Scalp Cooling: A Critical Examination 

Abstract
In this paper the author describes the scientific conceptual framework of chemotherapy-induced alopecia.  This includes the mechanisms of hair growth, the action of chemotherapeutic agents on the hair, how scalp cooling works and how the procedure is implemented.  She critically examines the published literature on scalp cooling efficacy and describes when it should be used and the pros and cons of the treatment.

Keywords
Scalp cooling, alopecia

Background
In this author's experience scalp cooling to reduce chemotherapy-induced alopecia is a controversial issue for many health care professionals.  This may be due to the differences reported in the literature on the success of this procedure, or because doctors and nurses have an inadequate knowledge about scalp cooling.  I remember as a junior staff nurse on one oncology ward finding some strange looking 'caps' in the ward freezer.  Asking what they were, I was told "they are for scalp cooling but they don't work".  Unfortunately, I believed the more senior nurse and never gave this another thought, until I saw the technique successfully used at The Royal Marsden Hospital in Sutton, England, six years later.