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About Scalp Cooling

What is Scalp Cooling?

What is Scalp Cooling Therapy?

Scalp cooling therapy, also known as cold cap therapy, is a technology that can help cancer patients reduce hair loss during chemotherapy.  It consists of wearing a cold cap (photo examples above) on your head before, during and after chemotherapy. There are two types of scalp cooling therapies: manual and machine caps (see below for more information).

Scalp cooling works in two main ways:

  1. The cold temperature restricts blood flow to the scalp, reducing the delivery of chemotherapy to the hair follicles

  2. Puts the hair follicles "to sleep" to decrease the effects of chemotherapy drugs. 

Scalp cooling has been around for decades, but has just recently gained traction in the United States due to recent clinical trials and other research papers supporting its use. Scalp cooling is NOT 100% effective, but most studies show that greater than 50% of patients keep greater than 50% of their hair. How effective scalp cooling is depends on many factors, including chemotherapy type and regimen.


Only patients with certain types of cancers can use the caps so please talk to your doctor to see if you are eligible. Using cold caps (especially manual caps) can be time intensive, and unfortunately, scalp cooling is expensive and costs approximately $1500-$3000 for the entire treatment. That is why we created Cap & Conquer!  To learn more about scalp cooling visit the following websites:


  1. Rugo HS, Voigt J. Scalp Hypothermia for Preventing Alopecia During Chemotherapy. A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clinical breast cancer. 2018;18(1):19-28.

  2. Shah VV, Wikramanayake TC, DelCanto GM, et al. Scalp hypothermia as a preventative measure for chemotherapy-induced alopecia: a review of controlled clinical trials. Journal of the European Academy of Dermatology and Venereology : JEADV. 2018;32(5):720-734.

  3.  Rugo HS, Melin SA, Voigt J. Scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases: systematic review and meta-analysis. Breast cancer research and treatment. 2017;163(2):199-205.

  4. Van den Hurk CJ, Peerbooms M, van de Poll-Franse LV, Nortier JW, Coebergh JW, Breed WP. Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients - results of the Dutch Scalp Cooling Registry. Acta oncologica (Stockholm, Sweden). 2012;51(4):497-504.

  5. Komen MM, Smorenburg CH, van den Hurk CJ, Nortier JW. Factors influencing the effectiveness of scalp cooling in the prevention of chemotherapy-induced alopecia. The oncologist. 2013;18(7):885-891.

  6. Rugo, Hope S., et al. "Association between use of a scalp cooling device and alopecia after chemotherapy for breast cancer." Jama 317.6 (2017): 606-614.

  7. Bajpai, J., et al. "Randomised controlled trial of scalp cooling for the prevention of chemotherapy induced alopecia." The Breast 49 (2020): 187-193.

We understand there is a lot going on when you first receive a cancer diagnosis. Please do not hesitate to reach out to learn more!

Two Types of Scalp Cooling Therapies

1. Manual Caps

Manual caps are placed on patients’ heads by a "capper" (i.e. trained family member, friend, volunteer etc.) before, during, and after the chemotherapy infusion for a total time based on one's specific chemotherapy regimen.  The caps are changed periodically (usually every 20-25 minutes) throughout the treatment day. Caps are not used on any day other than on treatment days. Caps are maintained at the recommended temperatures either through the use of dry ice or specialized freezers at certain infusion centers.

Manual caps are not FDA cleared or provided by oncologists directly but have been available for private patient rental in the US since the early 2000s. Manual caps require someone to put the caps on, usually a family member and/or friend. However, certain companies or volunteer groups can provide personnel to assist patients with capping.

Patients are required to contact manual capping providers for information on cap rentals and dry ice use. There are multiple companies that provide this service - please click the links below to learn more about each individual company. Also, don't hesitate to call as they are very knowledgeable and helpful!


Maddie Novice using Penguin Manual Cold Caps that were changed every 20-25 minutes in order to stay cold enough to freeze the scalp! Although they are definitely cold, they are still tolerable and improve after the first few caps! 

2. Machine Scalp Cooling Systems:

Machine scalp cooling systems consist of a cap that is hooked up to a machine, which the patient wears throughout the chemotherapy infusion. These caps require no changing as the machine circulates coolant throughout the cap at the desired temperature. Both machine caps- Paxman and DigniCaps- have received FDA clearance for solid tumors (example- breast cancer, ovarian cancer). Machine capping systems are leased by hospitals and clinics and are only available where they are installed. Click below to go to the websites for each of the machine scalp cooling providers if you would like to learn more!

Manual Caps
Machine Scalp Cooling Systems
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