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Scalp-Cooling Cap Could Prevent Hair Loss During Cancer Treatment

chemotherapy hair loss, DigniCap

Hair loss can happen when chemotherapy drugs travel throughout the body to kill cancer cells. Some of the drugs damage the hair follicles. Radiation therapy to the head can also be a cause of hair loss. Most often, hair loss begins within 2 weeks of the start of treatment and gets worse 1 to 2 months after starting therapy.

It isn’t about vanity, says Miriam Lipton, 45, one of twenty participants in a clinical trial in San Francisco. It’s about feeling good about yourself. “If you look OK on the outside, it can help you feel ‘OK, this is manageable. I can get through this.” Ms. Lipton is a breast cancer survivor who lost her hair 2 weeks after beginning her first rounds of chemotherapy.

During Ms. Lipton’s second bout with the disease, researchers tested a scalp-cooling cap in an effort to prevent hair loss. The theory behind the DigniCap and others like it is that chilling the scalp to 41 degrees can reduce blood flow to the brain, thereby reducing the ability of the chemotherapy drugs to reach the hair follicles.

Most of the clinical trial participants kept more than half their hair. Ms. Lipton says that hers thinned at the crown where the cap didn’t fit snugly, but overall she says “It was easier. I felt normal much more quickly.” The most common side effect is headache from the cold.

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Unfortunately, however, the caps may also interfere with the effectiveness of the treatment itself. To study this, Dr. Hope Rugo of the University of California, San Francisco, and Dr. Susan Melin of North Carolina’s Wake Forest Baptist Medical Center have recruited 110 early-stage breast cancer patients. Participants' hair will be photographed for experts to assess, and they'll be compared with a small group of similar patients who get chemo alone.

The researchers hope that their study will lead to FDA approval for the DigniCap to be used in the US. Currently patients can rent a similar product, called Penguin Cold Caps, from a British company for $455 per month.

"Do they work and are they safe? Those are the two big holes. We just don't know," said American Cancer Society spokeswoman Kimberly Stump-Sutliff, an oncology nurse who said studies abroad haven't settled those questions. "We need to know."

Hair-preserving approaches need good testing, adds Dr. Laura Esserman, a UCSF breast cancer specialist. "If it matters to our patients, it should matter to us," she said. "It's really not more complicated than that."

In the meantime, the American Cancer Society offers the following tips for cancer patients experiencing hair loss:
• If you think you might want a wig, buy it before treatment begins or at the very start of treatment when the shop can better match your color and texture. Try on several styles until you find one you really like. Keep in mind that synthetic wigs need less styling than human hair wigs which may be easier if you have low energy during treatment. Ask if the wig can be adjusted – your wig size can shrink as you lose hair.
• Be sure to get a prescription from your doctor for the wig because it may be covered by insurance.
• Some people find wigs to be hot or itchy. In that case, turbans or scarves can be used instead of wigs. Cotton items tend to stay on your smooth scalp better than nylon or polyester.
• Hair loss can be somewhat reduced by avoiding too much brushing or pulling of hair and by avoiding heat (such as electric rollers, hair dryers, and curling irons). Be gentle when brushing or combing (use a wide-toothed comb). Avoid styles that pull on the hair such as braids or ponytails.
• Wear a hair net at night, or sleep on a satin pillowcase to keep hair from coming out in clumps.
• If you are bothered by hair falling out, you may choose to cut your hair very short or even shave your head.
• Wear a hat or scarf outdoors in cold weather to reduce the loss of body heat.
• Use sunscreen, sunblock, or a hat to protect your scalp from the sun.
• When new hair starts to grow, it may break easily at first. Avoid perms for the first few months. Keep hair short and easy to style.

NBC News