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Cold Capping During Chemo

Updated: Dec 15, 2022

Woman cold capping during Chemo

One of the biggest concerns for a lot of cancer patients is the thought of losing their hair. The first question I asked my oncologist about chemotherapy was if I would lose my hair.

When he confirmed I would I went into a bit of a tail spin. This was more terrifying to me than the actual chemo. I have covered hair loss and the impacts in the chemo and hair loss article so here I’m going to cover cold capping in more detail.

Before I started my cancer adventure I had naturally highlighted brunette hair, it was chest length with a gentle wave in it. I didn’t realise how much I loved my hair until I was about to lose it.

It was pretty and I still miss it! Chemotherapy is essentially pumping a controlled poison into your body to kill off cancer cells. Your body is actually amazing and it is able to (mostly) tolerate these drugs whilst keeping you live during your treatment. Cancer cells are fast dividing cells which is what the drugs are targeting and killing. You know what else is created by fast dividing cells? Hair.

This is why some chemotherapy has such a devastating effect on hair. As well as targeting and killing off cancer cells it is also killing off hair cells and causing drastic hair loss. One of my drugs causes hair loss (Paclitaxel) and the other causes hair thinning (carboplatin) so it seemed I was destined to lose it.

In my research on chemo and what to expect I came across the term ‘cold capping’, I had never heard it before but a lady in a cancer support group mentioned it so I investigated further.

The theory behind cold capping is that cooling down the scalp during infusions narrows the blood vessels under the skin, this reduces the amount of chemo drug that can reach the hair follicles. As there is less drug entering the hair follicles not as much is able to get to the hair to kill off the cells and cause hair loss.

If you decide to cold cap you need to understand that it isn’t always successful and your results will vary based on the drugs, genetics, treatment times, the way the cap is worn and your own methods of caring for your hair.

Keeping 50% of your hair is considered a success. Up to 80% of patients successfully cold cap.

Not all patients are suitable candidates for cold capping, if you are having treatment for certain type of blood cancers for example your oncologist will probably advise against it.

My oncologist was OK with me having the cold cap treatment but unfortunately it wasn’t available at my hospital.

My cancer was ovarian and Ovarian Cancer Australia has a fantastic support system called the Teal Nurses. They are expects in the treatment of ovarian cancer and are a free support resource available to all women being treated for ovarian cancer. My nurse would advocate for me when I wasn’t sure what to do myself. I asked my support nurse to look into cold capping for me and after a few calls she advised that I wouldn’t be able to access it as Queensland health don’t provide it within the public system. It is however available in NSW and VIC which I found very frustrating.

I wasn’t put off and I was determined to find a way to cold cap and try to keep my hair. During my research I came across a company called Arctic heat, they are based in Queensland and ship across the country. They provide portable cold capping caps, these are available to purchase on their website and you are able to take them to hospital with you for your treatment.

After much trial and error I got into a bit of a system with the arctic heat caps and managed to keep a fair amount of my hair during the first part of my chemo (approximately 4 infusions out of 18).

If you are keen to try the arctic heat caps my routine is outlined at the end of this article.

After a few sessions I had to have a break from chemo have a portacath put in. Top tip - get your port before you start chemo if you are offered it. I didn’t and regretted it!

During my forced chemo break I was able to do some more research and came across a Facebook group for a company called Paxman. Paxman is a cold capping machine that cools your scalp constantly during treatment, no more changing the portable caps!

The women in that group understood my anxiety around losing my hair and I felt that I was finally understood as so many people had told me “it’s only hair”. The more I read about the machines and the results the more determined I was to access one of them.

At this stage I had lost some of my hair but not all of it. During the big shed (usually around 3 weeks after your first infusion) I had decided to cut my chest length hair to just above my shoulders to give myself a better chance of being able to brush it, stop it getting matted and keep as much as possible. One night I decided to cut it so I could donate the hair I had left before I lost it all. I platted my remaining hair and Mum, my partner and I all chopped off my hair with kitchen scissors before I could change my mind!

The next morning my dad was upset he missed out on the hair cutting experience so I let him ‘straighten’ up the mess we had made. As I’m writing this that is the last haircut I had, 7 months ago by my dad using the neck of a t-shirt as a guide!

After all my research to find a Paxman machine to use being in vein I decided to reach out to the company directly, to my surprise I had a response within a couple of hours.

They were amazingly helpful and before I knew it they had spoken to my medical team and arranged for me to access a machine for my next infusion. I was met by a representative from the company who showed me how to set it up, prepare my hair and fit the cap. I was blown away by their support and will be eternally grateful to Paxman for assisting me to cold cap with their machine and help me keep enough of my hair during this crappy time of my life.

My process for applying both the Arctic Heat and Paxman cold caps is below.

Now, cold capping isn’t the easiest thing and it won’t be for everyone. Some women can’t tolerate the cold and decide not to proceed. I didn’t find it too bad, uncomfortable but not awful.

When I first started I would take a Panadol 20 minutes before I put the cap on which really helped with the cold, however after a few weeks I found I didn’t need this and would just get through the first 15 minutes of cold and then be fine.

The most uncomfortable thing for me was actually the chin strap that holds the cap firmly on the crown of your head.

The hardest part was keeping warm whilst using the cap, the nurses were always happy to pile me up with warmed blankets, I took a jumper and would also take a hot water bottle to keep me cosy.

It was a bit more effort and meant a longer time for treatment (as you have to wear the cap for an hour after your infusion) but I am so glad I did it and I would 100% do it again.

Today, my hair isn’t the crowning glory it was before and I can’t wear it down in nice styles due to the fluffy re-growth BUT if I have it up in a ponytail or clip no one would guess I have just finished chemo.

I can’t tell you the amount of times in the 3 months since finishing that people have been shocked that I have only recently finished chemo as I have hair.

My Arctic Heat Process

I purchased 5 x caps from Arctic heat to use during my chemo sessions.

When I was using the Arctic heat caps I had a bit of trouble at the first session as the caps were frozen and stuck together so I couldn’t get my head in them. I spent about 30 minutes trying to get them unstuck and damaged them a bit. I’ve outlined my process below so you don’t have the same issues.

I also didn’t know to wet my hair first so I think I had a bit more hair loss then I would have if I’d had this process down from the start.

Preparation process:

  • I purchased a polystyrene mannequin head so I could freeze the caps on the head. NOTE: This did mean that I needed a second freezer as they took up more room but this did make it easier. I purchased a small bar freezer from Facebook Marketplace then sold it again once I had finished with chemo.

  • I covered the head with a plastic bag (I got some from the fruit and veggie section of Coles) and placed the bag over the mannequin head.

  • I fitted the cap over the head and tied the chin strap to hold it in place.

  • I covered the cap in another plastic bag to stop it sticking to the freezer.

  • Freeze overnight.

  • The next morning I removed it from the head, tied in the the plastic bag and stored it in the freezer.

  • Repeat over the next few nights for the remaining caps.

Infusion Process:

For the first few weeks I would take a Panadol before placing the cap on my head. I eventually got used to it and didn’t need this anymore but it helped at the start.

  1. As soon as I arrived at the chemo ward I would wet my hair with a spray bottle and cover in a gentle conditioner. This helps the cold to have contact with your scalp.

  2. Placed the cap and and get ready for the infusion. Note: You must wear the cap for 30 minutes before your infusion starts to ensure your scalp is cold enough. Accessing your port or vein and administrating the premeds will usually take this long but check with your team.

  3. During the infusion I would change the caps every 45 - 60 minutes depending on how warm the room was and how quickly the caps were thawing.

  4. To change the cap ensure you have another one ready to go and remove the cap you are wearing and replace as quickly as possible.

  5. Once your infusion has finished you need to wear a cap for at least another hour. I would wear my cap home from the infusion centre and wear it until it was completely thawed.

  6. Once I had removed the cap I would wash the conditioner out of my hair using cool water and then brush with a wide tooth comb.

  7. I followed the haircare procedure outlined below.

My Paxman Process

  1. As soon as I arrived at the chemo ward I ensure the machine was on and cooling down.

  2. Whilst that was happening I would wet my hair with a spray bottle and cover in conditioner. This helps the cold to have contact with your scalp.

  3. I placed a thin headband on my hair line, you can also use a cut up panty liner. Make sure it isn’t covering your hair, it needs to be as close as possible without covering. This is to make the cap more comfortable, you may find you don’t need it.

  4. I then pulled the inner cap down onto my head and ensured in was sitting the correct position. It should be covering the front of your hairline and centred on your head.

  5. Once I was happy with the position I would pull the outer cap down over the inner cap and tighten the chin strap as much as I could.

  6. Next I used the elastic and pull toggles on the outside of the cap to create as tight as fit as possible

  7. Once I was happy with the fit I would attach the cap to the machine and set it going.

  8. At this stage the nurses would start to get me ready for the infusion. You must wear the cap for 30 minutes before your infusion starts to ensure your scalp is cold enough. Accessing your port or vein and administering the pre-meds will usually take this long but check with your team.

  9. During the infusion if I needed to go to the bathroom I would unhook the cap from the machine and plug back in after. It is a simple process and I didn’t need assistance from the nurses.

  10. Once my infusion had finished I would wait another 60 minutes before turning off the machine & removing the cap.

  11. As I still had the Arctic Heat caps I would wear one home to extend the post cooling time. This isn’t necessary but I wanted to give my hair the best chance of staying on my head!

  12. I followed the haircare procedure outlined below.

I didn’t have any assistance from the Nurses and was comfortable fitting the cap myself.

You may have a nurse to help you, but if not and you want more information you can find videos on fitting the Paxman cap here.

You can find more information on cap fit and application in the Paxman Facebook group or on their website.

My hair care tips during cold capping

  • Brush your hair at least daily - this was a BIG mistake I made as I didn’t want to pull my hair out so wasn’t brushing it daily. As soon as it started shedding it became so matted I wasn’t able to brush it out and had to cut it. To minimise the chance of this happening brush daily with a wide tooth comb and gentle brush.

  • Wash as little as possible - I washed mine twice a week. Once when I came back from the infusion to wash out the conditioner and once on day 4 after chemo.

  • Wash in Luke warm water

  • Use a gentle shampoo & conditioner with no parabens and sulphates

  • Do not rub hair during the washing or drying process. You may be used to really scrubbing the shampoo into your hair and rough drying with a towel. These are things you’ll have to forgo for now. Use a hair wrap to allow your hair to dry naturally.

  • Do not use heat products, hair dryers and straighteners are going to be out of rotation for a while.

  • No colouring products. Think of your hair like a baby’s. If you wouldn’t do it to a toddler’s hair don’t do it to yours!

My hair care tips after cold capping

My hair stopped shedding and started re-growing during the last few months of chemo but this isn’t always the case. Other people have different opinions & experiences on this & you can read more experiences in the Paxman FB group.

  • Keep brushing your hair at least daily to ensure all hairs that have shed are removed.

  • Keep using the gentle shampoo and conditioner until your hair has stopped shedding

  • No heated products until 3 months after chemo

  • No colouring products until 6 months after your final chemo.

  • Find a good hairdresser who has experience with post chemo hair to offer advice on growing your hair back into a style you are comfortable with.


Top Hair Loss Choices

I tried so many products and spent so much money trying to find things to manage my hairloss so I’m recommending these to save you time and money.

These are the products that helped me navigate hair loss during my cancer treatment.

Cold-Pressed 100% Pure Castor Oil.

Cold pressed castor oil can help with hair growth on your eyebrow and eyelashes. It helps to moisturise the hairs as they grow to minimise breakage.

As a bonus I see improvements in the skin around my eyes as well.

Click to purchase

The Ordinary Multi Peptide Serum for Hair Density

This hair growth serum is is designed to support hair health so that it looks thicker, denser, fuller and healthier.

Be aware that it contains caffeine to stimulate the follicles so keep this for when you have finished chemo as it can actually have the opposite effect you are going for if you use it whilst undergoing treatment.

Click to purchase

Miracle Spray Hair Treatment

I LOVE this product and was using it before chemo on recommendation from a friend. It is great to leave in after washing when you can't blow dry to help contain fluffiness from dried out chemo hair!

Click to purchase

DermaVeen Daily Nourish Oatmeal Shampoo & Conditioner

Whilst I was cold capping DermaVeen Shampoo and conditioner were the only products I would wash my hair with as they are so gentle on the hair.

Click to purchase Shampoo

Click to purchase Conditioner

Philip Kingsley Body Building Shampoo & Conditioner

Now that I'm done with chemo I'm using this shampoo and conditioner to give my hair the best chance of coming back thick and strong. With a combination of this, the hair growth serum and my follicles being protected I do have great re-growth.

Click to purchase Shampoo

Click to purchase Conditioner

TOPPIK Hair Building Fibers

Toppik Hair Building Fibers, are made of colored keratin protein and it blends with existing hair strands to instantly create the appearance of naturally thick, full hair. I used this when my bald spot was at it's worse and I didn't want to wear a wig. I was skeptical about this product but it is honestly amazing how it works. I wouldn't use it everyday but occasionally to give you a break from hats and wigs it is perfect.

Click to purchase

Support Resources

Cancer Council Australia

CCA an organisation to support all Australians affected by cancer through support, research and prevention programs.

Ovarian Cancer Australia

OCA is an independent national not-for-profit organisation, supporting women diagnosed with ovarian cancer. Our focus is to provide care and support for those affected by ovarian cancer; and represent them by leading change. Our vision is to save lives and ensure no woman with ovarian cancer walks alone.

Breast Cancer Network Australia

BCNA Breast Cancer Network Australia (BCNA) is Australia’s leading breast cancer consumer organisation. We have worked tirelessly to ensure that all Australians who are affected by breast cancer receive the very best care, treatment and support.

Bowel Cancer Australia

BCA Peer-to-Peer Support Network connects patient’s and loved ones on a one-to-one buddy basis that enables members to give and receive advice about their bowel cancer experience in an informal and mutually beneficial way.

Leukaemia Foundation

LF is a support service for patients and supporters dealing with blood cancers.

*FU Cancer is supported by its audience. If you choose to purchase through the links on our site we may receive an affiliate commission. This goes towards paying our expenses plus a percentage of our monthly profit goes towards directly helping people with cancer. If you know someone who could do with a boost during their cancer treatment please let us know here.

*FU Cancer is supported by its audience. If you choose to purchase through the links on our site we may receive an affiliate commission. This goes towards paying our expenses plus a percentage of our monthly profit goes towards directly helping people with cancer. If you know someone who could do with a boost during their cancer treatment please let us know here.

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Sue Trainor
Sue Trainor
30 sep. 2022

Not every chemo drug causes hair loss. Carbonation does not. Taxol however does.

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