Tips for Making Chemotherapy Cooling Caps Work for Natural Hair

When Nanetta Bailey, 72, was diagnosed with breast cancer, she heard only two words: Hair loss.

“I wasn’t listening to anything else, because I was so upset,” says Bailey. “I knew I’d never be one of those warriors who proudly wear their bald head. Kudos to them, but that’s not me.”

A quick search on the internet revealed that scalp cooling, a relatively new technology, could stop or slow chemotherapy-induced alopecia (CIA) baldness caused by cancer medications. The catch? Nobody knew if it worked as well for kinky, coiled, or bulky hair, like Bailey’s.

“The lack of data for African American patients with natural hair was disheartening, and made me angrier than my diagnosis,” says Bailey.

Bailey selected a scalp cooling company anyway. Twelve weeks later, she emerged from her chemotherapy with her identity, her privacy, and her hair intact.

“I didn’t look like a cancer patient, and that was what I’d been so afraid of,” says Bailey.

Scalp Cooling

Scalp cooling technology relies on a snug-fitting gel cap or ice cap to deliver super-low temperatures to the skin. The cold temperature slows blood flow to the hair follicles, preventing chemotherapy drugs, which are notorious for causing hair loss, from reaching them. Research suggests that it can be effective in reducing hair loss during chemotherapy.

Because it had been primarily tested on straight or European hair, however, how well the technology works for those whose hair is a different “shape, texture, and density” is unknown, according to the National Comprehensive Cancer Network (NCCN).

Among the issues faced by people with natural hair, for instance, are how to get a cap that fits large quantities of hair, and how to get the cool temperature through dense hair to the scalp.

Researchers are now exploring ways to better accommodate coiled, kinky, or tightly curly hair. Until it’s complete, however, those with bulky hair, like Bailey and Nelly Gomez, are adapting their own strategies to yield the best results, and spreading the word.

First, Find Your Company, and Price It Out

Nelly Gomez, 44, who wears her hair natural, vowed she’d never sacrifice her hair to her cancer. She did her research.

The array of hair-cooling options are broadening. So, too, are the “extras” some companies offer, from pre-packed treatment kits to on-site experts. All providers share the singular goal of creating, and maintaining, a lasting chill that reaches as much of the scalp as possible.

“I contacted eight different companies that told me I had to get my own ice, carry it in a special container to each treatment, and train someone to prepare my hair, and that was not what I wanted,” says Gomez.

Instead, she found a that DigniCap cooling provided everything, including a trained aide to assist with hair preparation. The convenience came at a cost of roughly $6000.

That’s not unusual. Depending on the duration of treatment and the availability of local resources, the price for a course of scalp-cooling treatment can range from a few thousand dollars to the low five-figures.

Insurers rarely reimburse these “cosmetic” procedures, but the national nonprofit HairToStay subsidizes some eligible individuals.

Both Gomez and Bailey ended up paying the bill themselves or with help from crowdfunding.

Tips for Natural Hair Before Treatment

Achieving that requires advance planning and some specific rituals, say women in the know.

Among them:

The Day Before

• Remove hair extensions, synthetic braids, dreadlocks, twists, cornrows, weaves, and lace front wigs, which can block access to the scalp.
• Gently wash hair with clean products. “Choose sulfate-free products containing as few other chemicals as possible,” says Gomez.
• Air dry hair first; “I like to leave 18 hours between shampooing and the treatment,” says Bailey. Wrap your head in a silk scarf to further diminish puffiness, particularly if hair tends to “grow” while drying.
• Comb with care to reduce bulkiness. Use a super wide tooth comb, a paddle brush, or simply finger comb to break up clumps and reduce bulk.
• Moisturize with a heavy emollient conditioner to further flatten hair.
• Avoid heat unless specifically directed. Drying or pressing hair makes it less resilient.
• Protect your forehead by selecting a soft headband or cotton balls to use during chemotherapy to safeguard hair-free areas of skin.
• Consider painkillers to ease headache and discomfort during treatment. Many hospitals routinely provide the medications.

Immediately Before Treatment

• Drink liquids early to minimize bathroom visits later on, which involve disconnecting from the cooling system. Reconfiguring scalp-cooling equipment can be time-consuming.
• Pack a bag if needed. Include your wide-tooth comb or paddle brush, a towel, a small spray bottle for water, an electric blanket, warm socks, and reading material. Caps can’t accommodate earphones and cooling machines are noisy, so listening to music or watching TV is difficult. Arm yourself instead with abundant reading material — or plan to snooze. “They always give me Benadryl, so I’m out during my treatment,” says Bailey.
• Dress mindfully to allow for an IV line. Choose a short-sleeve top and an extra layer to preserve warmth.

Between Treatments

• Pamper your hair by avoiding chemical processing, harsh hair products, and aggressive brushing. “My natural hair required washing only every other week, so when I needed weekly shampoos, I treated it like gold,” says Bailey.
• Avoid elaborate or too-tight hairstyles that tug on follicles.
• Comb hair conservatively or finger brush to minimize breakage.

After Chemotherapy

Most people — even with scalp cooling — shed some hair and face dry, brittle, and tough hair regrowth. But both Bailey and Gomez consider that a small tradeoff for a big benefit. Both emerged from treatment with their hair largely intact. “All the scary misinformation beforehand almost convinced me this couldn’t work for African American hair, but I’m so glad I tried it,” says Gomez.