Preventing Hair Loss During Treatment
Scalp cooling
Scalp cooling may stop you from losing some, or all, of the hair on your head during chemotherapy. This technique works by reducing the blood flow to the hair follicles, which reduces the amount of chemotherapy drugs that reach them.

How well scalp cooling works depends on the chemotherapy drugs and doses used, and it does not work for everyone. If you do keep your hair, you may find that it’s patchy or thinner.

Scalp cooling is suitable for all hair types, although it may be less effective on Afro hair. You can find more information about scalp cooling and caring for your hair type at

There are two widely available ways of cooling the scalp. One method uses a cold cap, which is a gel-filled hat that is chilled and replaced at regular intervals during your chemotherapy treatment to keep the scalp cool. The other system uses a refrigerated cooling machine to continuously pump a liquid coolant through a single cap.

Both methods involve wearing a cold cap before, during and for one to two hours after your treatment. Increased cooling times may be recommended for different hair types. This may mean you’re at the hospital for longer.

You can ask your treatment team or chemotherapy nurse if scalp cooling is available and whether it would be suitable for you. The condition of your hair and any previous use of chemicals on it may affect how well scalp cooling works. Your chemotherapy nurse will discuss this with you.

Some doctors have been concerned that scalp cooling may increase the risk of developing secondary cancers in the scalp due to the possibility of constricted blood vessels limiting the amount of chemotherapy reaching the area. However, studies looking at people who had scalp cooling during their chemotherapy treatment have found that scalp cooling does not increase the risk of developing secondary breast cancer in the scalp.

Scalp cooling is not suitable if you’re having radiotherapy to treat breast cancer that has spread to the brain, as hair loss can’t be prevented.

Learn more about scalp cooling here and check out the guide below from Headwrappers.

Tips for scalp cooling

Your treatment team should give you guidance on scalp cooling depending on the type of cooling device your hospital uses.

The following tips may help:
- Removing hair extensions, weaves, or braids before scalp cooling
- Gently combing back your hair with a wide tooth comb or your fingers so the front hairline is visible
- Lightly dampening your hair underneath the cap with lukewarm water
- Applying a small amount of conditioner to the hair to help remove the cap
- The cold cap should cover the whole scalp and fit snugly

You don’t need to cut your hair short before you start using a cold cap. However, if your hair is very long or thick it may be helpful to cut it to reduce some weight and make it more manageable.

You may find the cap uncomfortable, as it’s very cold and often quite heavy. Some people get headaches, but these usually wear off quickly once the cap is removed.
Being able to tolerate the cold will vary widely from person to person. Some people report feeling discomfort, aching and sometimes nausea in the first 10–15 minutes of the treatment. These side effects are usually mild and should go away as you get used to the cold. Wearing warm layers, sipping hot drinks and covering yourself with blankets can also help.

If you’re struggling with the side effects of the cold cap speak to your chemotherapy nurse or treatment team. They may recommend taking mild pain relief, such as paracetamol, before wearing the cold cap.

As the hair will still be damp when the cold cap is removed you may find it more comfortable to take a hat or head covering with you to wear on the way home.
Things like water spray bottles, hair conditioner and extra layers may not be available in the chemotherapy day unit so you may want to bring your own.


If chemotherapy doesn’t cause hair loss, it may make it brittle, dry or straw-like, so it’s a good idea to treat your hair as gently as possible. Hormone therapy can also cause the hair to thin and feel fragile.

Due to its structure, African and Caribbean hair is the most vulnerable to damage of all hair textures so it is recommended to take special care and use specific products.
Hair care tips

The following tips may be helpful for all hair types:

- Use a mild, unperfumed shampoo and conditioner less than once every ten days
- Try not to wash your hair more than twice a week
- Use warm rather than hot water
- Pat your hair dry rather than rubbing it with wide tooth plastic comb
- Brush or comb your hair gently with a soft hairbrush
- Massage the scalp to improve the blood supply to the hair follicles
Things to Avoid

You may want to avoid the following to help protect your hair:

- Overly tight plaits or braids as it may cause tension and this may damage your hair
- Using elastic bands to tie back hair
- Hair colors and dyes, perms, relaxers and other products containing strong chemicals
- Products containing alcohol, such as hairspray, which can irritate the scalp
- Excessive heat from hair straighteners, hairdryers, hot brushes and heated rollers
- Hair extensions, weaves and braids as these can weaken the hair

Hair thinning, poor condition or a dry and itchy scalp can also be related to poor diet, stress and drinking too much alcohol. Changes to your diet and lifestyle may help improve the condition of your hair.

Treating long-term hair loss

If hair loss after treatment persists, you may wish to ask for advice from a specialist.

Your treatment team or GP may be able to refer you to a dermatologist (doctor who specializes in skin problems) who has a specialist interest in managing hair loss. They can offer information and advice to people experiencing hair loss.

There are also a number of trichologists (people who specialize in hair loss problems but are not medically trained) who can offer advice. The Institute of Trichology provides details of registered practitioners.