Scalp cooling may prevent up to half of hair loss for patients receiving chemotherapy for breast cancer, according to a study published in JAMA.1

Alopecia is a common adverse event associated with chemotherapy, particularly anthracyclines, and may contribute to worse overall quality of life. Scalp cooling may mitigate this side effect, though the safety and efficacy of this method was previously unverified.

For the randomized SCALP trial (Scalp Cooling Alopecia Prevention; Identifier: NCT01986140), researchers evaluated data from 142 evaluable participants who underwent 4 cycles of chemotherapy for breast cancer. Treatment success was predefined as grade 0 or 1 alopecia; grade 2 was considered failure. The scalp was divided into 6 sites, and hair loss was recorded for each patient on each site.

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Of 95 patients who received scalp cooling, 48 had successful hair preservation, compared with 0 among patients who received no scalp cooling. Thirty-five of the 48 cases of hair preservation occurred at site 2.

No differences in quality of life were found. Patients in both groups who received anthracyclines were more likely to have alopecia than those who received taxanes.

RELATED: Targeted Therapies Associated With Increased Alopecia Risk

The authors noted that the successful preservation of particular sites over others suggests that physicians must be adequately trained to place the cooling system properly. More research is necessary to determine the conditions under which this tool will be effective for particular patients.

Scalp cooling systems are not reimbursed by insurance companies, and may cost patients up to $3000.


  1. Nangia J, Wang T, Osborne C, et al. Effect of a scalp cooling device on alopecia in women undergoing chemotherapy for breast cancer: the SCALP Randomized Clinical Trial. JAMA. 2017;317(6):596-605. doi:10.1001/jama.2016.20939