Scalp Cooling During Chemotherapy Information for patients Cancer Resource Centre Macclesfield District General Hospital Phone no: 01625 663198 @EastCheshireNHS Leaflet Ref:10878 Published: Sep 17 Review: Aug 2020 Page 1
What is scalp cooling? Scalp cooling is a method of reducing the loss of hair from the head during treatment with some chemotherapy drugs. The method used is the Paxman TM scalp cooler which monitors and controls the temperature between -4 C and -7 C. Coolant is pumped at a low pressure through a scalp-cooling cap, which consists of a spiral-wound tube, shaped to the contours of the patient s head. There are different sizes to allow for individual head size, and they are fitted to the patient with the use of an outer fabric cap that has a chin strap which holds the cap in place. How does it work? Each hair on our bodies grows out of a hair follicle. Small blood vessels in the scalp supply the cells of the hair follicles. Any chemotherapy drugs in the bloodstream will also be carried to the hair follicles. When blood vessels in the scalp are cooled they become smaller, and so less blood flows through them which means that less of the chemotherapy drugs reach the hair follicles, and so the hair is less likely to fall out. Who can have scalp cooling? Scalp cooling is not suitable for all patients who will lose their hair with chemotherapy: it depends on the type of chemotherapy drugs being given and other patient factors. The oncologist and nurse will discuss suitability with you. Risks Some doctors worry about using scalp cooling that aims to cure the cancer treatment as they fear that cancer cells may be more likely to survive the chemotherapy than if it were not used. Some patients do not feel comfortable with scalp cooling for that reason. For other people not losing their hair may be the most important aspect of their treatment. The doctors or nurses can discuss this with you and advise you whether scalp cooling is suitable for you. Leaflet Ref:10878 Published: Sep 17 Review: Aug 2020 Page 2
What will happen when I go for scalp cooling? For scalp cooling to work, your scalp needs to be cold before your chemotherapy drugs are given and for some time afterwards. Your scalp temperature needs to be kept low for the whole time the drugs are circulating in your blood. The scalp cooling needs to be commenced about 30 minutes before you start having your chemotherapy. It will continue all the time you are having your treatment and for a period of time after the chemotherapy has finished, depending on the drugs that are used. You will need to sit by the machine while the cap is in place, so you cannot walk about freely. However, if you need to go to the toilet the cap can be disconnected from the machine for short periods. These caps do not need to be changed as the machine is continuously cooling the liquid circulating round your scalp. After each use the caps are washed with a detergent to prevent cross infection. You will probably feel chilly when having scalp cooling and may need to wear a warm jumper. Hot drinks are provided and these will help you to feel warmer. You may get a headache during scalp cooling, especially in hot weather. Things to take with you to hospital: Warm clothing Hat or head covering Conditioner* Wide tooth comb* Fabric elasticated hairband Pain relief* *The hospital may provide these. Important points to remember 1. The first 10-15 minutes of your cold cap treatment may feel very uncomfortable. 2. Pain relief is available to help you bear the initial feeling of cold please consult your medical team. Leaflet Ref:10878 Published: Sep 17 Review: Aug 2020 Page 3
Preparing your hair We recommend that the hair underneath the scalp cooling cap is lightly dampened prior to the fitting of the cap using a spray bottle with lukewarm water. This ensures the best overall cooling conductivity between the cold cap and the scalp, as the hair has insulating properties. The hair does not need to be very wet and any lengths of hair below the cap line do not need to be dampened. A small amount of mild, perfume-free conditioner should then be applied to the dampened hair. This helps with the removal of the cold cap on completion of treatment. The hair should then be gently combed back using a wide toothcomb or fingers so that the front hairline is visible. This is especially important if you have a fringe. As the hair will still be damp on completion of cold cap treatment, you may find it more comfortable to take a hat or head covering with you to wear on the way home. There is no real need to cut your hair shorter prior to starting your chemotherapy treatment, however if your hair is very long or thick it may be helpful to cut it shorter to reduce some weight and make it more manageable. How effective is it? Scalp cooling can be very effective in preventing or reducing the loss of your hair. However, you will not know how well it will work until you try it. Despite scalp cooling, you may find that your hair thins slightly. Unfortunately, some people who have scalp cooling will still lose their hair. Scalp cooling protects only the hair on your scalp. Body hair (including eyelashes, eyebrows, chest hair and pubic hair) may be lost. Any hair loss caused by chemotherapy is temporary, and once the treatment is over, your hair will start to grow back. At first, the hair is very fine, but you will probably have a full head of hair after 3 6 months. You may find that your new hair is curlier or coarser than it was before, or it may be a slightly different colour. Leaflet Ref:10878 Published: Sep 17 Review: Aug 2020 Page 4
Looking after your hair Use only gentle hair products, such as mild shampoo, to prevent dryness of the hair and scalp. Brush your hair gently using wide-toothed combs. Avoid using excessive heat from hairdryers, hair straighteners or heated rollers. Avoid wearing a tight hair band, as this can damage and break your hair, use a softer scrunchie type hair band Avoid sleeping in hair rollers. A poor diet, stress and alcohol can make the condition of your hair worse, so eating as well as you can. Having alcohol in moderation and avoiding stress, can help to keep your hair in good condition. Gently massaging the scalp may improve the blood supply to the hair follicles. Avoid colours and other chemical procedures. References This literature has been compiled using evidence from research articles, conceptual literature and reliable cancer information services. Leaflet Ref:10878 Published: Sep 17 Review: Aug 2020 Page 5
Comments, compliments or complaints We welcome any suggestions you have about the quality of our care and our services. Contact us: Freephone: 0800 1613997 Phone: 01625 661449 Textphone: 01625 663723 Customer Care, Reception, Macclesfield District General Hospital, Victoria Road, SK10 3BL For large print, audio, Braille version or translation, contact Communications and Engagement on 0800 195 4194. East Cheshire NHS Trust operates a smoke-free policy (including e-cigarettes) For advice on stopping smoking please contact the KICKSTART Stop Smoking service on 0800 085 8818. East Cheshire NHS Trust does not tolerate any form of discrimination, harassment, bullying or abuse and is committed to ensuring that patients, staff and the public are treated fairly, with dignity and respect. If you have any comments about how we can improve our services please inform a member of staff in the department or complete a comment card available throughout the hospital. Macclesfield District General Hospital, Victoria Rd, Macclesfield SK10 3BL Leaflet Ref:10878 Published: Sep 17 Review: Aug 2020 Page 6