Scalp cooling caps appear to limit this damage by constricting blood vessels in the scalp, reducing the amount of chemo that is delivered to the hair follicles, Nangia explained. The cooling caps also might decrease the biochemical damage done to follicles by whatever chemo does get through.
Patients put on a tight scalp cooling cap for a half hour before chemotherapy, and leave it on for 90 minutes to 120 minutes afterward, according to the two studies.
“The key is to have a tight fit, because if you have any gaps you’ll lose hair where there’s not good contact,” Nangia said.
Nangia’s clinical trial included 182 breast cancer patients. Two-thirds were randomly chosen to receive scalp cooling, and the rest received chemotherapy without a cooling cap.
However, the trial was halted after data came in for the first 142 patients and it became clear that cooling had a significant effect in slowing or stopping hair loss, Nangia said.
The second study, conducted at five U.S. medical centers and led by Dr. Hope Rugo from the University of California, San Francisco, involved 101 breast cancer patients fitted with a cooling cap and 16 patients in a control group. Again, all patients without the cap lost their hair, while hair loss was limited or halted in those who used the scalp cooling cap.
The risk of hair loss varied widely in both studies, depending on which medical center provided the scalp cooling therapy and which chemo drugs were used in treatment, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society. He was not involved with the research.
The amount of experience a center had with the devices appeared to improve their ability to preserve hair, and the relative harshness of the patient’s chemotherapy also seemed to play a role, Lichtenfeld explained.
“These devices do prevent hair loss in some women, but it’s very much operator-dependent and chemotherapy-dependent,” Lichtenfeld said.
Scalp cooling devices currently cost between $1,500 and $3,000 per patient in the United States, and aren’t reimbursed by health insurance, Nangia’s study noted. That’s not counting the time and cost of applying the device during chemo, Lichtenfeld added.