Q & A Library

It's possible, but from what I've read, the procedure is much more complicated than just placing a bag of ice on your head. It's also so expensive that you may not want to bother.

Here's the story: the reason hair comes out during chemotherapy is that the drugs that kill rapidly dividing cancer cells, also kill rapidly dividing normal cells in the body, including those in hair follicles. Depending on the duration of chemotherapy and the specific drugs used, all or some of your hair may come out, or you may not lose any. This side effect of cancer treatment is distressing, and for some patients it's one more burden imposed by the disease and by treatment that can be unpleasant.

Cooling the scalp seems to help preserve hair because cold skin prevents hair follicles from absorbing the chemotherapy agents - either by reducing blood flow to them or by temporarily stopping their growth.

A review published in the March 2005 issue of the Annals of Oncology found that, of 53 studies of scalp cooling to prevent hair loss during chemotherapy, success rates were 56 percent prior to 1995 and 73 percent since then. Patients who consider scalp cooling should know, however, that some studies reported that cancer spread to the scalp in a few patients who used cooling methods.

To do scalp cooling effectively you need to buy or rent special cooling caps that have to be chilled to extremely low temperatures (40 degrees below zero) and changed every 20 to 25 minutes during chemotherapy. (Infusions can last for hours.) An article in the Washington Post in January 2011 reported that one local woman spent $430 per month on scalp cooling caps for four months of chemo. On top of that there was the monthly cost of 60 pounds of dry ice at $1.60 per pound needed to keep the caps cool enough for use. All told, this woman spent more than $2,600 on the scalp cooling process. She also needed help with changing the caps during treatment; her husband along with friends and relatives performed this chore, which involved warming the frozen caps slightly to 35 degrees below zero and then kneading them to make them pliable enough for use. In her case, scalp cooling proved successful - her hair did not fall out.

Bottom line: it is possible to prevent your hair from falling out during chemo, but only you can decide whether scalp cooling is worth the cost and all the trouble involved. By the way, I've known a few cases of people who avoided hair loss during chemotherapy simply by using interactive guided imagery, a mind/body wellness therapy.

Andrew Weil, M.D.