The Changing Faces of Cancer- Scalp cooling, Hair loss and Regrowth.

7 minute read time.
The Changing Faces of Cancer- Scalp cooling, Hair loss and Regrowth.

Jane was diagnosed with a rare and aggressive type of endometrial cancer in March 2022. She underwent surgery, chemotherapy, and external beam radiotherapy. During chemotherapy, she decided to scalp cool to try and prevent hair loss. During her Community Champion role, she often comes across people who need support with hair loss and have questions about it. Sometimes pictures can speak louder than words so she has put together a visual timeline to share her experience.

Scalp Cooling- The positives…

But will I lose my hair? Was one of the first questions I asked when told I needed chemotherapy. Hair is not just about vanity, it is part of our identity and although I knew I was really ill, I did not want to look ill. I wanted where I could, to keep any struggles private while I was dealing with them. The thought of losing my hair made me question whether or not to go ahead with treatment. I decided to give scalp cooling a go. I felt I had nothing to lose but hair.

It is important to know that scalp cooling is not suitable for all cancers and it will not work for everyone. Also, not all chemotherapy causes hair loss. Scalp cooling will only affect the hair on your head and it cannot prevent the loss of eyelashes, eyebrows, or any body hair.

I was told scalp cooling aims to reduce the amount of chemo drugs being absorbed through the scalp, to prevent hair loss, to protect hair follicles, to encourage regrowth and to prevent the chance of permanent hair loss.

Scalp cooling- the challenges…

I found it painful. The first 20 minutes or so are the worst. They reduce the temperature of the scalp to around 18-22 degrees. This is cold, very cold. I found that paracetamol does help. For me it was a case of taking deep breaths, focusing on my breathing, trying not to panic, and just knowing that the pain would eventually become a sort of numbness with a tight pressure feeling. There were times when I wanted to rip it off (you can if it becomes too much) but if you can just get through those first minutes, I will say it becomes tolerable. I found taking a warm blanket from home was a comfort and also regular hot drinks.

The other thing is it can add a bit of time to your chemo session. It needs time to cool down before the infusions start and it needs to remain on for a while after the infusions ended. For me this extra time was taken up naturally with waiting for blood test results, going through side effects and medications and generally getting support from the nurses.

Scalp Cooling- The Process

To start with your hair is sprayed with water and conditioner is combed through. This helps ensure contact with the scalp and easier removal.

There are different sized caps, and they must be tight fitting. The first one contains the coolant, and it is blue and rather like a swimming cap. The grey corded one goes over the top. There is a strap that goes under your chin. Once the cap is on you are attached to the machine and it is turned on. It is a weird trickly sensation as the coolant starts to flow and it is surprising how quickly it feels cold. It would be at this point that it would all feel a bit of a shock to the system, I would feel panicky and a bit nauseous.

The cap then stays on until about an hour after chemo finishes. You can disconnect for a few minutes for toilet trips.

When the machine is turned off, you need to sit for around 15 minutes to enable your scalp/hair to defrost a bit. Then slowly you remove the cap. Don’t be alarmed if you see ice crystals at this point.

Hair Care

Hair care is important during scalp cooling. At around 14 days post chemo I would have an itchy/sensitive scalp and shedding would start. However much you are prepared for this to happen, it can feel devastating. Shedding is normal and not a sign it is not working.

Wash hair twice a week using a mild shampoo. Comb hair regularly to prevent any matting with hair that has shed. I would be reluctant to wash my hair or comb it too much as that is when you notice hair loss. But if it has come out there is nothing you can do. I found it helped to try to focus on the hair that was left on my head rather than what was in my hand.

Heated appliances and colouring are not recommended. When your hair does thin then spray in root sprays or hair fibres can disguise any thinner areas. This can really help, I used dry shampoo.

Being prepared with a wig, hat or scarves can help you feel a bit more in control. I found that silky pillowcases can help.

My regrowth after Scalp Cooling

I had some regrowth between chemo cycles. My hair became lighter and changed in texture. I had some chemo curls. Shedding settled down within a couple of months of chemo ending. Regrowth was fast and the condition improved within a few months.

With hair loss, it is important to do what is right for you. For me scalp cooling made the chemo journey manageable. I have no regrets and would do it again. These photos show my journey.

Visual timeline

Chemotherapy May 2022

        

Chemotherapy June 2022

            

Chemotherapy July 2022

selfie of person showing their hair after using the cold cap   Person in a hospital bed wearing a cold cap   Black and white image of someone showing their hair after using the cold cap

Chemotherapy August 2022

selfie of person showing their hair after using the cold cap   Person in a hospital bed wearing a cold cap   selfie of person showing their hair after using the cold cap

Radiotherapy August 2022

selfie of person showing their hair after using the cold cap   Black and white image selfie of person showing their hair after using the cold cap   

Radiotherapy September 2022

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

End of treatment October 2022

Black and white selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment November 2022

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment December 2022

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment February 2023

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment March & April 2023

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment May 2023

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment June & July 2023: 

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment August 2023

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment September 2023

selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Post-treatment October 2023

selfie of person showing their hair after using the cold cap

Post-treatment January and February 2024

selfie of person showing their hair after using the cold cap       selfie of person showing their hair after using the cold cap   selfie of person showing their hair after using the cold cap

Further reading and support information

Anonymous
  • Hi  

    It’s Megan here from Macmillan’s Online Community team. I hope as a member of the forum you will find it to be a comforting source of support as we see every day how helpful it can be to connect with others with similar experiences.

    It’s lovely of you to comment on Jane’s blog and leave a supportive comment. With you looking for some clinical guidance about treatment decisions and the cold cap, you can speak to the Nurses here at Macmillan. You can contact the Nurses and other specialist teams either by posting in our Ask an Expert section on the Community from Monday to Friday, or by contacting the Macmillan Support Line 7 days a week. They will be able to talk through your concerns and answer any questions you have.

    To get in touch on the Support Line, please call 0808 808 00 00 from 8am to 8pm every day. You are also welcome to send an email or use live webchat during the opening hours.

    It’s a good idea to speak to those who have personal experiences so you may find joining and posting in our cancer type forums like the Brain cancer forum would be a good place to start.

    We have also published another blog about the experiences members had when using the cold cap I will link below:

    I do hope this information is useful and will help you access the information and support you are looking for. If you need any help using the site or finding additional support, please don’t hesitate to email community@macmillan.org.uk or by sending a private message to the moderator account.

    Best wishes, 

    Megan
    Macmillan's Online Community team

  • My goodness JanDeb, you do indeed have a lot to think about, and I hope you get the best results imaginable whatever you decide.

  • I meant to say, I opted not to have the cap, and had a classic  loss of hair 3 weeks after my first chemo. It does mean you have to get used to seeing  a new you, and I spent many evenings looking at  headwear and wigs...and  buying  them !! but gradually I got used to it and the weather warmed up a bit and I decided I may need to explain if  people asked. I also was aware to cover up if out in the sunlight, so that had a 'dress up' aspect to it.

  • guess who keep pressing the send button. my hair ( mostly white) is  now growing   richer and fuller than  before, about 1cm on a white skinhead, it doesnt show up as much as a colour maybe  would, but  it feels amazing, and i'm  hoping for some  curls. I am looking forward to it  growing out a bit more and having a shorter edgy  sort of style even at 79 !! I have a stack of  white/grey wigs and  turbans if anyone is interested. I am holding on to  a few as its turning cooler, and  being bald has  affected  my  thermostat.