Prevention of Doxorubicin-Induced Alopecia by Scalp Hypothermia: Relation to Degree of Cooling

In a study from 1982, scalp hypothermia was used to prevent alopecia in 24 patients undergoing chemotherapy with doxorubicin for breast carcinoma. Scalp cooling was achieved using frozen cryogel packs, and scalp temperature was measured to be between 18.5°C and 28.5°C. The study found that to prevent hair loss, scalp temperature had to be reduced to 22°C or below before the injection of doxorubicin and maintained for at least 20 minutes. Of the patients, 42% showed satisfactory hair retention, which was significantly better than the 5% retention rate before the introduction of scalp cooling. The degree of hair loss was dependent on the temperature achieved during cooling, with those maintaining a lower temperature experiencing less hair loss. The study concluded that when using high doses of doxorubicin, reducing scalp temperature below 22°C before injection and maintaining it is necessary to prevent alopecia.