# Hair loss and scalp cooling with breast cancer chemotherapy

Source: https://onco.cc/terms/hair-loss-and-scalp-cooling-breast/  
OnCo record `hair-loss-and-scalp-cooling-breast` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Taxane and anthracycline chemotherapy for triple-negative breast cancer causes hair loss in most people, usually starting after the first or second cycle and almost always growing back; scalp cooling kept more than half the hair in about half of women in a randomised trial and is offered in many UK units.

## Summary

In the SCALP randomised trial (Nangia 2017, JAMA) 50.5% of women cooled during taxane, anthracycline or both kept more than half their hair after the fourth cycle against 0% of controls. In the DigniCap cohort (Rugo 2017), which excluded anthracycline regimens, 66.3% kept at least half their hair. Macmillan says hair loss usually starts after the first or second treatment, that eyebrows and eyelashes can go too, that a wig is best fitted before treatment starts, and that hair usually starts to grow back after treatment, sometimes different in texture or colour. This is orientation from public patient pages and guidelines, not advice for your case: your own team's instructions and 24-hour number come first.

## Fields

- Kind: Term
- Last checked: 2026-09-24
- Also known as: chemotherapy hair loss; cold cap

## Sources

- Nangia et al., scalp cooling device and alopecia in women having chemotherapy for breast cancer, SCALP randomised trial (JAMA 2017): https://doi.org/10.1001/jama.2016.20939
- Rugo et al., scalp cooling and alopecia after chemotherapy for breast cancer, DigniCap cohort (JAMA 2017): https://doi.org/10.1001/jama.2016.21038
- Macmillan: hair loss: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/hair-loss
- Macmillan: sacituzumab govitecan: https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/sacituzumab-govitecan

## Connected records

- cancers: [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [Scalp cooling (cold caps: DigniCap, Paxman)](https://onco.cc/technologies/scalp-cooling/)
- drugs: [Epirubicin](https://onco.cc/drugs/epirubicin/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/), [Sacituzumab govitecan](https://onco.cc/drugs/sacituzumab-govitecan/)

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