Hair Regrowth with
Cold Capping
Scalp cooling motivation
The majority of people choose to scalp cool to retain their hair, but increasingly there is an additional motivation in the form of faster, healthier and stronger hair regrowth as a result of scalp cooling.
As we know, retention rates with cold capping can vary a lot from drug to drug as well as from person to person – even those with the highest rates of hair retention see shedding, so faster regrowth is a true benefit to anyone who chooses to scalp cool.
Clinically proven faster regrowth
For a long time, it was believed that scalp cooling resulted in faster regrowth, now there are several clinical studies to confirm this.
Alopecia is measured in grades – grade 0 = no hair loss, grade 1 = <50% hair loss, grade 2 = >50% hair loss
A study conducted in Japan in 2019 called ‘Efficacy of Scalp Cooling in Preventing and Recovering from Chemotherapy-Induced Alopecia in Breast Cancer Patients: The HOPE Study concluded that scalp cooling resulted in faster recovery of hair volume within 12 weeks of chemotherapy, even in patient whom scalp cooling failed to prevent chemotherapy induced alopecia.
This was particularly important as the patients in the trial received TC (docetaxel and cyclophosphamide), or AC (doxorubicin and cyclophosphamide) both of which are particularly challenging regimens for hair retention.
A study conducted in 2020 in India Randomized Control Trial of Scalp Cooling for the Prevention of Chemotherapy Induced Alopecia concluded that scalp cooling patients saw significant hair regrowth at both 6 and 12 weeks post their final chemotherapy treatment.
At 6 weeks, 89% of the patient who had scalp cooled saw grade 0/1 alopecia, whereas the control group who didn’t scalp cool saw 12% of patients with grade 0/1 alopecia. By week 12 this had increased to 100% in the scalp cooling group and 60% in the control group.
As you can see from the images from the studies, faster regrowth is important for those with retention, but particularly important for those that see significant hair loss. Hair regrowth will happen naturally, but scalp cooling can turn the process of hair density returning to normal from months to weeks. Depending on the drug regimen, it is not uncommon for some patients to see regrowth occurring before the end of their chemotherapy treatment.
Examples of regrowth from patients who have scalp cooled
Helen – Doxorubicin, Cyclophosphamide
Helen – 2 months post final chemo
Tessa – 4 rounds of Docetaxel, Cyclophosphamide
Tessa – 1 year post final chemo
Louise – 3 rounds of Epirubicin, Cyclophosphamide and 8 rounds of Taxol
Louise – Regrowth 8 weeks post final chemo
Teresa – 6 rounds of Docetaxel, Cyclophosphamide, Herceptin, Perjeta
Teresa – 9 weeks post final chemo
Jax – 4 x Epirubicin, Cyclophosphamide
Jax – 4 x Epirubicin, Cyclophosphamide
Jax – Regrowth shown during Paclitaxel and Carboplatin
Jax – Regrowth shown during Paclitaxel and Carboplatin
Minall – 4 rounds of Epirubicin, Cyclophosphamide
Minall – Regrowth 1 month post final chemo
Jessica – 12 rounds Paclitaxel and Carboplatin
Jessica – 2 Months Post final Chemo
Sarah – 6 rounds of THP
Sarah – Regrowth 2 months post final chemo
Zara – Epirubicin, Cyclophosphamide
Zara – 2 months post final chemo
This is why we would always encourage patients to continue to scalp cool, even if they do see a lot of hair loss
Those patients who are facing anthracycline based regimens may see the potential retention rates with their treatment plans and decide that scalp cooling isn’t for them, but many patients are now citing increased hair regrowth as motivation enough to scalp cool, and that any hair retention is a bonus. It has certainly been a reason that many patients have persisted, and in the long term have acknowledged that despite disappointment that the retention rates weren’t what they had hoped, the increased regrowth made scalp cooling a choice they were glad to have made.
If you do decide to continue with scalp cooling, despite significant hair loss, it is important to ensure that any exposed areas of scalp do not have direct contact with the inner cap, to increase comfort and tolerability. Please use a disposable theatre cap, or rearrange any retained hair over the exposed area of scalp. There is more guidance on this in our hints and tips tutorial video.
“I was grateful for the hair that I did keep and what was amazing was the speed at which it returned whilst still going through Carboplatin & Paclitaxel. So, I know without scalp cooling I wouldn’t be in the position I am now with my hair.”
Gail, UK
If you would like to know more about regrowth and what to expect, have a look at our Regrowth Blog Post
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