Short to medium-term side effects include:
- Cold discomfort (during scalp cooling)
- Headache (during and after scalp cooling)
- Forehead pain (during scalp cooling) caused by pressure and tightness of the cooling cap
- Dizziness or light-headedness (during scalp cooling)
The above side effects are temporary and usually only happen during the scalp cooling process. Patients who are known to be, or suspected of being, affected with either of the two following conditions should not use scalp cooling and the cold cap:
Cold urticaria - an allergic reaction to cold temperature, which results in welts on the skin. There is a risk that scalp cooling could elicit a severe anaphylactic reaction, which can be life-threatening.
Cold agglutinin disease - individuals with this condition have high concentrations of circulating antibodies to red blood cells. There is a risk that scalp cooling could cause the low-temperature binding of these antibodies to the patient’s red blood cells, potentially resulting in haemolytic anaemia.
Longer-Term Side Effects
There is only one known potential long-term side effect. Scalp cooling, when used on patients receiving chemotherapy for breast cancer, could potentially lead to an increased rate of scalp metastases. In summary:
- The evidence all suggests that the risk of getting skin scalp metastasis in women is very low <2.5%.
- It is extremely rare for skin scalp metastasis to be the first single site of recurrence (0.025%).
- Nor is there a difference in survival, between women breast cancer patients undergoing chemotherapy who received scalp cooling and those who did not receive scalp cooling.
- When a patient has scalp metastasis, there are usually other sites of metastatic disease already present.
- The studies performed to date do not show an increase in scalp metastasis in breast cancer patients receiving scalp cooling to prevent chemotherapy induced alopecia.
- The data demonstrates the low risk of scalp cooling in an increased incidence of scalp metastasis and that this risk is outweighed by the clinical benefits to the patient of hair preservation.
For an expert statement on the risk of scalp metastases, please contact us.
Download the 2011 Lemieux paper
Breast cancer scalp metastasis as first metastatic site after scalp cooling: two cases of occurrence after 7- and 9-year follow-up.
Download the 2015 Lemieux paper
No effect of scalp cooling on survival among women with breast cancer.