A clinical review revealed scalp cooling devices were both safe and effective at treating
hair loss induced by chemotherapy.
The analysis was conducted by Megan Kruse, MD and Jame Abraham, MD - both from the Taussig Cancer Institute at the Cleveland Clinic. Their work follows similar research conducted in 2017 which confirmed the efficacy of
Paxman's scalp cooling system.
Around eight per cent of women reject chemotherapy, citing the prospect of losing hair. It is clear the possibilities offered by scalp cooling machines may help to save more lives in the future.
The authors compared three studies which tested if scalp cooling could prevent
"chemotherapy-induced alopecia in patients receiving chemotherapy for solid tumor malignancies".
Scalp cooling studies
They discovered it was 100 per cent effective at reducing hairloss in patients receiving weekly paclitaxel cancer treatment. It was also around 20 per cent effective at limiting hair fall in patients undergoing anthracycline
chemotherapy.
The research also challenges the notion that
scalp cooling devices can increase the risk of metastases - secondary malignant growths which develop away from the primary site of
cancer.
Among the study participants, who were monitored for seven years after their treatment with manual cooling cap systems, the highest risk of scalp metastasis was 0.45 per cent.
Writing in the
Journal of Oncology Practice, Kruse and Abraham note:
"these studies support the safety of scalp cooling in patients with solid tumor malignancies undergoing chemotherapy. Clinicians should be aware of the available data on hair preservation with scalp cooling to counsel patients on the likelihood of success with various chemotherapy regimens".
The FDA has already cleared two systems for routine use in the US: the
Paxman Scalp Cooling System and the
DigniCap. The former was finally cleared for American use in April 2017.
How do these devices work?
Chemo drugs fail to differentiate between healthy and cancerous cells. As a result they can attack hair follicles which may result in thinning hair from
anagen effluvium.
Inside the DigniCap Cold Cap
As explained on the Paxman website, scalp cooling treatment works by reducing the head's temperature
"by a few degrees immediately before, during and after the administration of chemotherapy". This is achieved through a
"cold cap" which is worn by the user.
This process prevents baldness by restricting blood flow to the top of the head, reducing the potential for chemotherapy drugs to reach hair follicles and damage them.
Considering the freezing temperatures used in scalp cooling treatment, there are some potential adverse side-effects, which Kruse and Abraham list as
"scalp pain, headache, and chills". Fortunately these symptoms were tolerable for most of the patients surveyed in recent clinical trials.
The authors mention hair loss remains
"one of the most feared complications of chemotherapy" for
men and women alike. BBC TV presenter
Victoria Derbyshire described losing her hair as the worst part of her cancer experience.
Consequently, these devices can help to address the emotional impact of cancer-related hair shedding. Kruse and Abraham state,
"Because prevention of chemotherapy-induced alopecia may have an effect on quality of life and psychosocial well-being, use of scalp-cooling technology should be viewed as a means to care for the whole patient rather than a solely cosmetic issue".
In most cases hair begins to grow back naturally around 12 months following a course of chemo, but this cannot be guaranteed. Many people also notice their hair
grows back slightly differently to how it was before treatment but this is usually temporarily, lasting a few hair growth cycles.
It is hoped cold cap systems will continue to become more effective, meaning more people will have access to these hairloss prevention devices during cancer treatment. This ambition is shared by Paxman CEO,
Richard Paxman, who aims to eliminate hair loss from chemotherapy entirely.