Joy.
Location: UK
Cancer type: Breast Cancer
Drug type: EC, Docetaxel
Hair type: Short
"Whatever you decide to do, cold cap or not use the cold cap, that is the right thing for you."
I was diagnosed with breast cancer in June 2021 following a routine mammogram. I had 2 different types of chemo over 5 months which ended in March 2022. I had EC (epirubicin and cyclophosphamide) followed by docetaxel.
I heard your scalp is sore after rapid hair loss and that this affects sleep. As tiredness increases the risk of infection, I decided to use the cold cap. I also felt that it would improve my psychological health to retain my hair.
My 3 top tips to retaining your hair during chemo treatment:
I had my hair cut short as I knew it was going to make combing it easier, I have very fine hair prone to tangling so a pixie style was easier for my hair.
Keep hair washing to a minimum and only comb twice a day with a wide tooth comb.
Accept that your hair is not going to look beautiful but you have hair. I left my hair 7 days between washes and for someone who washed it every other day this was a big change.

Before Chemo

During Chemo

Post - Final Chemo
Cap fitting
- Read carefully the booklets from Paxman who make the cold cap machines and ring their help line if you want advice, watch the online videos on how to put a cap on.
- Cap fitting is not difficult, but takes time. The nurses do not mind how long you take, I had two caps on and off numerous times.
- The cold protects your hair follicles, most vulnerable is the crown of your head.
- I got my hair very wet and covered it in conditioner before I had the cold cap put on.
- Once the cap is on, I did not find it painful, but it isn’t pleasant.
- The first 5 to 10 minutes are the worse, I could not think clearly with the cap on. I could do short texts and read a magazine but I could not do much more than that.
- Chatting to someone else does help at the start to divert you from the unpleasant feeling.
Treatment timings
- The most important thing is that you keep the cap on for the required amount of time which is different for each chemo combination – check the timings on the chart
- The chart is in the Paxman leaflets and fastened to the cold cap machine.
- Always check and agree timings on this chart with the nurse you do not want to come off sooner than you should, I lost hair when this happened to me. As the chart says, ‘Any uncertainties always cool for 90minutes post infusion’
Hair washing
- I went once a week to a hairdresser. She only used tepid water, to protect the hair follicles.
- She mixed my Paxman shampoo, a 50p sized amount, into 30g or 30 mils of warm water and then slowly poured this over my head and patted my head.
- You may need to increase this if you have more hair to wash.
- Never massage your hair as you would normally, when using shampoo.
- By simply patting my hair it came up into a lather.
- We left it 4 minutes then gently rinsed with cool water. The one time we put shampoo on my head undiluted my scalp was itchy.
- No hair dryer as this will stress your already very stressed hair follicles.
Whatever you decide to do, cold cap or not use the cold cap, that is the right thing for you. It is a very personal choice and for me it was an additional distraction that helped, but for others it is not worth it.
"I wish you all the very best as you start on chemo treatment. The one thing that I found is time passes very quickly. I was in constant contact with the telephone help line, it was invaluable. Chemo is tough but it is manageable. "