'COOL caps' are beginning to come into use – albeit in very limited number – in Spanish hospitals to help prevent patients in chemotherapy from losing their hair.

Already standard in many UK hospitals – brands such as 'Dignicap' are often worn, especially by women – oncologists in Spain are mostly unaware of the availability of 'cool caps' as the focus is more on treating the cancer and relieving the painful and uncomfortable side-effects than on the psychological effects.

'Cool caps' look like transparent silicone swimming caps which are kept at sub-zero temperatures and then placed on the patient's head, covered then with a tightly-fitting skull-cap held in place with a chin strap.

They have 'tubes' running through them, filled with a cold gel, and are attached to a cooling machine to keep them as chilled as possible throughout and after the treatment session.

The aim is to 'freeze' the circulation in the veins in the scalp so that the drug combination, which destroys healthy cells as well as cancerous cells, does not reach the hair follicles.

Some oncologists are unsure about them as they believe it could be risky with the chemotherapy drugs not travelling through the scalp veins, as they may not pick up any microscopic cancerous cells there, but as yet reports do not appear to support any significant increase in the danger of tumour cells being 'left behind' as a result of using 'cool caps'.

Reporters from Spanish media sources spoke to a patient and nurses at the Complexo Hospitalario Universitario in Ourense, in the north-western region of Galicia, who is now halfway through chemotherapy for breast cancer but, thanks to the 'cool cap', has retained her full head of hair.

The 49-year-old, smiling, says having been spared the emotional agony of losing her hair has given her the mental strength to deal with her treatment in a more positive way and that the psychological difference it has made means she also feels physically stronger, less affected by the other side-effects of the treatment.

'Cool caps' can be very uncomfortable, however – some patients describe them as 'like a severe ice-cream headache or brain-freeze', at least for the first 10 or 15 minutes.

They have to be put on before treatment starts, and for some time after the chemotherapy drip is removed as the drugs will still be circulating in the system, meaning appointments are much longer.

It does not work for all chemotherapy patients, although a high number said that even if their hair became thinner or patchy, they still 'looked like themselves' and often did not have to use a scarf or a wig.

According to the UK's breast cancer association, patients' tips for dealing with the 'brain-freeze' include sipping hot herbal tea through a straw from a flask, listening to music on headphones, and wrapping up warm in blankets and heat pads.

They recommend wetting hair before putting the cap on and combing it down flat, so it lies as close as possible to the scalp, since the 'cool cap' needs to be as tight as possible against all areas of the head to prevent patchy hair loss.

The cap needs to fully defrost before being taken off so it does not stick to the hair and pull chunks away with it.

In between chemotherapy sessions, women who had used the cool cap said they tried to wash their hair as little as possible – only once or twice a week at most – pat it dry with a towel rather than rubbing and never using a hairdryer, using warm or tepid water and mild, unperfumed shampoo and conditioner, and being extremely careful when combing it, wet or dry.

Even when the 'cool cap' does prevent hair loss, chemotherapy makes hair dry, straw-like and brittle, tangle easily and with split ends, meaning it needs to be treated with exceptional care and should never be coloured, bleached or permed.

Photograph: YouTube

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