Can Chemo-Related Hair Loss Be Prevented?

Chemotherapy almost inevitably produces total hair loss, which can be emotionally distressing for the patient.  Indeed, it’s possibly the chief feature of chemotherapy that causes patients to decide against chemo.  The Breast Oncology Program at University College of San Francisco (UCSF) has announced its plans to investigate devices to help prevent hair loss in chemo.

The idea is that cooling the scalp will cause blood vessels surrounding the hair roots to contract, effectively reducing the flow of chemo-containing cytotoxic chemicals to the follicles.  Thus the hair follicles should be largely protected from the toxic effects of chemotherapy.  There are several ways to achieve scalp cooling.  One is a device already widely used overseas called the “DigniCap”.  This is a Swedish cap or helmet worn during chemotherapy treatments that has a circulating coolant inside a lining silicone gel. 

Another approach is to have the patients wear a series of caps that have been cooled in a freezer;  unfortunately the caps warm up during treatment, and have to be replaced every 20 minutes or so.

One of the reasons for the reluctance of US oncologists to use scalp cooling is the fear that cancer cells might be ‘hiding’ in the scalp and could thereby survive chemotherapy;  however, the incidence of such scalp metastases is extremely low, and the caps have proved effective in preventing hair loss in up to 80% of subjects without mishap (this information comes from Dignitana, the manufacturers of the DigniCap).

UCSF is planning safety and effectiveness studies of the DigniCap and the replaceable freezer-cooled caps.  It’s likely that one or the other method will receive approval from the FDA, something that will remove one of the common objections that wavering patients may have when confronted with chemotherapy.  This would be a significant step forward, indeed.