Efficacy of Scalp Cooling System Versus Chemical Cooling Cap in Preventing Chemotherapy-Induced Alopecia in Breast Cancer: A Prospective Randomized Trial

April 2026 in “ The Breast ”

Jie Zhang, Lize Wang, Yingjian He, Hongjuan Sun, Jiaxiaopan Niu, Mengcai Duan, Chao Miao, Jinfeng Li, Wei Cao, Xing Wang, Xinguang Wang, Yang Yang, Zhaoqing Fan, Xinying Yu

scalp cooling system chemical cooling cap chemotherapy-induced alopecia CIA anthracycline alopecia breast cancer hair loss chemotherapy hair loss cooling cap

TLDR Both scalp cooling and chemical cooling caps effectively prevent hair loss in breast cancer patients undergoing chemotherapy.

The COHAIR study, a prospective randomized trial, compared the efficacy of a scalp cooling system and a chemical cooling cap in preventing chemotherapy-induced alopecia (CIA) in 152 breast cancer patients. Results showed that hair preservation success rates were 74.5% for the scalp cooling system and 71.2% for the chemical cooling cap, with both methods demonstrating good tolerability. While scalp cooling was more effective during early anthracycline treatment, the chemical cooling cap resulted in lower anxiety scores and better quality of life (QoL). Disease-free survival was similar between the two groups.

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3 / 3 results

research Scalp Hypothermia as a Preventative Measure for Chemotherapy-Induced Alopecia: A Review of Controlled Clinical Trials

37 citations , October 2017 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

Scalp cooling effectively reduces hair loss from chemotherapy.

research Chemotherapy-Induced Alopecia Management: Clinical Experience and Practical Advice

48 citations , February 2017 in “Journal of Cosmetic Dermatology”

The conclusion is to use scalp cooling, gentle hair care, and treatments like minoxidil for managing hair loss from chemotherapy, and stresses the need for more research and collaboration in this area.

research Chemotherapy-Induced Alopecia: Emotional Distress and Mitigation Strategies

155 citations , March 2009 in “Seminars in Cutaneous Medicine and Surgery”

Scalp cooling might reduce hair loss from chemotherapy, but evidence is weak and other treatments are being tested.