For many people undergoing chemotherapy, hair loss is one of the most distressing side effects of treatment. While doctors and nurses focus on treating the cancer itself, patients often feel the emotional impact of losing their hair just as deeply.

Hair loss can make someone feel visibly ill. It can affect self-esteem, privacy, identity, and control during an already overwhelming time. As caregivers, understanding why this happens — and what options exist — can make a meaningful difference in supporting a loved one.

Why Does Chemotherapy Cause Hair Loss?

Chemotherapy works by targeting rapidly dividing cells. Cancer cells typically divide quickly, which is why chemotherapy is effective against them. However, cancer cells are not the only fast-growing cells in the body.

Hair follicles — the tiny organs in the scalp that produce hair — are also rapidly dividing. Under normal conditions, they are constantly growing and shedding hair. When chemotherapy interferes with that process, hair growth slows and often stops. Eventually, hair falls out because the follicles cannot function normally during treatment.

Other fast-dividing cells are affected as well, which explains additional side effects such as:

Low blood counts
Gastrointestinal symptoms
Fatigue

Hair loss is not a cosmetic issue alone. It is a visible reminder of illness, and that emotional weight is significant.

Can Hair Loss Be Prevented?

While chemotherapy-related hair loss cannot always be prevented, there are strategies that may significantly reduce it. The most established approach is scalp cooling.

Scalp cooling works by narrowing (constricting) the small blood vessels in the scalp. This process, called vasoconstriction, reduces the amount of chemotherapy drug that reaches the hair follicles. With less exposure to the drug, the follicles may be protected.

Earlier concerns suggested this method might prevent chemotherapy from reaching cancer cells in the scalp. Research has largely shown that this risk is very low, making scalp cooling a commonly accepted option for appropriate patients.

Two Main Options for Scalp Cooling

1. Cold Caps

Cold caps are gel-filled caps that are chilled before use, often with dry ice. They resemble snug helmets and must be changed every 20–30 minutes to maintain a low scalp temperature.

What to know:

Must be brought to the treatment center by the patient
Require frequent switching during infusion
Typically cost $400–$500 per month
Insurance coverage varies

This option requires planning and often assistance from a caregiver during treatment sessions.

2. Scalp Cooling Machines

Scalp cooling systems, such as those available in many infusion centers, circulate coolant continuously through a fitted cap.

What to know:

Typically available at the hospital or clinic
Provide continuous cooling without manual cap changes
Cost several hundred dollars per month
Insurance coverage varies

Both methods require cooling to begin before chemotherapy starts and continue for at least an hour after treatment ends. This is because chemotherapy drugs continue circulating in the bloodstream even after the infusion is complete.

How Effective Is Scalp Cooling?

Scalp cooling is not 100 percent effective. Results depend on several factors, including:

The specific chemotherapy drugs used
The dose and treatment schedule
Consistency of use

For example, scalp cooling tends to be more effective with taxane-based chemotherapy than with anthracyclines. For newer treatments such as immunotherapy or antibody-drug conjugates, research is still ongoing.

Many patients who use scalp cooling retain enough hair that, to others, they appear to have a full head of hair. Some shedding still occurs, but often far less than without cooling.

The Importance of Consistency

Consistency is critical. Missing even one session of scalp cooling may result in increased hair loss.

Both cold caps and cooling machines must:

Start before chemotherapy begins
Continue throughout the infusion
Extend at least an hour after treatment

Caregivers play an important role in helping patients stay on schedule and prepared.

What Does It Feel Like?

Scalp cooling feels cold — intentionally so. Patients often describe:

Head discomfort during the first 10–15 minutes
Chills or feeling cold overall
The need for warm clothing, blankets, gloves, or sweaters

Planning ahead can improve comfort significantly.

Emotional Impact: More Than Hair

Hair loss is one of the most visible signs of cancer treatment. For many patients, preserving their hair provides:

A sense of normalcy
Greater privacy about their diagnosis
Improved self-esteem
A feeling of control during treatment

Oncology teams recognize that appearance matters. Supporting patients emotionally — not just medically — is essential.

For caregivers, listening without minimizing the distress of hair loss is powerful. Even when the focus is survival, quality of life remains deeply important.

When Is Scalp Cooling Most Commonly Used?

Scalp cooling is frequently considered for patients with early-stage breast cancer undergoing a defined course of chemotherapy. After treatment ends, hair typically regrows.

Breast cancer treatment varies widely depending on subtype, stage, and individual factors. Patients are encouraged to discuss scalp cooling with their oncology team to determine whether it is appropriate for their treatment plan.

Final Thoughts for Patients and Caregivers

Chemotherapy hair loss can feel overwhelming, but options exist. Scalp cooling offers many patients the possibility of maintaining much of their hair during treatment.

It requires preparation, consistency, and sometimes financial consideration. But for many, the emotional benefits are significant.

If you are considering scalp cooling, speak openly with your oncology team. Ask about:

Effectiveness with your specific chemotherapy regimen
Availability at your treatment center
Costs and insurance coverage
What support you will need during sessions

You deserve care that addresses both survival and quality of life.

**About Dr. William J. Gradishar**

William J. Gradishar is Betsy Bramsen Professor of Breast Oncology in the Division of Hematology and Medical Oncology at the Feinberg School Medicine at Northwestern University and a member of the Robert H. Lurie Comprehensive Cancer Center. He is Director of the Maggie Daley Center for Women’s Cancer Care. He has been Chair of the Annual Lynn Sage Breast Cancer Symposium since its inception. His research focuses on the development of novel therapeutics for the treatment of breast cancer.

For more information on how HuMOLYTE can support your gut health during chemotherapy, visit our product page or consult your health care provider.

This blog was reviewed by Dr. Sourabh Kharait.

This blog is for educational purposes only and is not intended as medical advice. Always consult with your healthcare provider before making any changes to your treatment plan, hydration strategies, or diet. The information provided here is based on general insights and may not apply to individual circumstances.

Chemotherapy and Hair Loss: What Patients and Caregivers Need to Know About Scalp Cooling