Management of Chemotherapy-Induced Alopecia With Scalp Cooling

The document reviewed the use of scalp cooling to manage chemotherapy-induced alopecia, a common side effect of chemotherapy. Scalp cooling, used since the 1970s, had limited use in the US due to safety concerns, particularly the risk of scalp metastases. However, two recent US prospective studies supported its efficacy and safety, especially for taxane-based chemotherapy regimens. The US FDA cleared two scalp-cooling devices, and various cold caps were available for rental. Adverse effects included scalp pain, headache, and chills but were generally tolerable. Retrospective data indicated a low incidence of scalp metastases, suggesting that safety concerns should not hinder the use of scalp cooling. Logistic challenges included device availability, insurance coverage, and integration into infusion center workflows.