Derm-it Trotter! Don't Swear About Skincare.
Feeling frustrated or overwhelmed with everything skin? Does the skinformation overload make you want to swear about skincare? Join Dr. Shannon C. Trotter, board certified dermatologist, as she talks with fellow dermatologists and colleagues in skincare to help separate fact from fiction and simplify the world of skin. After listening, you won’t swear about skincare anymore!
Derm-it Trotter! Don't Swear About Skincare.
Preventing Hair Loss During Chemotherapy: The Role of Cold Cap Therapy
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Your hair can feel like a small thing until cancer treatment threatens to take it away. We sit down with board-certified hematologist-oncologist Dr. Tiffany Pompa to talk honestly about chemotherapy hair loss, why it happens, and why the emotional impact is often underestimated by everyone except the people living it. We also dig into how immunotherapy differs, why hair loss is usually uncommon with many immunotherapy regimens in real practice, and where the published numbers can be confusing without context.
From there, we get practical about scalp cooling and cold cap therapy: who benefits most, when to start, and what to expect on infusion days. Dr. Pompa explains why taxane chemotherapy such as paclitaxel and docetaxel is a common setting for scalp cooling, especially in breast cancer, gynecologic cancers like ovarian cancer, and lung cancer. We walk through the three FDA-approved systems DigniCap, Paxman, and AMA, including the real-life routine of wearing the cap before, during, and after treatment, plus the most common side effects like headaches, intense cold, and rare frostbite.
Access matters as much as science, so we talk insurance coverage, cost, and advocacy. Dr. Pompa shares how she argues medical necessity, why NCCN guidelines help, what Medicare and Medicaid approval in 2026 changes, and how state legislation can expand coverage. We also discuss manual frozen gel cap options like Penguin caps for patients who need a more affordable workaround, along with the tradeoffs. If you or someone you love is starting chemo, this conversation gives you language, options, and a clear next step: ask early. Subscribe, share this with someone who needs it, and leave a review so more patients and clinicians learn that hair loss prevention is part of quality cancer care.
Welcome And Why Hair Loss Hits Hard
SPEAKER_02And actually, those regimens are used in a lot of different types of cancers, but the big ones that I think about where I discuss the cool cap or cold cap is breast, gynecologic cancers like ovarian cancer. And then the third one is lung cancer. So sometimes it's very easy to remember because that's the first question most patients ask is is this regimen going to make me lose my hair? So far, I haven't had a patient concerned about their hair that was getting like a taxane therapy. I have a lot of gentlemen who are on immunotherapy loan, which as we mentioned earlier, they're not going to see the hair loss. Or I could use a different regimen. Unless you're a patient or physician that takes care of patients with cancer, you don't understand the impact that it has.
SPEAKER_00Welcome to Dermot Trotter, Don't Swear About Skin Care, where host Dr. Shannon C. Trotter, a board-certified dermatologist, sits down with fellow dermatologists and skincare experts to separate fact from fiction and simplify skincare. Let's get started.
SPEAKER_01Welcome to the Dermot Trotter Don't Swear About Skin Care podcast. On today's show, I've got Dr. Tiffany Pompa. She's a board-certified hematologist oncologist that works in Tom's River, New Jersey, and she's passionate just like myself about patient education. Welcome to the podcast, Tiffany. It's great to have you here.
SPEAKER_02Yeah, thank you, Shannon, and I'm happy to be here.
SPEAKER_01Well, we're going to tackle a topic that we sort of share, hair loss, and specifically, you know, with chemotherapy and cold cat therapy, which I think a lot of dermatologists and even patients may not even realize even exists, or what does it really, you know, include? Like what is it, right? So I wanted to kind of just talk about hair loss that we see with chemotherapy. You know, why do patients go through it? And do we see it with newer medications like immunotherapy as well?
Chemo Vs Immunotherapy Hair Loss
SPEAKER_02So when it comes to chemotherapy, so chemotherapy is given IV mostly. It could be given by pill, but basically what it does is it goes throughout your whole body. And by doing so, it actually goes to your scalp and can affect your hair cells. What chemotherapy does is it goes after rapidly dividing cells, which are our cancer cells, but also they could be our hair cells. So that's why hair loss is very common with certain types of chemotherapy. In regards to immunotherapy, so immunotherapy works a little bit different. So think of chemotherapy as knocking down your DNA, affecting the DNA in these cancer cells. When you're doing something like immunotherapy, it actually revs up your immune system to see the cancer. It still goes throughout your whole body, but the interesting thing apart about it is because it doesn't affect the DNA, it doesn't usually affect hair loss. And to be honest with you, when I looked at the literature to prepare for this conversation, it actually said it could go anywhere from 1% to 45%. That's with the immunotherapy. But I will tell you, probably if you take one in three, one in five patients getting treatment in my office, like most of them are getting immunotherapy. And I could say probably in my career since immunotherapy came out, I've maybe had one patient that complained about immunotherapy causing hair loss. Chemotherapy, depending on the type, that's a different story.
SPEAKER_01Yeah, and I feel like too, you know, we don't tend to see it, you know, like a direct, you know, effect with a lot of the immunotherapy like we have with chemotherapy. And but the one thing I think we can agree with, no matter the cause of the hair loss, but especially with our you know cancer patients that are undergoing chemotherapy, boy, can it be devastating. You know, it takes an emotional toll on them where they're already going through so much and trying to, you know, handle the diagnosis of cancer, let alone just how the treatment's gonna make them feel. And if they're getting chemotherapy on top of it, getting hair loss.
Radiation Hair Loss And Scarring Risk
SPEAKER_01What about radiation though? Is that something that you know people experience hair losses, and particularly, I guess, radiation to the scalp or other hair-bearing areas of the body? Do you see hair loss in those patients as well?
SPEAKER_02So you're right. So radiation, that's why I mentioned systemic or throughout the whole body. So radiation is usually localized or pinpoint. So unless you're hitting the scalp, which is the hair most people are concerned about, or you know, then you would you would say, hey, when it hits the scalp, yes, you're gonna have hair loss. So it's more localized as opposed to chemotherapy, which goes throughout your whole body.
SPEAKER_01And I think the radiation that I've seen a lot of patients, the downside is sometimes that hair loss is scarring. You know, those hair follicles don't come back, and it can be quite devastating for patients where there isn't a lot maybe potentially to do on the prevention side. But I think that's what's exciting though, if we look at you know, chemotherapy and potentially, you know, cold cap therapy, which we're gonna get into a little bit more, I know, here in a moment.
Who Loses Hair And Why
SPEAKER_01Do you know, like, you know, from your standpoint, if you have a patient coming in, you're getting ready to think about a chemotherapy regimen for them, are there risk factors or predictors sort of in your mind with their likelihood of getting hair loss with their treatment?
SPEAKER_02Yes. So it actually comes down to one, what type of chemo you're using, two, if you're using combination chemotherapy. So instead of one medicine, you're using two. The other thing is how much treatment they're getting, what the intervals are in treatment. And also, interesting enough, I found that the younger you are is actually a higher predictor of hair loss, which I found very interesting. Then other things could play a part too, like genetics, nutritional factors, but really when it comes down to the chemotherapy part, it's really about the brand or the type that you're using. But also if you're using combination chemotherapy regimens.
SPEAKER_01And specifically, because we want to talk about kind of you know, cool cap therapy, what person, you know, walks through, because I think a lot of people might say, oh, I have colon cancer, can I do cool cap therapy? Or I have breast cancer. Like, who in your mind that, you know, can you talk to? They like, you know, cool cap therapy is really designed for this cancer patient with this type of chemotherapy regimen.
Best Candidates And Who Should Not
SPEAKER_02So actually, the the type of chemo that comes to mind is something called taxanes, such as Paclitaxel or DOC Taxal. And actually, those regimens are used in a lot of different types of cancers, but the big ones that I think about where I discuss the cool cap or cold cap is breast, gynecologic cancers like ovarian cancer, and then the third one is lung cancer. Those are the three big ones. And usually taxanes regimen taxane regimens are the most common culprits when it comes to hair loss.
SPEAKER_01And then I I guess kind of on the flip side, you know, the the you know, lymphoproliferative disorders, or, you know, for you know, our listeners out there, you know, just what they think of maybe like a blood cancer, why aren't they good candidates for talking about potentially prevention or cold cap or cold cap therapy?
SPEAKER_02So when you're talking about things like leukemia or lymphoma, the problem with those types of cancers is it's in the blood. So what a cold cap does is it actually prevents blood flow to the scalp. So the fear is that some of those cancer cells will become untouched by the chemotherapy because they're residing in a place that's like a sanctuary where they're hidden from the treatment because the cold cap is preventing blood flow to that area, hence preventing the treatment from getting there. So as of now, there's been no approval to use the cold cap in that kind of setting.
SPEAKER_01It's kind of a fascinating, you know, treatment on how I think that actually works. I think, you know, scalp cooling, I don't know, it's just you know, lowering that temperature, you know, and just really kind of you know reducing that risk of potential hair loss.
When To Start Scalp Cooling
SPEAKER_01If you have a patient then you're looking at, you know, putting on a regimen, if they do have, you know, breast or potentially gynecologic cancer or lung cancer, is this a conversation you're having like right out the bat with them? Is this something that's done right along with their treatment, or when is this actually kind of put into place?
SPEAKER_02So sometimes it's very easy to remember because that's the first question most patients ask is is this regimen going to make me lose my hair? So it's a common conversation. I also in my office do chemotherapy teaching sessions. So if I miss it, my nurse will go over it. And the very interesting thing about breast cancer is it's actually part of our recommendations in regards to our comprehensive network guidelines that we follow. It actually says in there cold cap therapy. So it's something that every oncologist, especially when it comes to breast cancer, is going to discuss. But anytime I'm using a taxane, I discuss it because I know that it could get approved.
Insurance Coverage Cost And Quality Of Life
SPEAKER_01So you mentioned approved. So that's probably the a lot of people are wondering, okay, this sounds good that this might actually work. And we'll talk more, you know, maybe about the process. But when you mention approved, how is the insurance coverage? I mean, are people getting this typically covered or is it something they're often paying out of pocket for?
SPEAKER_02So since this year, so in 2026, they actually allowed approval for Medicare and Medicaid. And also, we're trying to get a lot of the states on board. New York's on board, Louisiana's on board. I think Maryland's another one we're getting with getting people approval. But I'll tell you what, Shannon, I don't like to call it a fight, but I think of it that way because that's what gets me ready for it. But I don't mind a good discussion or a good fight with the insurance company to get my patients approved, especially if it's going to improve their quality of life while they're on therapy.
SPEAKER_01Yeah, because I I mean I don't know there's studies to show this, but I'd be curious to see, you know, and again, it'd be hard maybe to have two groups, those that get it and those that don't, how it might impact outcomes, you know, potentially even independent of their treatment regimen. How does it enhance quality of life? But also be curious, you know, if they have that positive feel about themselves. I mean, the mood is a powerful thing, as you know, with cancer survivorship, and there's been studies about that too, and how it impacts outcomes, you know, even in addition to their therapy. You know, I I don't know how the insurance could, you know, really refuse that, but they find creative ways, obviously, to do it. Is it an expensive process in general overall, or do you know the cost estimates or kind of what it might you know cost the healthcare system or a patient potentially?
SPEAKER_02So according to the literature, it's about three to five thousand dollars a session.
SPEAKER_01Okay.
SPEAKER_02I think that's more out of pocket, though. I don't know about with insurance what out of pocket would be then or what the insurance covers. But that's basically what I found with doing my research. And to answer your question about, you know, whether it would show improved outcomes, I think I think it would. Because think about how much less stress the patient has to go to. Because a lot of it is when they look in the mirror, they don't see their hair. Or, you know, I have a lot of patients who still want to work. And, you know, they don't want to have to tell their coworkers, they don't want to have to tell their family, they don't want to have to tell their small children, hey, I'm on treatment. So I think if we actually could do a study that way, it would show that improved quality of life, improved mental health during treatment, and probably better overall, I wouldn't say overall survival, but overall outcomes physically and mentally for those patients.
SPEAKER_01Yeah, I would agree with you because I because I do feel like in, you know, and there's been some other studies about attitude and the power of the mind, if you will, over other things, I think it'd be fascinating to show that benefit. And for those patients, you know, that, like you said, that don't want them or want their, you know, loved ones or folks at work to know. I mean, the first sign that people think if you see somebody who doesn't have any hair, I mean, the first thing most people think of, oh my gosh, they must have cancer, right? Like it's kind of a social stigma. So I can definitely get that where they're coming from, and it gives them sort of that, I think it's empowerment, right, over their condition and ultimately may have better outcomes for them as well. But let's talk about the cold cap, you know, therapy, you know, a little bit
FDA Approved Cold Caps And How They Work
SPEAKER_01more. Because I I know there's a couple different, you know, things to think about. Like people call them scalp cooling caps or cold caps as well. Um, but I know they're kind of different, you know. I want to talk about the cold caps because I know there's three currently sort of FDA approved. I just wanted to get your thoughts on sort of the different ones that exist out there and maybe if you have a preference or if you've seen any differences amongst them as well.
SPEAKER_02So I could say there's three approved: there's the Dignity Cap, there's the Paxman, and then there's the AMA. And really, they all show about 40 to 80 percent improvement in regards to hair loss. They've never been compared head to head. So it's hard to know which one might be better, but it seems like the statistics match up. In regards to the one that I've had the most experience with, it's been the the Paxman, just because I don't know, I don't know if it's the paperwork, I don't know, but I get it approved. And it might just be that one, just like the DignaCap, is actually one that's clinic based. Like you don't bring it with you. It's already there at the office. It requires refrigerant cooling that continuously cools your head. And for the AMA, that one I actually read is portable, but it pretty much does the same thing. It's just a portable machine. And all three of them are FDA approved. I think what's what's interesting about them is that you know the patients don't really complain about it. They describe it as like a helmet that goes right attached to the head. And they actually have to wear it before, during, and for a good amount of time after treatment just to prevent the chemo from making its way into the area of the follicles.
SPEAKER_01When they're getting treated with these cap devices, you know, are there any side effects or downsides that patients report? Maybe I know time consuming. You know, I've talked with some patients that feel like it's just a lot of time, but they said if it's for my hair, it's worth it. But are there other things you counsel patients on to potentially as a side effect?
Side Effects Safety Limits And Timing
SPEAKER_02Yeah, so some of the side effects could be one is headaches, two is, you know, talking about who can't use it, might as well mention that too. Somebody who has cancer on the scalp, like somebody who has a squamous cell cancer on the scalp, somebody who has like cold urticary or sensitivity to cold. But when you read the literature, a lot of it's headaches. Uh, what was the other one? Headaches was a big one. The other one was frostbite. Really, though, what I've experienced is patients just complain that it's cold. And like you said, it's time consuming, but worth it.
SPEAKER_01And I think it's fascinating. I mean, basically, I was reading about how these devices work, that they have this, you know, circulated liquid or gel, you know, cooled to that specific temperature, and you know, that it's really exposure time. Yeah, do you recommend this throughout duration of chemo? And do they need to continue it at all post-chemotherapy as well, or is it really just during the treatment course itself that they do this?
SPEAKER_02So it's only for prevention, not for treatment of hair loss, but it's only used while they're on treatment. So, like I have some patients where like let's just say they're getting uh two chemos plus immunotherapy, and then the immunotherapy continues on. I would only keep them on it during the chemo sessions.
SPEAKER_01Makes sense. Because I think that's an important distinction. A lot of people are wondering, you know, where that focus, like you said, is on the prevention aspect. And we're always about prevention, you know, if we can do it, it's better to be there than to deal with the hair loss later. You know, I I think it's just amazing though, like how, at least from my standpoint as a dermatologist, I feel like this isn't really talked about. And we have patients come in that experience hair loss from chemotherapy, what we call antigen affluvium. And I think for so many years, we're just kind of like, yeah, it's just something that happens, right? Like without any thought of intervention. So I know this conversation out there is definitely gonna inspire some Durhams and our listeners to ask more
Manual Gel Caps As A Backup Option
SPEAKER_01about it. In addition to those FDA-approved devices, I was also reading about these gel caps that you can do with like this manual cooling process. Can you tell me a little bit more about those and if you've ever recommended that process to a patient as well?
SPEAKER_02So I haven't had as much experience, but I did like you read up about something called the Penguin, which is different caps that you have to switch during treatment. So, and it looks like they're used uh like with dry ice. So I haven't had as much experience with it, but you know, if it's affordable and your insurance won't approve it, you know, and you're concerned about hair loss, which most of us are, then I think it's another good option to consider.
SPEAKER_01Yeah, because I'm sure if your insurance is not going to cover, you know, traditionally using the cold caps, it sounds like the frozen gel caps might be another solution, but it's important to highlight they're not regulated by the FDA. So I know a lot of people are concerned by about that. But at the same time, I think you're right, it could be a reasonable option, especially if it's not cost effective to truly do cold cap therapy in and of itself. And, you know, I I I've wondered over time, like you've had to have seen, I mean, several patients that have benefited from this. I was curious if, you know, you had sort of a patient story or something just to show the impact of this. Because we talked earlier about the quality of life aspect that I think is so important. And one now just increasing awareness, you know, especially I think on the dermatology side, where if it hasn't been addressed by oncology, we might even be able to have that conversation. Because sometimes it gets, you know, released in our office. The patient just comes in and they're here for a skin check and like, oh, by the way, you know, I have to start chemotherapy soon. I have breast cancer. And, you know, I think it's our duty. I mean, hair loss is our area of expertise, even if we're not going to administer this type of preventative treatment to at least make the patients aware about it, to have the conversation with you, obviously. But I I think that's something that, you know, I wanted to find out what has been the impact you see for patients? Do you have somebody that sticks out in your
A Patient Story That Changed Everything
SPEAKER_01mind?
SPEAKER_02Oh, a hundred percent. So I I had a patient, she was quite young, just diagnosed with breast cancer, had to go on chemotherapy, and her biggest thing was her hair and most of all her kids. She had two young kids at home. So uh for her, that was her biggest thing. She's like, Dr. Pompa, I could survive the side effects. I know you'll be there for me, but what do I do about the hair loss? I'm gonna have to get a wig, I'm gonna have to wear a scarf. What do I tell my children? And we had brought up the cold cap. And at first, her insurance company did not approve it. So I did have to talk to them on the phone and I politely explained to the gentleman, I'm like, look, she's gonna lose her hair. This is gonna impact her children. This could change how they see their mother, how it impacts their lives, it could affect their school, it could affect, you know, how they interact with their mom at home. Are they gonna be too scared to touch her? You know, these are things that you learn over the years of taking care with pay of patients, how their children react to when they're on therapy. And then I also reminded him it's not like once she finishes chemo, there's not gonna be more for her to handle. In her case, chemo was before surgery, which is not the same for everybody. But I explained to him, then you're gonna, she's gonna undergo surgery. She may need more treatment afterwards. And then after that, she's gonna wait about three to six months for her hair to grow back. So that's more time that she's gonna have to hide and be protective of what her children know. So I told him, I said, for her mental health, for her children, will you approve it? And finally he said yes. But I went in there guns blazing because I was ready to get it approved.
SPEAKER_01How often do you feel like you're kind of on the front lines there making that argument? Is would you say that accounts for the majority of cases when you're trying to get approval, or do you feel like overall insurance companies are open to getting this approved?
SPEAKER_02Overall, I've done very good at getting approvals. So, but I'm sure some insurances maybe I haven't met them yet to discuss. But so far, thankfully, things have been well. And we're actually working hard in New Jersey to get more approvals, just like New York has.
SPEAKER_01So it sounds like through your state legislature legislature, you've been able to kind of make some of that movement happen. Is that kind of where there's actually been legislation to improve this process for patients?
SPEAKER_02Yes. So that's that's the way that it has to go. But I think I think the fact that it's on NCCN guidelines, the fact that we could talk about these things that I mentioned, I can't see anybody. I think it's just getting it to them and making them understand that, hey, this is very important in patient care. And look, if we had a study like the one you were just discussing, we mentioned earlier, that would probably just give us more data and more reason to get for the legislatures to approve it.
SPEAKER_01Well, I know we talked more about breast and gynecologic cancers, but I was curious, have you ever had a male go forward with it and see the benefit? Because I think sometimes we underestimate, right, the power of hair loss even on men. I think you know, from a societal standpoint, we're like, oh, guys lose hair, they can handle it, but it can be very emotional for men as well. Have you ever had a male undergo the therapy as well with benefit?
SPEAKER_02So not yet, but I can say I have a lot of men, some of them in their 80s, 90s, that have like beautiful hair. And they are, they are concerned about, they are worried about it. But so far I haven't had a patient concerned about their hair that was getting like a taxane therapy. I have a lot of gentlemen who are on immunotherapy alone, which as we mentioned earlier, they're not going to see the hair loss. Or I could use a different regimen.
SPEAKER_01And I know when you talked about kind of hip hop, you know, jumping around here, but I wondering about the insurance issue. Made me think of something when you mentioned that and getting the approval. Are they timely and getting it? Because I can imagine if I'm sitting there and you're telling me, Tiffany, like Shannon, you've got breast cancer, we need to do this type of treatment now. Are they timely in getting it approved where it can start concurrently? Because I'm thinking also, you know, if I had cancer, I'm like, oh my gosh, I want to start chemo yesterday, right? Tiffany, I'm like telling you, like, yes now. Do you ever find it holds up the chemotherapy process or patients are worried about that? Or does it pretty much kind of coincide where you're able to get things rocking and rolling at the same time?
SPEAKER_02Not yet, because I have a really good authorization department.
SPEAKER_01Okay. Because I think that would be a fear I would have as a patient, you know, where I've seen it in the dermatology space. Sometimes we have a medication where a patient might actually need a second treatment, and insurance has sort of taken the time to get the approval. And I think that's, you know, it's frustrating for patients, right? We know the second treatment's warranted, it's indicated, and sometimes that approval process will lag behind. But that's really good news to hear. Yeah. Because that puts people in a very awkward position. And and hair loss is powerful enough. I I could see some patients delaying treatment if that, you know, is not covered yet because of how impactful it could be potentially for their outcomes.
SPEAKER_02And or you have weddings. It's like I have some people who have events coming up. They'll tell me, but I have my grandson's wedding, or I have, you know, something important, something I have to be at. And that was years ago. Now I could give them. Hey, why don't we try the cold cap? You don't have to delay your therapy. But in the past, I've had patients say, hey, can we wait another week or two because I have this wedding? Or, you know, they don't want to start it. They don't even want to do chemo because of the hair loss. I've come across that.
SPEAKER_01That's very interesting. And that's, I mean, but I love that too, because it's real world, right? It's practical to figure out how do we navigate this. And, you know, and it also shows too for these patients, which kudos to them. I can't imagine having such a diagnosis. And, you know, you want to live your life though, too, you know, and things are important, you know, that we take that into consideration. And sometimes I know in the insurance game, that often gets forgotten because we're just looking at dollars and cents and bottom line, and sometimes not realizing the quality of life or emotional toll it can take on somebody.
SPEAKER_02And or sometimes, oh, sorry. No, you're I was gonna say sometimes we hear it from our own like colleagues. Hey, it's just hair. Yeah, hey, it'll grow back. And it's like until you're in it, unless you're a patient or physician that takes care of patients with cancer, you don't you don't understand the impact that it has.
SPEAKER_01You're right. I mean, hair loss, you know, for dermatologists, some of us struggle to manage it because we see the emotional toll it takes on a patient, and we have a hard time, you know, helping the patient through that journey. And up until a little while ago, you know, for some of our forms of hair loss, we didn't really have a lot of options to offer. And we're still looking to improve upon it. Or I think managing hair loss, you know, is becoming something that's a bit more friendly to the dermatologist because we have things to offer, but we see for patients just how devastating it can be. And so that's why I was excited to kind of bring this topic up more for germs to be aware of and really maybe even approach the subject with, you know, their patient prior if they're aware of a cancer diagnosis, or at least get them to talk with their oncologists and for patients too, that advocate for themselves. If maybe it's something that's not offered at their institution, or maybe their oncologist didn't bring it up, they were busy, it got skipped over, that they're also empowered to kind of
Other Regimens Other Hair Loss Options
SPEAKER_01know about it. And we talked about you know, good candidates, obviously. So you mentioned, you know, breast, gynecologic cancers, lung, taxane therapy, immunotherapy kind of puts them out. What about like, are there other conditions that people might have, like central nervous system cancer or other things that you would think of that, you know, aren't good candidates or reasons that you wouldn't recommend cold cap therapy?
SPEAKER_02So, like I mentioned earlier, I would never recommend cold cap in somebody who actually has a skin lesion or something on the scalp. Um, more like neurological, that I think it really depends on what regimen they're using. Like the biggest thing now is if you say to the insurance company that patient's going on a taxane chemotherapy, because there are other regimens with hair loss, but like adriomycin is another one, but unfortunately that one didn't pan out too well in the data that was driven by approving the cold cap. So there probably are other instances aside from obviously the blood cancers where you could talk to the insurance company about it, but it would be a harder fight or a harder discussion.
SPEAKER_01And besides doing cold cap therapy, is there anything else that you've seen work or recommend for hair loss with chemotherapy as well? Or is this really the main go-to with the best preventative outcomes you've seen?
SPEAKER_02Yes, it's the best one for prevention. There are topicals that, and you probably know more about this, there are topical things that you could use after chemotherapy, after chemotherapy is finished. But during treatment, cold cap is the best thing because, like I said, it blocks the blood flow of allowing this chemotherapy to actually make it to your hair follicles. But what's cool about it, and I think people should know this because I thought it was interesting when I read up on this in preparing for this topic, is that it affects the follicle, but it doesn't usually affect the stem cells. That's why most patients, their hair grows back after they've completed treatment, which I found totally amazing because I find the human body absolutely amazing. And that just added to my knowledge of how cool our body is. And I didn't use cool because we're talking about cool caps.
SPEAKER_01I like the pun. I'm a pun fan. I liked it.
Eyebrows Lashes And The Unsolved Gaps
SPEAKER_01And then I I've got to ask, because probably there's some people, okay, obviously they have cold caps for scalps. Are they doing anything for eyebrows, eyelashes? Because obviously a trickier area to put something ultra cold on. Maybe the eyebrows, something could be fashioned. I was trying to think creatively how that could potentially be done. But do you know if they're doing any research in this area or you see anything work or has anyone modified cold cap therapy, maybe for the eyebrow area or anywhere else on the body?
SPEAKER_02No, not yet. There are some like anecdotal areas when people say it actually helped them retain their eyebrows, but nothing definitive. I've read too some people wear those cold eye masks during treatment, but even that, nothing definitive that I could say is, you know, research-based standard of care. So mostly it's for the scalp.
SPEAKER_01Because I I think that's another area, probably another topic of you know, ways we could help patients dealing with that type of hair loss or trying to grow back. But sometimes I've noticed for our patients, eyebrows and eyelashes can be just as devastating as the scalp. Or if I can get away with a hair prosthesis or a wig, you know, I can throw down my scalp, but gosh, it's hard to pencil in those eyebrows, or you know, I can't wear eyelashes, you know, it just you know they don't stick or the glue is terrible, or I can't really make those work as well. Uh, you know, I think as we've gone through this, this is fascinating because I really think that this is where, you know, people are going to be able to like make some change, especially with cancer therapy. Obviously, immunotherapy is definitely taking center stage for options, but with chemotherapy still playing a role in some of these cancers, I think this is fascinating that we've been able to maybe prevent hair loss for patients and make an experience that ultimately I know is daunting potentially more tolerable. And I think you're spot on, Tiffany. I think it definitely could improve outcomes for our patients. And you just talked about, you know, a patient that really, you know, was impactful for you. You know, in the last, you know, few minutes here, anything else about coal therapy or cool cat therapy that really kind of, you know, that for you, you feel like people really need to know? Because I that's really what I'm trying to do is get the word out, make people aware of this and think about it, you know, for their patients, and then for patients to think about it for themselves as well.
The Takeaway Ask For Cold Caps
SPEAKER_02So I think for patients, I would say the most important thing to get from what we spoke about, because I'm sure a lot of the details will disappear as as they get farther out from listening to our discussion, is just to ask. Ask your provider, bring it up. And if they don't know, they'll look it up. We can get knowledge so easily now that if your provider doesn't know, they'll look it up for you. Or you could even look it up. I've had patients come to me and say, I want that cold cap. And I'm like, right on, let's do it. Like I said, that's usually the first thing on their mind is, and it's not just women, it's men too, is am I going to lose their hair? So a lot of patients already come prepared. And I think for uh, you know, physicians out there as healthcare workers, again, just to mention it, hey, did you talk to your provider about the cold cap? Oh, I see, you know, you just had a biopsy that showed something. You know, this is something you may want to discuss. Because not only, not only is chemotherapy cancer hard, it's that as a patient, you lose so much control. It's like you're you you have no control over what's going on. And if you could just control hair loss, which hair brings memory, I mean, we could sit here, and even the people that are listening to this discussion, you could sit and think back and say, you know, a wedding or, you know, somewhere when you graduated high school. Like, I could remember the points in time I cut my hair short. I could remember the points in time after I've gone out dancing, clubbing, 3 a.m., I decide to cut my hair. Like, hair brings memory. It it serves as our identity. So to have this as an awesome way to allow patients to keep control of an uncontrollable environment and situation that they're in, why not? I think that's 100% awesome.
SPEAKER_01I love that. And and I just want to highlight, you know, as a dermatologist, we need to be partners in this. We are specialists in hair loss. And I think this is one area that we can improve to bump up that awareness for our colleagues and definitely for our patients and collaborate with oncology to make it happen. You know, and like you said, it brings that dignity back to a process that's so incredibly horrifying for so many patients out there. And you're right, to give somebody, you know, their hair back or prevent that loss if you can do it. How powerful is that? So thank you so much, Tiffany. It's amazing to have you on today to talk more about this. I know we're gonna make a difference for some people out there today with this conversation. Thank you, Shannon.
SPEAKER_02It was an honor to be on.
SPEAKER_01Well, stay tuned for the next episode of Dermotrotter Don't Swear About Skin Care.
SPEAKER_00Thanks for listening to Dermot Trotter. For more about skincare, visit dermittrotter.com. Don't forget to subscribe, leave a review, and share this podcast with anyone who needs a little skincare sanity. Until next time, stay skin smart.
