Cold Caps During Chemo: How They Work and Why to Ask About Them

I stitched a video from a patient who shares her cancer treatment online as CarrieBeatsCancer, and she was singing the praises of her cold cap. Thank you for sharing, Carrie.

So what is a cold cap, and why would a patient be that enthusiastic about one?

Many of you know that with chemotherapy, a lot of patients lose their hair, and it's an absolutely devastating side effect.

The reason is how these drugs work. The job of many chemotherapy agents is the indiscriminate targeting of rapidly dividing cells. Your hair follicles are rapidly dividing cells too, so they end up getting targeted.

A cold cap is a device that's placed over your scalp. It's cold, and the cold reduces blood flow to the area.

Less blood flow means the chemotherapy isn't circulating in that area as much, so less of it reaches the follicles.

It isn't a guarantee, and results vary from person to person and with the chemotherapy being used. But for a side effect patients dread this much, that's a meaningful difference.

Unfortunately, cold caps aren't an option for everybody. Whether you're a candidate really depends on:

• The type of cancer you have
• Your overall health
• What type of chemotherapy you're getting

That's a decision to make with your doctors, not from a video. But it's definitely worth a conversation with them to see whether you're a candidate.

Cold caps are sometimes covered by insurance. Not always. But that's worth a conversation as well, because you may end up getting it covered.

Update (2026): Coverage has been expanding since this video was recorded. According to the American Cancer Society, Medicare began covering automated scalp cooling systems on January 1, 2026 (FDA-approved automated systems, not manual frozen caps), some private insurers cover or reimburse them, and some states now require private insurers to cover scalp cooling. Check your own plan before assuming the answer is no.

Here's why a plastic surgeon is talking about a chemotherapy side effect.

If there are things we can do as clinicians that lessen the aftermath, I think we should be doing them. It's the same reason I insist that how a reconstruction looks is part of the job. Getting you through treatment comes first. What you live with afterward still counts.

Unfortunately, a lot of doctors don't mention cold caps to patients, even when they're a candidate.

So make sure that you advocate for yourself. If you're facing chemotherapy and nobody has brought it up, ask:

1. Am I a candidate for a cold cap, with my cancer and my chemotherapy?
2. Is it covered by my insurance?

• Chemotherapy targets rapidly dividing cells, and hair follicles get caught in that
• A cold cap cools the scalp, reduces blood flow, and limits how much chemotherapy reaches the follicles
• Many patients keep 50% or more of their hair
• Not everyone is a candidate. It depends on your cancer, your overall health, and your chemotherapy
• It's sometimes covered by insurance, and coverage has been improving
• Many doctors don't bring it up, so ask

Hair loss isn't always preventable, and chemotherapy isn't its only cause; surgery itself can trigger temporary shedding. But when there's a tool that can lessen what you carry out of treatment, you deserve to at least be told it exists.