Chemotherapy-induced alopecia, or CIA, is one of the most common and distressing side effects of cancer treatment, affecting some 65% of patients.

Scalp cooling is a treatment helping with hair loss. 

"Less of the chemotherapy is reaching the hair follicles"

Nancy Vega, 54, is battling breast cancer. 

"I'm a mother of four, and I want to continue being a mother of four, so that's my strength," Vega said.

Vega has been strong since receiving her diagnosis. She got the news while on the job working at a dialysis center caring for patients. 

"Never imagined I would have to sit in a similar chair," Vega said. 

Vega wanted to keep her cancer private, especially at work, so she was concerned about losing her hair from chemotherapy. She began researching and came across scalp cooling to reduce hair loss.

A cap keeps the scalp cold as chemotherapy is being infused, Dr. Beth McLellan of Montefiore Einstein Comprehensive Cancer Center said. 

"This causes the blood vessels in the scalp to kind of restrict and clamp down, so less of the chemotherapy is actually reaching the hair follicles where it causes damage," McLellan said. "Previously most research of scalp cooling had been done in Caucasian women with more straight or thin hair types, and there was one study that actually showed scalp cooling might not work in Black women." 

Clinical trial in the Bronx to help women of color

McLellan said cold caps are most effective when the cap is close to the scalp.

"Chemotherapy is still reaching all the places it needs to go in order to treat the cancer, just less of it reaches the hair," she said. 

However, it can be difficult to achieve when hair is thick or tightly curled, which prompted the clinical trial underway at Montefiore Einstein Cancer Center to help women of color. 

"Our trial is the first one that's really focused on using different techniques to prepare the hair so that people with more curly, textured hair types can have better chance of success," McLellan said. 

About 25 patients undergoing Taxane-based chemotherapy are involved in the Bronx-based study, including Vega. Patients are followed for six months after treatment so researchers can see the long-term effects of scalp cooling.

McLellan said the results are promising, so far. 

"We've seen over time as other side effects have had better management options like nausea and vomiting, hair loss remains that one thing that we just don't have a lot of options for that is so impactful and devastating for many women," the doctor said. "There are some women, in fact, who actually turn down chemotherapy or choose a less effective regiment just because they don't want to lose their hair."

Vega completed her scalp cooling treatment in February. 

"I didn't lose all my hair," she said. "That was the best part."  

"Health is everything" 

Vega underwent chemotherapy, a lumpectomy, and completed radiation in May 2025. She still comes in to get her chemotherapy maintenance infusion, each month.

She has her hair, but most all, she has her health. 

"Hair is not everything. Health is everything," she said. 

More cancer patients will soon have access to the treatment. A law requiring private health insurers in New York to cover scalp cooling goes into effect in January. 

The study, still in progress, will also include a control group in which the participants will receive no hair preparation or scalp cooling. The goal is to have the results of the trial sometime next year.   

Researchers are also investigating the cellular and genetic determinants of chemotherapy-induced alopecia. Rather than traditionally used skin biopsies which are more invasive, they are performing genomic sequencing on samples of plucked hairs, to identify possible biomarkers for it.