Chemotherapy drugs are designed to damage or kill cells with a ‘fast division rate’, such as cancer cells. Unfortunately, other cells in the body also have a fast-dividing rate, including your hair. This similarity makes these cells susceptible to the chemotherapy drugs and causes hair loss.

Although a popular therapy throughout Europe and other parts of the world, scalp cooling awareness in the USA is still growing. Research indicates that many doctors aren’t well informed about its advancements, effectiveness or availability.

The FDA has approved several scalp cooling devices since 2015.

Some doctors may have outdated information about scalp cooling's efficacy from early studies. (The Polar Shift intends to change this!)

Not all infusion centers have machine scalp cooling equipment. However, with physician approval, individuals can rent a set of their own manual caps from manual cold cap providers and use them with dry ice or a biomedical freezer at any center.

Many chemotherapy patients can use cold cap/scalp cooling therapy, including all solid tumor patients. The specific drug treatment plan and various health factors will need to be considered. Generally, the first step is to consult with your physician. Scalp Cooling Provider websites can also be a great starting point, offering specific guidelines about the process, how to order caps, and providing more detailed information.

Scalp cooling works with most chemotherapy drugs for various solid tumors, but may not be suitable for all situations. Your doctor can advise on its suitability for your specific case. Scalp Cooling Providers can additionally assist and advise.

Generally, manual cold caps need to be worn for approximately 50 to 60 minutes before your infusion starts for the best success rate. This is to ensure your scalp is sufficiently cooled before the chemo enters your system. You will continue wearing the caps continually during your infusion, changing them out every 20 to 25 minutes to maintain correct scalp temperature. When your chemo infusion ends, you will need to continue wearing the caps for approximately 3-5 hours more, depending on you drug regimen, to give the body time to dilute and clean out the chemo toxins. Every scalp cooling company and cold cap provider should provide you with detailed information and many offer personalized schedules based on your specific drug regimen. They should also provide hair and scalp care instructions for you to maintain throughout your treatments. It is essential to follow your schedule and hair care instructions meticulously in order to achieve optimal results. (And our founders say it is absolutely worth it!)

Like the name implies, the caps themselves are cold! Individual pain thresholds vary and are obviously a factor in determining tolerance.

The first cap is generally the coldest, but as the scalp cools and the nerve endings numb, the initial discomfort typically dissipates and the remaining 10-25 minutes of wear is comfortable to the point that one can hold a normal conversation, snack, walk around or even play cards to pass the time. Manual caps are changed at regular intervals of 20-25 minutes throughout the entire chemo day, so this cycle repeats. Cold capping requires commitment and a positive mindset – But if saving your hair is important to you and you stick to your personalized schedule, you’ll have a high chance of success!

For comfort, clients are encouraged to bring an electric or other blanket, warm socks, and wear layered clothing.

Machine caps are not changed. The patient puts on a room temperature cap and ensures the fit is good. The nurse then turns on the scalp cooling machine, and the cap gets cooled. Once it reaches the set temperature, it stays there for the duration. Machine caps are not as cold as manual caps, because the machine keeps them at a constant temperature and they don't warm up during the chemo session.

IMPORTANT TO NOTE:

Even if a patient has chemotherapy without scalp cooling therapy, his/her body would feel cold because the saline being infused into the blood circulatory system is at ambient (room) temperature, not body temperature. This is why infusion clinics often supply blankets and patients are usually advised to wear sweaters. Also, some patients report feeling “hot” from the chemotherapy drugs and welcome the cold!

While practice makes perfect, accurate cap placement is crucial for success with both manual and machine systems. To ensure successful application and maximize effectiveness, The Polar Shift strongly recommends seeking thorough training from qualified capping specialists or considering hiring a specialist to assist you throughout your treatment. Investing in proper training equips you with the knowledge and confidence to manage the process effectively. For manual caps, having at least one trained individual (or professional capper) to assist you is essential. This individual’s responsibilities include tasks like:

Monitoring treatment intervals: Ensuring cap changes occur at the recommended times (approximately every 20 minutes).

Verifying cap temperature: Checking the temperature of new caps before application, especially when using dry ice.

Swapping caps and straps: Performing efficient cap changes at designated intervals.

Maintaining comfort: Helping you stay warm during cap application and encouraging fluid intake.

While the process may seem complex at first, The Polar Shift founders agree that mastering it not only helped them retain their hair, but also provided them with a sense of control and focus during each chemotherapy session, and made the time pass by very quickly.

[Read Liesel’s Story]

For machine caps, the patient needs to practice fitting the cap to her/his head before chemo day. At the clinic, once the cap is on, a nurse will connect the cap to the hoses and turn on the scalp cooling machine. (The nurse may or may not help you with the cap fitting.)

Not at all! Manual cold caps have been used by men, women and some older children (adolescents). With regard to machine scalp cooling systems, they have been cleared for all adults. Check with your provider regarding age limitations.

Any and all types of hair. Temperatures are adjusted for each individual based on hair thickness and texture to ensure optimal results.

Hair shedding is normal! Cold Caps reduce the damage to the hair follicles, but they can’t protect them completely.

Chemotherapy accelerates the hair cycle, and as a result, the older hairs are pushed out earlier, which is why patients experience shedding. But with proper capping and hair care, you won’t lose it all and most likely, you’ll lose very little.

In studies, cold caps have had a success rate of 50% with success being dictated by at least 50% hair retention.

Without using scalp cooling or cold caps, for patients receiving chemotherapy that causes hair loss, there is a 0% hair retention rate. Even when a patient experiences “unsuccessful” results, there are positive outcomes to using cold caps. Hair grows back faster and stronger than if patients did not utilize the technology.

The Polar Shift founders report minimal hair loss, yet their friends and family never noticed any loss!

According to Breast Cancer Research and Treatment, a study published in 2017 reviewed patients with breast cancer receiving chemotherapy while using scalp cooling for hair preservation and found there was no statistical difference in the incidence of scalp metastasis between patients using scalp cooling vs. no scalp cooling. It was concluded that the incidence of scalp metastases was low regardless of scalp cooling. This analysis suggests that scalp cooling does not increase the incidence of scalp metastases.

Machine scalp cooling has received CPT diagnostic codes from the American Medical Association.

CPT® codes effective July 1, 2021

0662T Scalp cooling mechanical; initial measurement and calibration of cap

+0663T Placement of device, monitoring, and removal of device

www.ama-assn.org/system/files/2020-12/cpt-category3-codes-long-descriptors.pdf

Effective 1/1/2022, Medicare started to reimburse chemotherapy facilities for the cost of machine scalp cooling. Please discuss with your provider or clinic if you are Medicare eligible.

Manual cold caps have no unique CPT codes assigned to them.

Some suggested CPT codes are:

97039 (Constant attendance) This code is also reported to be used by Blue Shield for Durable Medical Equipment

A9273 (Ice cap, cold wrap or pack)

A9282 (Wig any type, Cranial/scalp prosthesis)

Both DigniCap and Paxman have insurance sections on their websites that will be helpful to their users. Your manual cap rental provider may know of patient insurance successes. Coverage is inconsistent but not uncommon. Be sure to discuss with them before filing your claim.