Saturday, September 23, 2023
Saturday, September 23, 2023

Chemotherapy Starts With Scalp Cooling Treatment: The Path to Improved Access | By Claire Paxman, Director of Global Training of Paxman

When Real Housewives of Miami star Guerdy Abraira recently proclaimed “Chemo Starts Now” after shaving off her hair before starting her treatment for breast cancer in People Magazine1, this made me realize just how little the general public and even celebrities like Abraria know about the medical technology being utilized today, such as scalp cooling systems, to manage and prevent chemotherapy-induced hair loss.

As August was National Hair Loss Awareness Month, the impact hair loss can have in our lives was highlighted throughout the month to address how imperative it is to raise awareness of the proven solutions helping to fight hair loss, especially during chemotherapy where the thought can be incredibly daunting for both men and women. While chemotherapy is an essential treatment in fighting cancer, hair loss is one of the most distressing side effects affecting one’s confidence, self-esteem, and overall sense of identity daily.

Even though various forms of technology have existed since the 1970s that narrow the blood vessels beneath the skin of the scalp, reducing the entry of chemotherapy drugs that reaches the hair follicles, access to this scalp cooling treatment primarily in the U.S. has been denied to many cancer patients due to the fact the systems are generally not covered by insurance and many hospitals as well as cancer treatment centers not being fully equipped to provide the service. This has meant patients who want the service have unfortunately had to pay out of their own pockets, even despite scalp cooling, for example, being cleared by the U.S Food and Drug Administration (FDA) since 2015.

With that being said, the conversation to improve access of technologies mitigating chemotherapy-induced hair loss, such as scalp cooling, also known as cold capping, needs to be had with patient advocates, oncologists, and other cancer treatment specialists and no there is no better time than right now with National Hair Loss Awareness Month approaching.

The Impact of Chemotherapy On Hair Loss & The Concept of Scalp Cooling Treatment

Just as chemotherapy targets and kills rapidly dividing cells, including cancer cells, it also affects healthy cells, leading to the side effects of fatigue, nausea, and of course hair loss. The prospect of losing hair can be emotionally distressing, and it often serves as a visible reminder of a patient’s battle with cancer.

In addition to confidence and self-esteem, hair loss can also profoundly impact a patient’s body image, and emotional well-being, which is why this side effect is one of the most challenging aspects of their cancer journey. Addressing this issue is essential for improving patients’ mental health and overall resilience in the face of treatment.

Scalp Cooling treatment, or cold caps, have shown promising results in reducing hair loss during chemotherapy, in which the most recent studies from the National Institutes of Health found high success rates in the efficacy and safety2. While scalp cooling hasn’t even been FDA cleared for a decade yet, the process of cooling the scalp before, during, and after chemotherapy infusions demonstrates its ability to minimize the amount of chemotherapy that reaches the patients hair follicles.

Whether its empowerment, maintaining normalcy, or impacting a patient’s psychological resilience, allowing healthcare professionals to provide the option of scalp cooling during chemotherapy should be prioritized to allow patients to take an active role in their treatment and recovery. Additionally, further research has shown that maintaining one’s physical appearance, including hair, has a significantly positive effect on better coping mechanisms and improved treatment outcomes.

The Need for Increased Access & Expanded Educational Initiatives

Despite the significant benefits highlighted of scalp cooling during chemotherapy, access to these innovations remain very limited, with the lack of insurance coverage and flexibility from hospitals and cancer treatment centers to adopt these systems as mentioned earlier.

To improve access, it is essential for policymakers and medical organizations to collaborate and advocate for broader insurance coverage of the treatment. Ensuring that this technique is a covered benefit will remove financial barriers and make it accessible to a more extensive range of patients. U.S House Appropriations Committee Chair Rosa DeLauro actually introduced a bill in 2022 to increase access of scalp cooling therapy, which would require all health insurers to provide coverage for scalp cooling treatments for chemotherapy patients3, and this is expected to be voted on by the full House Appropriations Committee later this year. The hope is then for the bill to be considered by the Senate and the House of Representatives and if ultimately passed, being signed into law by The President.

Raising awareness about technologies, like scalp cooling, among patients, healthcare providers, and the general public is vital. Educational initiatives can debunk myths, inform patients of their options, and encourage conversations between patients and healthcare providers about the potential benefits.

The Importance of Continued Research and Development

Continued investment in research and development will further enhance scalp cooling technology and its efficacy. Advancements in technology, coupled with clinical studies on different cancer types and chemotherapy drugs, will strengthen the evidence base for this treatment and drive its adoption in medical practices.

Chemotherapy is an integral part of cancer treatment, but its side effects, particularly hair loss, can be emotionally challenging for patients. Scalp cooling offers a glimmer of hope, providing patients with the opportunity to maintain a sense of normalcy during their cancer journey. Increased access to this groundbreaking technique is paramount in empowering patients, improving their quality of life, and enhancing overall treatment outcomes.

As we raise awareness of scalp cooling, let us work collectively to address barriers to access, advocate for insurance coverage, and invest in research and development. By doing so, we can ensure that chemotherapy truly starts with these proven technologies, providing patients with a more hopeful and positive experience on their path to recovery. Together, we can make a meaningful difference in the lives of cancer patients across the United States and all across the globe.

About The Author: Claire Paxman is the Director of Global Training of Paxman, the global leader in scalp cooling and cryotherapy, pioneering this technology for over 25 years to help prevent chemotherapy-induced alopecia worldwide. For more information on Paxman, please visit





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