Q+A: Scalp Cooling

A Scalp cooling prevents chemotherapy-induced alopecia in two ways. First, it reduces blood flow to the scalp. Cooling causes the blood vessels in the scalp to constrict, which reduces the amount of medication reaching the follicles. Secondly, when our scalp’s temperature is lowered, our metabolism is reduced. This causes the follicles to absorb less chemotherapy. The key to keeping as much hair as possible is to keep the scalp cold for an extended period. Each chemotherapy has a set post-cool time in which chemotherapy is finished but the scalp cooling continues.   

Q Where is scalp cooling offered, and how do patients make appointments to receive it?    

A Currently scalp cooling is offered at Vanderbilt-Ingram Cancer Center Belle Meade. 

Appointments can be made in several ways: Patients’ oncologists can inform them of the benefits of scalp cooling, then send me a message through 

Epic, our electronic health record system. Oncology staff nurses can call me or send a message through Epic if they have patients who are interested. If patients are familiar with our Belle Meade clinic, they can directly reach out to me. I like to schedule the patient’s entire treatment plan at one time, so when new scalp cooling patients inquire, I can quickly look at my calendar to see if we have availability.  

Q Which cancer patients undergoing chemotherapy are suitable for scalp cooling?  

A DigniCap is FDA-approved for solid tumors. Many of our scalp cooling users are breast cancer patients. However, we have had a couple of men successfully use the system. 

Q How long does the procedure take, and is it painful or uncomfortable?  

A The duration of treatment varies based on each patient’s chemotherapy plan. DigniCap includes a specific cooling period after chemotherapy, typically ranging from 90 to 120 minutes. For breast cancer patients, the total time spent on treatment day is approximately five to six hours. While scalp cooling may be uncomfortable, it is not typically painful. The initial 15 minutes during which the scalp is cooling and reaching peak temperature can be the most challenging. However, once the scalp is numb, patients can relax in our heated recliners with warm blankets and often find themselves drifting off to sleep.  

Q How many patients have undergone scalp cooling, and are they pleased with the results? 

A About 75 patients have used scalp cooling since we implemented the program in March 2023. Our patients have been extremely happy with their results.  

Q Is there a certain group of patients who respond better to scalp cooling than others? 

A We have not found any significant correlation between age, ethnicity, hair length and the effectiveness of scalp cooling. However, we have observed that the condition of the hair at the beginning of treatment plays a crucial role. For instance, individuals who have regularly colored or bleached their hair may not respond as effectively to the treatment compared to those who have not. It’s important to note that this information is not meant to discourage anyone from trying scalp cooling, but rather to set realistic expectations. 

Q Are there any plans to expand scalp cooling to other locations?   

A Yes, Vanderbilt-Ingram Cancer Center Hendersonville has just received their DigniCap machine. Their staff has completed training and will begin accepting patients soon. There are talks of a few more clinics starting scalp cooling in the future.