Cold Cap: Hair Loss Facts and Myths

As if fighting cancer was not difficult enough, watching strands of your hair float down the drain after chemotherapy really is adding insult to injury. It follows that if you or someone you care about is undergoing chemotherapy, you are likely interested in knowing more about a device that has been proven to achieve some results in preventing treatment-induced hair loss.

The device is generically called a “cold cap” and looks like a hockey-helmet-shaped icepack.  Just this past December the first and only cold cap to receive FDA approval was Dignitana DigniCap Cooling System, from a publically traded Swedish medical technology company.  So far the FDA approval extends to only female breast cancer patients.

How do cold caps work?

When particular chemotherapy medications are intravenously introduced into the bloodstream, their job is to seek out and destroy rapidly dividing cancer cells and kill them.  Unfortunately, like cancer, cells that produce hair also divide quickly, and are therefore also targeted by the drugs.  This mechanism causes hair loss, or chemotherapy-induced alopecia (CIA), which in in most cases is temporary.

What research has shown is that because chemotherapy medications travel through the bloodstream, cooling the scalp to roughly 22C will slow blood flow to the follicles, which in turn limits the drug’s ability to reach and then destroy hair-producing cells.  Because results depend on the intensity of the medication and the patient’s hair type, age, and more, a cold cap treatment regimen and expectations must be tailored to the individual patient.

It doesn’t work for everyone.  The side effects, while not life-threatening, can include headaches, neck and shoulder discomfort, chills, and pain.


Cold caps have been regularly used in Europe and in Japan since the 1970s, but there has been some concern that by inhibiting the progress of the drugs to the scalp area, there may be an increased risk of cancer metastasis to the scalp.

Why haven’t I heard about this before?

The first cold cap patent was filed in 1979, but interest in developing this device in the United States did not capture medical researcher or investor interest until the mid-1990s.  And the simple fact is while men have been using cold caps for years, the emphasis has been on seeking FDA-approval for and then using this devise with women patients.

What if I am a man and I want to know more?

How chemotherapy affects men’s hair can be found on numerous highly reputable cancer websites, but the advice, while sound, is almost exclusively about how to mentally prepare for changes to your self-image.  If you want to learn more about cold caps and whether this device is right for you, and other proven methods to support the return your hair after chemotherapy, Armani Medical can help.

Dr. Abraham Armani is an internationally recognized hair restoration specialist, who is a repeat winner of the Patients’ Choice Award.  Make an appointment for a confidential one-on-one consultation, and discuss your concerns with hair loss and what your realistic options are for the return of your hair.