Kate Dilligan, our Cooler Heads Founder and CEO, has been in your shoes. Below are Kate’s tips and recommendations based on personal experience with scalp cooling treatments. Some tips are specific to women. Kate shares she probably lost 60% of her hair, but since it was evenly distributed, she still felt normal.
Take care of your hair
The steps below are advice I was given and followed. It worked for me. I followed these steps for about two months after I finished chemotherapy. Remember, the chemo is still circulating for several weeks following the last infusion. This may seem like a lot, but trust me, it becomes a matter of habit.
Before Starting Chemo:
- Don’t cut your hair. Cutting your hair changes its weight, which stresses it. Don’t cut your hair within 1 week before starting chemo, and don’t cut it during chemo.
- Don’t color your hair. The advice is the same on this one. The chemicals and pulling involved in the coloring process can lead to hair loss. I used spray-on color for my roots.
Hair Washing & Drying:
- Wash your hair on day 3 following chemo. This is when the chemo is coming through your skin, so it’s important to get it off your scalp. All the suggestions below apply to getting your hair clean.
- Gently wash your hair with warm water. I like hot showers. Heat, however, is the enemy of hair preservation. I would take a hot shower avoiding my scalp, then, when I wanted to get my hair wet, turn the temperature to tepid and the stream to lower intensity.
- Shampoo and Conditioner. I used non-sulfate shampoo and conditioner and didn’t work the shampoo into my scalp. Conditioner I would just wipe gently onto my hair and then rinse out.
- Limit hair washing. I washed my hair only 2 or 3 times a week, though I did get it wet every day to make it easier to manage.
- Blot your hair dry. I normally make a towel turban on my head, but when I was going through chemo, I would tilt my head to the side and use the towel to blot my hair up against my scalp. Avoid rough toweling.
Hair Brushing & Styling:
- Gently brush your hair. I have a lifelong passion for horses. The rules for brushing a horse’s tail are the same as for brushing a toddler’s hair–and should be followed by people using cold caps. Brush your hair gently, starting at the ends and working your way up. To avoid pulling on the roots, hold your hair away from your head when you are brushing it.
- Hair dryers, braids, and tight ponytails are out. Any styling tool or hairstyle that heats your scalp or pulls on your hair is out. I used scrunchies to pull my hair back into a low ponytail.
Misc. Hair Care Items:
- Avoid tight hats. Does it pull on your hair? If so, don’t wear it. I love baseball caps but put them aside for the duration of chemo.
- Avoid all kinds of excess heat that can make you sweat. Going for runs is one of my favorite things to do. But I sweat a lot when I work out, so even though I went through chemo November through February, I opted for walks over runs.
- Pools and the ocean are off limits. It is not recommended to go swimming while undergoing cold cap therapy as salt or pool chemicals are really hard on hair.
Symptom Management
- Know your pain level. One of the people I spoke to about cold caps as I was doing my research recommended pain medication at the start of each chemo infusion. I asked my medical oncologist for a prescription and got one for Vicodin. I took one dose as I got to the office to have my labs drawn (mine were always drawn the day of) and another as I got to the infusion center.
- Use vitamins. I used silica and biotin to help my hair. It’s hard to know if they worked, but they were recommended to me and I used them.
- Manage Body Temperature. Cold caps gave me the feeling of brain freeze for a few minutes. My scalp rapidly became numb. I always kept a coat and a blanket with me at the infusion center. It is cold, but it’s not that bad. I could joke, eat, and even nap while doing cold caps.
- Hydrate, hydrate, hydrate. My first chemo infusion was AC (Adriamycin and Cyclophosphamide), which I was told is known as the “red devil.” It is unclear to me why that was deemed helpful information to tell me as I was getting ready for my first infusion. AC turns your urine red, and I was glad I’d been warned about that beforehand. Hydrating not only helps flush the chemo out but also aids digestion, which Zofran and the other anti-nausea meds mess with. During my four months of chemo, I had a goal of about 100 ounces of water a day.
Menstrual Changes
Chemo did throw me into menopause for about a year, and I started to have brutal night sweats. I would wake up in the middle of the night to change my clothes.
- Especially bad was the sweat around my hairline. I wound up losing my hair just above my ears and at the very back of my hairline from night sweats.
- A friend of mine who is an OBGYN recommended a low-level antidepressant that has an off-label use of stopping hot flashes. I got it from my medical oncologist. That was the right decision for me, and I stopped using it about 6 months after chemo ended. I wish I had known about it earlier, as I think it would have saved the hair along my hairline.