Cold Capping

Let me start this by saying I am beyond thankful for cold-capping. When I was first diagnosed and my doctors reassured me that I could save my hair, my mind was on much bigger things (my lifespan, enduring treatment, staging, etc.) but as treatment approached I started looking all over Instagram for examples of people who saved their hair. Now that I'm done with chemotherapy I am so glad that I can look in the mirror without being reminded of my disease.

I get a lot of questions about cold capping from newly diagnosed women, so I'll do my best to answer those here. If you have other questions please feel free to email me at

How does cold capping work?

I’ll let the professionals take this one… “Cold caps and scalp cooling systems are tightly fitting, strap-on, helmet-type hats filled with a gel coolant that’s chilled to between -15 to -40 degrees Fahrenheit…. Cold caps and scalp cooling systems work by narrowing the blood vessels beneath the skin of the scalp, reducing the amount of chemotherapy medicine that reaches the hair follicles. With less chemotherapy medicine in the follicles, the hair may be less likely to fall out.”

How much hair did you lose?

I probably only lost about 15% of my hair. It started coming out during my third round of treatment went I switched to the automatic cap. I didn't have any bald spots to cover because it came out all over in individual strands.

Did you lose your eyebrows and eyelashes?

I probably lost 70% of my eyelashes and I didn't lose them until the last couple rounds of chemo. I don't think my eyebrows thinned too much, but it's hard to tell because I microbladed them (with Amber Garton at ZO in Dallas) before I started treatment just in case!

Does cold capping hurt?

It was pretty tough but not as excruciating as I expected. The best piece of advice I got was to ask the nurses for Ativan during treatment to help with the pain. It made a huge difference for me.

What did you do to take care of your hair during cold capping?

I read online that I should use ph-balanced shampoo during cold capping so I washed my hair with Briogeo and rinsed with cold water. I only washed my hair once every 4 days because most of my shedding happened after washing my hair. I used a wet brush throughout treatment to avoid pulling on my hair follicles. I avoided caffeine as well because I read that contributes to hair loss during chemo.

Did you style your hair during treatment?

I always let my hair air dry. I used a curling wand to style my hair during treatment since it doesn't pull or add heat to the hair follicles. As my hair thinned throughout treatment I added in a halo extension when I went out. Unlike clip-in extensions they don't pull on your hair or distress the scalp/hair follicles.

What brand of cold cap did you use?

I used Chemo Cold Caps and absolutely loved my experience with them. These are "manual" cold caps, meaning you have to take a cooler full of dry ice and caps into the hospital and have someone monitor the temperature and change them out every few minutes. It is a lot of work!

Half way through my treatment my hospital got automatic cold caps. I was so excited! This meant I could come in and put one cold cap on and have a machine regulate the temperature of the cap for the duration of my treatment. The temperatures were much higher than the manual caps and it didn't require any extra work. Unfortunately, these didn't work quite as well for my hair. The round I used the automatic caps I experienced more hair loss, so I switched back to Chemo Cold Caps.

Shout out to Xavier and my mom for putting in the hours of work it took to keep my hair! Xavier had to pick up pounds of dry ice every Thursday before my treatments and wake up at 5 in the morning to start freezing my caps! He and my mom monitored the temperature of my caps during chemo and worked together to trade them out. I am so thankful.

When did you start coloring your hair again?

I colored my hair and added in tape-in extensions 10 weeks after treatment. I waited until I didn't notice any more shedding!

What kind of chemo did you do?

My cancer was Her2+, so I had a THCP regimen. This is one of the best combinations for cold capping. For whatever reason, cold caps seem to work especially well with this regimen.

I hope this is helpful to you! For me, cold capping was absolutely worth the cost, time, and discomfort. I'm so thankful that during treatment I was able to live my life as best I could without strangers knowing what I was going through. Now that I'm done with chemo I can move on with my life without a constant visual reminder that I've been to hell and back this year!

hilary schleier