Cold cap therapy, or modern day scalp cooling, involves the use of special caps, frozen to a very cold temperature, and worn for a period of time before, during and after each chemotherapy treatment. The cooling of the hair follicles prevents chemotherapy toxins from reaching them, preserving the follicles and therefore preserving the patient’s hair. This process has been in use in Europe for more than 15 years. Well over a thousand individual patients in the United States have learned of and successfully used cold cap therapy in the last few years.

Cold caps are manufactured by a number of companies. For more information on the cold caps that Shirley successfully used, please visit the official website of Medical Specialties of California.

The cold cap process requires any freezer that can maintain a temperature of -30°C (-22°F). (Note that each cap has to be stored in its own box to ensure uniform temperature throughout.). Specifications for the freezer that The Rapunzel Project generally donates are as follow:

For a picture of this freezer, click here.

• Beverly Hills Cancer Center – Beverly Hills, CA
• Tower Oncology (Cedars Sinai) – Beverly Hills, CA
• East Valley Oncology and Hematology (Disney Family Cancer Center) – Burbank, CA
• UCLA Hematology Oncology (100 UCLA Medical Plaza) – Los Angeles, CA
• Valley Medical Oncology – Pleasanton, CA
• Ccare –  San Diego, CA
• UCSF Carol Franc Buck Breast Care Center – San Francisco, CA
• UCLA Hematology and Oncology – 2020 Santa Monica Blvd, Santa Monica, CA
• UCLA Hematology and Oncology-Parkside – 2336 Santa Monica Blvd, Santa Monica, CA
• The Angeles Clinic – Santa Monica, CA
• Kaiser Permanente – San Rafael, CA
• Redwood Regional Medical Group – Santa Rosa, CA
• Los Robles Hospital – Thousand Oaks, CA
• UCLA Oncology Santa Clarita – Valencia, CA
• Norwalk Hospital – Norwalk, CT
• Hematology-Oncology Associates of Boca Raton – Boca Raton, FL
• Memorial Breast Cancer Center – Hollywood, FL
• Memorial Breast Cancer Center – Pembroke Pines, FL
• South Miami Gynecologic Oncology Group – South Miami, FL
• H. Lee Moffitt Cancer Center – Tampa, FL
• Tampa General Hospital – Tampa, FL
• Atlanta Hematology/Oncology – Atlanta, GA
• Peachtree Oncology-Hematology – Atlanta, GA
• Great River Hematology & Oncology – West Burlington, IA
• Block Center for Integrative Medicine – Skokie, IL
• Michiana Hematology Oncology – Westville, IN
• Kansas City Cancer Center – Shawnee Mission, KS
• Anne Arundel Hospital – Annapolis, MD
• Harbor Hospital – Harbor Cancer Center – Baltimore, MD
• Medical Oncology – Chevy Chase, MD
• Maryland Oncology & Hematology – Columbia, MD
• Cancer Care Associates, Rose Cancer Center – Royal Oak, MI
• Hematology-Oncology Consultants, Rose Cancer Center – Royal Oak, MI
• Oakland Medical Group, Rose Cancer Center – Royal Oak, MI
  
  ** PCHS – Botsford Hospital Medical Center – Farmington Hills, MI
  ** PCHS – Huron Medical Center – Port Huron, MI
• Fairview Southdale Medical Oncology Clinic – Edina, MN
• Minnesota Oncology/Abbott Northwestern Hospital – Minneapolis, MN
• Minnesota Oncology St. Paul Cancer Center/United Hospital – St. Paul, MN
• Bozeman Deaconess Cancer Center – Bozeman, MT
• 21st Century Oncology, Las Vegas, NV
• Columbia Medical Center at New York Presbyterian Hospital – New York, NY
• Weill Cornell Breast Center at New York Presbyterian Hospital – New York, NY
• North Shore Hematology Oncology Associates – Patchogue, NY
• Cancer Specialist of Oklahoma – Oklahoma City, OK
• Lancaster Cancer Center – Lancaster, PA
• Chestnut Hill Hospital – Philadelphia, PA (Drs. Cantor, Biermann and Fellin)
• The Miriam Hospital – Providence, RI
• Vanderbilt Breast Center at One Hundred Oaks – Nashville, TN
• Methodist Hospital – Houston, TX
  
  ** PCHS – Texas Oncology, Austin, TX
  ** PCHS – MD Anderson, Houston, TX (with 3 days notice)
• Virginia Cancer Specialists – Fairfax, VA

A cold cap starter kit is now available. Created by a former cap "helper," this is one-stop-shopping for those who don't want to have to search for all the needed supplies. Click here to download the PDF.

1.  Use only cool water in shower 

2.  Wash hair no later than 3 days before and no sooner than 3 days after chemo 

3.  Use a gentle shampoo with ph similar to that of the hair in the 4.5 to 5.5 range. Use clear shampoos, not "milky" or "creamy" ones.

4.  Do NOT use products that say moisturizing or volumizing, or that are opaque (rather than clear). Such products may coat the hair and keep oxygen from reaching the hair follicles

5.  Use a detangling spray such as Kenra® Classic Daily Provision* (spray-on conditioner) rather than a regular conditioner. Again this helps keep the hair follicles from being coated

6.  Make the transition to these new hair care products as soon as possible before chemo starts, as it may take 2 weeks or more to fully clean old product residue off the hair

7.  Coloring hair is not recommended until 3 months after chemo is finished, because the follicles still need time to recover from the trauma of chemo

8.  Keep hair straight down during chemo; do not bunch or pile on top of your head

9.  Don’t pull on the roots

10.  Hold hair when combing so not to strain the roots

11. Sleep on a satin pillow case

12.  Do not use curling irons, electric rollers, or hot air hair dryers

13.  DRINK AS MUCH WATER AS POSSIBLE DURING CHEMO DAY

14.  Use adhesive-backed moleskin**, cut to the shape of the forehead, to protect skin when cold caps are on

15.  Have warm blankets, an electric blanket, or heating pads on hand to use, especially during and right after each cap change

16.  Sit in a chair without a high back – otherwise working at the back of the head during cap changes is difficult

17.  Use a travel-type neck pillow to support your head/neck during chemo

18.  Find out if you can have lab work done the day before chemo, because this shortens chemo day waiting time considerably

19.  Find out if you can call in and request to have your chemo order sent up from the pharmacy before you leave home the morning of chemo – saving you up to an hour

20.  Be sure to change the hair part line with each session of chemo. It helps to protect the scalp

*Click here to find a location in your area that carries Kenra Professional™ hair care products.

**Moleskin Plus is a Dr. Scholl’s product that can be found in any drug store. Purchase the padding roll so you can cut it to the size needed for your forehead

Dignitana, a Swedish company, has begun clinical trials of its DigniCap at the University of California at San Francisco (UCSF) and Wake Forest University. At this time Dignicaps are not available to other U.S. patients. The Dignicap system involves circulating a very cold gel through a single tight fitting cap which is worn for the duration of the chemotherapy session, as well as for a period of time before and after chemo. For more information go to www.dignitana.com.

The doctors conducting this trial published a paper in March 2011 concluding that scalp cooling does not pose a risk for scalp metastases. Read the report here: http://ecancer.org/news/1632

To view research and results for the cold caps that Shirley successfully used, please visit the official website of Medical Specialties of California.