Hilary by a fountain
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Posted by Target Ovarian Cancer on Friday 12 August 2016

Using a cold cap can help to keep your hair (or most of it) during chemotherapy treatment.

Three years ago I was diagnosed with primary peritoneal cancer after keyhole surgery. It came as such a shock.

Over the next couple of weeks I learnt that I was going to have weekly chemotherapy for 18 weeks and I would lose my hair about three weeks after the first dose.

I wanted to keep my diagnosis private from anyone other than close friends, colleagues and my family as I needed time to adjust and come to terms with it personally before my cancer was made obvious to everyone I met by losing my hair. I'm a private person and not confident with my appearance, and am totally useless with hats and hairstyles. I love walking and exercise and didn't see how I could do this in a wig, but also didn't feel brave or confident enough to be able to go out in public without my hair.

Have you heard of a cold cap?

An old school friend of mine mentioned using a cold cap to prevent hair loss. She'd met women who'd successfully used them at a Macmillan day centre where she volunteered. I asked my oncologist about a cold cap and she said I could try it.

The chemotherapy unit had two - both bright pink and donated by breast cancer charities. One of the nurses on the chemotherapy unit showed me how it was used and worked out which of the three sizes would fit best. She expressed sadness that so few patients tried using them and was excited I wanted to try.

She explained that the cap freezes to minus 4 degrees. Having this tight against your scalp greatly reduces the blood flow to your scalp skin and hair follicles so hardly any of the chemotherapy drugs reaches your scalp skin.

I was going to have Taxol (which causes hair loss) two weeks out of every three of my chemotherapy regime (a total of 12 of my treatments).

Putting the cap on

When I came for my first dose of Taxol the nurse helped me prepare for the cold cap. I had to soak my hair (I just put my head under a tap!) and then cover it in conditioner. The cap (which is attached to a freezer unit by a pipe) was frozen solid and firmly placed on my head. It was essential that the ice cap made good contact with all of my scalp for it to work. To hold it in place a tight neoprene bright pink cap with a tight chin strap was eased over the ice cap (a bit like trying to pull on a wet suit that is too tight!). Once in place the chin strap was pulled tight making me look like a hamster in a pink cap!
Hilary wearing a cold cap
The cap has to be applied thirty minutes before the chemotherapy infusion starts and remain on for an hour after the drug has finished, so it does add another hour and a half to your treatment.
Within seconds of the cap going on, your scalp starts to feel so cold. It actually hurts for about the first 10-15 minutes (but nothing too unbearable) and then it just feels cold and numb for the rest of the time. I always snuggled under a blanket on my chemo-chair to keep warm, and drank lots of hot drinks.

Once I'd finished, the freezer unit was turned off and the cap quickly defrosted. When I removed the cap my wet hair was frozen in lumps but quickly thawed out - dropping bits of ice everywhere. I found a nice woolly bobble hat to pull on when I went home.

The nurses advised me to brush my hair carefully and not wash my hair too often. I found as the weeks went on that the combination of cold and conditioner on my hair for several hours at a time made my hair really soft and shiny.

To my amazement it worked! My hair did thin out a bit and I lost a small patch of hair on my crown where the cap didn't fit snugly. However, my hair still looked the same to others and only my 6ft 3 husband (kindly) mentioned my small bald patch on top of my head! I moved my parting over to cover it up!!!

When I finished my chemo after 18 weeks I still had long straight shoulder length hair. I was so relieved to have kept my hair. The chemotherapy nurses were also genuinely thrilled for me and paraded me round to talk to any new chemotherapy patient starting treatment who was interesting in trying it.

It’s a personal choice

For me it made my cancer journey a lot less traumatic and it helped me to feel confident enough to go out and socialise. Everyone is different, and many women bravely accept their hair loss and look confident and stylish - I really admire them for it.

We are so lucky in the UK that many of our chemotherapy units have these high quality very effective cold caps free for us to use, with nurses specially trained to use them.

I did buy a wig in a panic before my chemo started. My brother who has been bald for years visited and tried my wig on to cheer me up. He'll kill me for posting this, but I must admit he looked gorgeous in the wig! And he's the only one who's ever worn it.

Hilary with her husband

Find out more

Cold caps can be uncomfortable and treatment takes longer, however some women find they work really well. Your hospital may also offer a free wig service. Ask your Clinical Nurse Specialist for more details about cold caps and wig services.

We'd like to hear about other people's experiences of using a cold cap. If you have used one during treatment, let us know how you found it in the comments.