Save Your Hair During Chemo

Cold Cap Therapy during Chemo Treatments

It’s the worst moment in any stylist-client relationship, and it happens way too often. One of the most frustrating aspects when a client undergoes chemotherapy and loses her hair is the helplessness we feel. After all, we're the hair experts, yet there is nothing we can do to help. But maybe there is!

I’m a cancer survivor and so is my daughter. We know what it’s like to go through surgeries, treatments and the emotional roller coaster that goes with it all.

Cold Cap Therapy is common in Europe and now, thanks to an organization called The Rapunzel Project®, it’s gaining attention in this country. Here’s how it works. A patient rents several specially designed, gel-filled caps that are frozen to -30 degrees Celsius. The first cap is placed over the head for 50 minutes before a chemo treatment and is worn for 20 minutes until it cools. Starting with the third cap, the caps are changed every 30 minutes for the duration of the treatment and then for an additional three to four hours afterward, during which time the liver dilutes the strength of the chemotherapy medication in the bloodstream.

According to The Rapunzel Project® Co-Founder, Nancy Marshall, who is also a cancer survivor, the science behind the cap is straightforward. Chemotherapy attacks the body’s fastest-growing cells, and along with the cancer cells, the hair follicles are also killed, which leads to hair loss. The cap constricts the blood vessels in the scalp, drastically reducing the rate at which the chemo drugs reach the follicles. It’s admittedly cold and uncomfortable, but the results are heartwarming. Up to 90 percent of Cold Cap Therapy patients keep their hair!

When Debra Neill Baker, Chief Energy Officer of NEILL, a large Aveda distributor—was diagnosed with breast cancer in 2014—she recalled a friend who had used Cold Cap Therapy as a part of her treatment. Debra knew the emotional boost of keeping her hair would help her endure her cancer treatment so she did Cold Cap Therapy during her chemo. It worked. “The state we’re in emotionally makes a huge impact on our physical health,” explains Debra. “Going through chemotherapy and being able to keep my hair was one less emotional trial I had to go through. It made a difference in how I came through the treatment.”

Cold Caps are frequently used overseas, but here, they’re relatively unknown. And that’s something that Nancy is out to change, for the sake of stylists and their clients. “You can’t make a choice if you don’t know there is a choice,” Nancy points out.

At The Rapunzel Project®, Nancy and Co-Founder Shirley Billigmeier, have been working to raise awareness within the medical community, but they keep hitting roadblocks. “The oncology community has been very slow to get behind this because we live in a very litigious society, and when practices have yet to be FDA approved, it’s very difficult for a lot of doctors to be openly supportive even if they are quietly supportive,” explains Nancy. One of the main reasons the FDA is acting cautiously has to do with a belief that Cold Caps could hinder chemotherapy’s effectiveness. The thinking is that since the Cold Cap prevents hair follicles from receiving the full dose of chemotherapy, the client is at risk for a primary metastasis—or the spread of cancer—to the scalp. However, Nancy notes, 20 years of research conducted by Dr. Hope Rugo, Professor of Medicine at the University of California San Francisco, indicates that there is only about a 2 percent chance of scalp metastasis with Cold Cap wearing breast cancer patients—a rate no greater than the non-Cold Cap using breast cancer patients.

With skepticism preventing progress in the medical community, The Rapunzel Project® has turned to another industry to raise awareness—the beauty industry. “When most people need a wig or need to shave their head, the first person they consult is their stylist,” says Nancy. “The stylist is in a very unique position to provide this information at the single most critical juncture.”

To increase stylist awareness, The Rapunzel Project® has partnered with Kenra Professional. “We feel this subject really resonates with stylists,” says Kenra Professional Artistic Director, Robb Dubré. “It’s devastating to lose your hair while going through chemotherapy. Cold Cap Therapy allows patients to keep their hair, which is so uplifting and gives them more fighting power.” Kenra has also placed The Rapunzel Project® logo, along with the Breast Cancer Awareness ribbon, on all cans of Volume Spray 25. Kenra representatives will also speak to stylists about Cold Cap Therapy during events they will participate in with The Rapunzel Project®.

Debra is all for it. She hopes that more people become aware of Cold Cap Therapy as an alternative to hair loss. After 38 years as a beauty industry leader, Debra understands the power and influence stylists have and hopes they will share their knowledge about this hair loss alternative with their clients. “If only hairdressers could understand how powerful they are and the difference they make—it goes way beyond making someone look good,” she says. “If they could really grasp the influence they have, they could change society. That might sound a bit idealistic, but hey, that’s OK!”

For more information on Cold Cap Therapy and to receive free brochures to display in your salon, contact:

I first posted this article in 2016 BEFORE being diagnosed with breast cancer in 2019 and then my daughter being diagnosed in 2020. I chose NOT to do the cold cap because I didn’t mind losing my hair and I don’t like to be cold (silly) – My daughter, however, DID choose to cold cap during her chemo treatments and reduced the loss of her hair significantly to the point she was able to hide it very well! We are both healthy and happy and CANCER FREE!

We both now try to give back and help those going through cancer by offering reduced price and free hair treatments when possible. I ended up going through quite a bit of further education on the process of non surgical hair replacement and wigs to help those in need as well.

Since the original writing of this article the cold cap therapy has been FDA approved and is used widely in chemo therapy treatments.