misconception online is the idea that scalp cooling will save all of your hair. In reality, it’s a tool that may reduce hair loss, not prevent it entirely. And there are no guarantees. These devices do not prevent hair loss for everyone.

If you’re interested in trying scalp cooling as part of your breast cancer care, bring it up with your oncology team to determine if you’re a good candidate, and set realistic expectations.