Preventing Chemotherapy-Induced Hair Loss, by Wish Dhillon, MD
Hair loss is one of the most distressing side effects of chemotherapy. Hair loss can have detrimental effects on a patient’s sense of physical and psychological well being. The fear of alopecia may negatively impact patients’ willingness to accept chemotherapy as a treatment option.
Recent advances and regulatory approvals in the field of scalp cooling offer hope and promise. Many trials have evaluated the role of scalp cooling in breast cancer patients.
Scalp cooling refers to the process of cooling down the scalp during chemotherapy infusion. Cooling can be accomplished by wearing cold caps or use of specialized equipment that circulates coolant through caps. It is hypothesized that drop in scalp temperature causes constriction of tiny blood vessels, thus reducing the exposure of scalp hair follicles to the chemotherapy drug. There are many commercially available scalp cooling systems.
In general, scalp cooling has been effective in reducing the risk of alopecia by approximately 50% in breast cancer patients. Patients who use scalp cooling are less likely to require a wig. The technique is generally considered safe, with reasonable efficacy and mostly minor side effects. The concern about scalp metastasis has not been a widespread problem in clinical practice.
It is quite remarkable that for decades, alopecia remained an “acceptable” side effect of chemotherapy. Images of patients with hair loss are an enduring legacy of the struggles of living through chemotherapy. To be able to”survive” chemotherapy without hair loss would be awesome! In that context, scalp cooling has the potential to provide a significant and symbolic victory.
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