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What Is Cold Capping?

While cold caps and scalp cooling systems differ from manufacturer to manufacturer, all work by narrowing the blood vessels beneath the skin of the scalp which reduces the amount of chemotherapy medicine that reaches the hair follicles. With less chemotherapy medicine in the follicles, the hair is less likely to fall out.  

There are two main types of cooling systems:

Machine scalp cooling systems —Two machine systems, DigniCap and Paxman, have been cleared by the FDA. These systems are leased by hospitals and clinics and are only available where installed. Caps ares attached to a small, computer-controlled refrigeration machine. The refrigeration machine circulates cool liquid in the cap during the entire chemotherapy infusion session, so the cap doesn’t need to be changed like manual cold caps do.  A growing number of cancer centers are offering these systems for patients to rent during treatment. 

Manual cold caps — These caps are not currently FDA approved but have witnessed much success in reducing or eliminating hair loss during chemotherapy.  These cold caps are kept in a cooler with dry ice or in a special biomedical freezer before wearing them. Each cap warms up and thaws while it is worn so it must be replaced it with a new cold cap every 20 to 30 minutes during a chemotherapy infusion session.The major manufacturers that make cold caps include Penguin Cold Caps, Chemo Cold Caps, and Arctic Cold Caps.

The cost of using cold caps or scalp cooling system varies depending on the manufacturer, the number of chemotherapy sessions you have, and the number of months you need to use the scalp cooling method.

Cold caps typically cost about $380 to $450 per month, plus shipping costs and a refundable security deposit in some cases. Scalp cooling systems can cost from $2,000 to $2,200 for a full course of chemotherapy. Some cancer centers also charge a facility fee each time you use their scalp cooling system during a chemotherapy infusion.

Insurance coverage for scalp cooling is not yet standard in the United States, but some people have successfully gotten their health insurance to cover some or all of the cost. Aetna is one health insurance company that considers scalp cooling to prevent hair loss during chemotherapy to be a medically necessary, covered expense (although whether it’s covered depends on your individual health plan). Check with your health insurance company to find out their policies. Also, contact the manufacturer that makes the cold cap or scalp cooling system you plan to use for advice on how to submit a claim to your health insurance company for reimbursement. 

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Penguin is a well established company that has been providing cold caps directly to patients in the U.S. since 2005.  They are reportedly the only company with active clinical trials (for breast cancer.)  According to their website, Penguin cap users have had an average hair retention >80% even with strong regimens of chemotherapy.  Penguin’s latest caps  contain a proprietary Crylon Gel that makes them more malleable and allows them to stay colder for longer. Penguin supplies the cooler, 3 caps and all accessories needed for capping.  Penguin Cold Caps' rental price is $449 per month, with a refundable security deposit of $189 plus shipping cost.

Chemo Cold Caps was established in 2012 after the co-founder saved her hair using Cold Caps. The company uses a trademarked Elastogel cap with an outer insulated cover and a special four-point strap to ensure a snug fit as well as a patented surgical steel cooler.  They provide 6 caps, cooler and all needed supplies for each rental. The cost for Chemo Cold Caps is $425 per month plus shipping one way and with no security deposit.

Arctic Cold Caps started in 2015 and  uses an Elastogel cap and provides 8 caps, cooler and all needed supplies for each client.  Arctic reports  excellent results with the taxanes and a number of other drugs. The rental cost for Arctic is $379 per month, a refundable $379 security deposit and shipping cost.

Wishcaps began in 2013 uses a flexible, high glycerin gel that is covered with a four-way stretch material and allows maximum conformity.  The company states that the caps are up to 85% effective at reducing hair loss during chemotherapy with taxanes.   The company provides renters with 6 caps and all needed accessories. It also has a working relationship with Airgas, a national dry ice supplier.  The cost to rent Wishcaps is $325 per month, a refundable $150 deposit plus shipping costs.

Warrior Caps was founded in July 2016 after its founder successfully cold capped during chemotherapy. The company uses a proprietary cap and provides everything needed for patients to have a successful capping experience. According to the company, Warrior Caps have been used with high levels of success with even the toughest chemo regimens, including AC.  The cost to rent Warrior caps is $350 per month plus shipping and no security deposit.

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