Cold cap chemotherapy in London — where, how much, does it work?
Scalp cooling now preserves hair in more than half of London chemotherapy patients. Here is where to get it, and what to expect.
Dr. Amara Okafor
Consultant Trichologist · Harley Street
In short
- 50–70% hair preservation with taxane regimens.
- Paxman and Dignicap systems widely available on NHS.
- Extends chair time by 90 min per infusion.
- Best results when started at first infusion, not later.
Scalp cooling reduces blood flow to hair follicles during chemotherapy infusion, cutting drug uptake and preserving hair. It's now routine at every major London oncology centre and available privately.
Where in London
- NHS: UCLH, Royal Marsden, Guy's, King's, Imperial, Barts
- Private: HCA hospitals, Cromwell, London Bridge
- Community: some breast cancer services in outer boroughs
How well it works
Depends heavily on regimen. Taxanes (docetaxel, paclitaxel): 50–70% preservation. Anthracyclines (doxorubicin, epirubicin): 30–50%. Combined AC-T regimens: variable. Newer targeted therapies: often no hair loss to prevent.
Practical tips
- Start at first infusion — retrospective addition doesn't work
- Long hair: braid loosely, no tight bun
- Wash hair gently, no chemical services during course
- Expect thinning even with success — total preservation rare
- 3-week fitting appointment strongly recommended
Frequently asked
Common questions
Does it hurt?+
Cold for first 15 minutes; tolerable for most. Paracetamol helps.
Is it safe?+
Yes — decades of data. Small theoretical risk of scalp metastases in some cancers; discuss with oncologist.
Does the NHS charge?+
No — free where offered.
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