Approximately 65% Achieve Positive Results with Scalp Cooling: Cooling Caps Protect Hair During Cancer Treatment

Can Chemotherapy-Induced Hair Loss Be Reduced? The Hope of "65% Success" in Scalp Cooling and the Conditions Behind the Numbers

Seeing a different reflection in the mirror. Being asked about an illness you never intended to explain at work or in the neighborhood. Hair loss from chemotherapy is not just about the amount of hair. The change in appearance also affects daily life and interactions with others.

As a way to alleviate this burden, there is "scalp cooling," which involves cooling the scalp with a special cap during treatment.

On October 2, 2026, Germany's AD HOC NEWS reported that approximately 65% achieved a satisfactory appearance with scalp cooling. While this number offers hope, a review of the original conference abstract reveals conditions not apparent from the headline alone.

The "65%" Does Not Mean Everyone's Hair Is Protected

At the European Academy of Dermatology and Venereology (EADV), Spyridon Kostaras and colleagues presented a retrospective analysis of medical records involving 468 breast cancer patients.

Of the 468 patients offered scalp cooling, 414 chose to use it. Among them, 225 completed the treatment as planned, while 189, or 45.7%, discontinued midway.

The notable 64.9% refers to the result where 74 out of 114 patients, who were evaluated based on photos and a five-point scale, were judged as "good" or "very good" among those who completed the treatment.

In other words, it is not the success rate for all who started, nor the percentage of those who experienced no hair loss at all. Reasons for discontinuation included inability to tolerate hair loss or the cold.

While some can feel the effects, others find it difficult to continue. This study lacks a randomly assigned non-cooling comparison group, and the evaluation only covers a portion. The individual success rate cannot be predicted from this number alone.

Why Does Cooling the Head Reduce Hair Loss?

Scalp cooling is not a method to treat cancer itself but a supportive therapy to mitigate the side effects of chemotherapy.

The U.S. National Cancer Institute (NCI) explains that by lowering the temperature of the scalp and constricting blood vessels, the amount of chemotherapy drugs reaching the hair follicles is reduced. The specialized equipment circulates a cooling liquid in a cap fitted tightly on the head, cooling it before, during, and after the drug administration.

There have been studies supporting its effectiveness. In a randomized trial involving breast cancer patients introduced by NCI, about half of the cooling group fell into the "no hair loss or less than 50% hair loss" category after four cycles of chemotherapy, whereas all 47 in the non-cooling group experienced more than 50% hair loss.

The evaluation criteria of this study differ from the current "good appearance" assessment. Numbers from different studies cannot be directly compared as the same success rate. Nonetheless, the fact that some can reduce the degree of hair loss provides a basis for considering scalp cooling.

Choose After Confirming the Burden and Suitability

The results of scalp cooling vary depending on the type and dosage of chemotherapy drugs, as well as the fit of the cap. The American Cancer Society explains that treatments involving anthracycline drugs may have reduced effectiveness.

Cold-induced discomfort, headaches, and nausea can also occur. Cooling requires time beyond the infusion, affecting the schedule and the burden on companions on treatment days. The necessary time varies by drug and equipment, making individual confirmation essential.

Additionally, it is not recommended for blood cancers like leukemia and malignant lymphoma, or certain conditions related to cold stimuli. Whether it can be used depends on the judgment of the treatment team.

The desire to reduce hair loss and the desire not to increase the burden are both natural. Being able to consult about changes or discontinuation when it becomes difficult can also make the choice easier.

Not Only Success Stories on Social Media

On the breast cancer community of the overseas bulletin board-style SNS "Reddit," there is a public thread asking those who did not choose scalp cooling or stopped midway about their reasons.

There are posts stating that continuing cooling left about 60% of their hair, and it was worth the cost. On the other hand, some posts mention that despite cooling, much hair fell out, and the long hours increased stress on treatment days, leading to discontinuation.

There were also voices that did not choose it from the start, considering the additional time and discomfort, and did not regret that decision.

The posts summarized here are in Japanese and not direct reactions to this news. The medical history and degree of hair loss are self-reported by the posters, and this is not data verifying treatment effects or a survey representing the opinions of all patients.

Still, it conveys decision-making factors that are hard to see from numbers alone. Even if the same amount of hair remains, some find it a great support. Others feel the time and discomfort weigh more heavily. It's natural for choices to differ based on what the individual values.

Available in Japan, But with Differences in Cost and Acceptance

Scalp cooling is not just a story from distant overseas.

The National Center for Global Health and Medicine offers scalp cooling to those undergoing chemotherapy before and after surgery for breast and gynecological cancers. The listed fees are for non-insured medical services, with a cap rental fee of 8,250 yen per session and equipment usage fee of 17,050 yen per session, totaling 25,300 yen per session.

This is an example from the center and not a nationwide uniform fee. The center also notes that the days and slots available for use are limited, and requests may not be accommodated.

Therefore, it's not just about checking if the equipment is available. It's necessary to confirm whether it can be used for your treatment, whether it can start on the desired date, and what the total cost will be.

Overseas, there are systems in place to support usage from a cost perspective. West Virginia's law mandates coverage for scalp cooling related to chemotherapy for applicable insurance contracts issued or renewed after January 1, 2027. However, deductibles and co-payments may be set, meaning it is not entirely free.

Even if effective equipment exists, if it cannot be used due to costs or reservation slots, it is not a practical option. When considering widespread adoption, ease of use is as important as the performance of the equipment.

Things to Discuss Before Treatment

The American Cancer Society explains that if choosing scalp cooling, it should be done from the first chemotherapy, before, during, and after administration. If desired, it's best to consult before starting treatment.

The contents to confirm are as follows:

• Whether it can be used for your illness and medication, and what level of effectiveness can be expected
• How much longer each visit will take
• How much it will cost over the entire treatment period, including cap fees
• How they will respond if headaches or coldness become unbearable
• Whether there are consultation points for wigs, hats, and changes in appearance if hair loss occurs

For Those Who Want to Protect Their Hair and Those Who Do Not Choose Cooling

"Wanting to protect one's hair" does not mean not facing treatment. It can be tied to the hope of working in a familiar appearance, interacting with children, and deciding for oneself who to tell about the illness.

At the same time, not choosing scalp cooling or stopping midway is also an important decision for the individual. Those for whom the effect was insufficient should not feel a lack of endurance or effort.

The "about 65%" is one result indicating the possibility of maintaining hair. If conveying that possibility, it is important to also share who the numbers evaluate and what burdens are involved.

Supporting medical care for cancer treatment requires a perspective that supports the daily life the individual values, along with life-saving treatment.

Source URL

1. AD HOC NEWS:
   Introducing clinical reports on scalp cooling and movements regarding usage and cost burden.
   https://www.ad-hoc-news.de/wissenschaft/chemotherapie-und-haarausfall-kopfhautkuehlung-erzielt-bei-65-prozent/70217755

2. EADV Congress 2026, Abstract 4378: Primary Source of the Study
   Analysis of 468 breast cancer patients. Of the 414 who started, 189 discontinued, and 74 out of 114 evaluated by photos had good results.eadvdistribute.m-anage.com
   https://eadvdistribute.m-anage.com/from.storage?image=D1sNQbkNJ-1GueSF7ZEalq7AcYMLcJFrXCeAPyqKQ-990LOz1Kv5yD2zjz63bnLQ0

3. U.S. National Cancer Institute (NCI): Mechanism and Past Clinical Trials
   Referencing the mechanism of scalp cooling and trial results for breast cancer patients. As the article is from 2017, insurance information from that time is not used for current explanations.NCI
   https://www.cancer.gov/news-events/cancer-currents-blog/2017/fda-cooling-cap-chemotherapy

4. American Cancer Society: Patient Guide on Scalp Cooling
   Confirming usage methods, precautions regarding suitability, conditions affecting effectiveness, and side effects.American Cancer Society
   https://www.cancer.org/cancer/side-effects/hair-skin-nails/hair-loss/cold-caps.html

5. Reddit "r/breastcancer": SNS Experiences
   Referencing reasons for not choosing scalp cooling, experiences of discontinuation, and posts stating it was beneficial to continue. Not used for medical effect evaluation.reddit.com
   https://www.reddit.com/r/breastcancer/comments/1td7wx1/people_who_decided_against_cold_capping_or_quit/

6. National Center for Global Health and Medicine: Introduction and Fee Example in Japan
   Confirming target patients, fees for non-insured medical services, and usage restrictions.hosp.jihs.go.jp
   https://www.hosp.jihs.go.jp/cancer/024/index.html

7. West Virginia Law §33-16-20: Insurance Coverage Regulations
   Confirming mandatory coverage for applicable contracts after January 1, 2027, and clauses on co-payments.§33-16-20
   https://code.wvlegislature.gov/33-16-20/