Frequently Asked Questions

Why Does Chemotherapy Cause Hair Loss? 

Chemotherapy is designed to kill rapidly dividing mutated cancerous cells. While chemotherapy is often the most important part of your treatment process, chemo agents also attack other cells in your body that are naturally rapidly dividing; like your hair.
Read more here

How Does Scalp Cooling Work?

When a patient’s scalp is hypothermically cooled, two physiologic reactions occur:
(1) The blood vessels in the localized scalp area constrict (vasoconstriction): the narrowed blood vessels limit the amount of chemotherapy agents delivered to scalp area.
(2) Slowed metabolic processes: a reduced scalp temperature causes normal cellular activity in the localized scalp area to slow dramatically. This means that much fewer chemotherapy agents become absorbed by the hair cells and damage is significantly reduced.

For who is the DigniCap® System designed?

The DigniCap® scalp cooling system has received FDA Clearance specifically to reduce the likelihood of chemotherapy-induced alopecia in women with breast cancer.  However, cooling of the scalp is a proven approach to reduce chemotherapy-induced hair loss that has been used successfully by thousands of patients worldwide with a variety of cancers and chemotherapy regimens.

The DigniCap® System multi-site scalp cooling trial proved that scalp cooling is a safe and effective method for reducing the risk of chemotherapy-induced hair loss for breast cancer patients. However, almost everyone can expect to experience some degree of hair loss during chemotherapy. The outcome is dependent on several factors including the chemotherapy regimen, dose, duration of drug infusion, chemotherapy drug metabolism, and concomitant comorbidities.

The DigniCap® System has been evaluated with regimens that include taxanes (such as paclitaxel and docetaxel) and anthracyclines (such as doxorubicin). The effectiveness of scalp cooling with chemotherapy regimens that include both anthracycline and taxane chemotherapy is not currently recommended by Dignitana. Your clinician can tell you if scalp cooling is suitable for your specific condition and treatment plan.


Contraindications include cold sensitivity, cold agglutinin disease, cryoglobulinemia and cryofibrinogenemia. Scalp cooling is contraindicated in patients with hematological malignancies, if chemotherapy is given with a curative intent.

How long does scalp cooling treatment last? 

The scalp cooling device is operated by a certified technician and will be used during each chemotherapy session. Scalp cooling begins approximately 30 minutes before chemotherapy starts, continues during the infusion of hair loss causing chemo agents, and then continues for a set period afte depending on the chemotherapy drug and dose. With many regimens, patients will need to maintain a reduced scalp temperature for 30 – 150 minutes following the completion of their chemotherapy infusion. After completion of the post-infusion cooling time, the cooling cap remains on your scalp for another 15 minutes to allow temperature to slowly increase and diminish any discomfort.

How does it feel? 

Most patients tolerate scalp cooling with DigniCap® scalp cooling system very well. The system cools the cap down gradually from room temperature and the cap temperature never drops below freezing to help make the treatment more comfortable for patients. Common side effects include a feeling of coldness, headache, scalp pain and/or light-headedness. Your doctor can provide a pain reliever if you develop a headache.

What should I bring with me to the infusion center on the day of the scalp cooling treatment? 

Your clinician can best tell you what you should bring on the day of the treatment. It’s generally recommended that you bring your own wide-tooth comb as well as warm clothing.

How should I take care of my hair? 

The DigniCap® scalp cooling system offers you the chance of minimizing hair loss during chemotherapy for breast cancer. However, chemotherapy can cause scalp irritation and make hair dry, brittle and more difficult to manage.

Practical recommendations to minimize hair loss during chemotherapy in conjunction with scalp cooling:

  • Wash your hair at home prior to the scalp cooling/chemotherapy session. Greasy hair may affect the thermal contact. However, avoid daily shampooing (to avoid wear of the hair), shampoo less if your hair feels dry.
  • Use lukewarm water (avoid hot water) and gentle shampoo.
  • Avoid applying heat to hair with appliances such a blow-dryers, curling irons, straightening iron, and 
hot rollers. Let your hair dry naturally as much as possible.
  • Avoid harsh chemicals that can lead to dry hair, breakage, progressive hair thinning and hair loss such as the following:
    • Peroxides for hair coloring
    • Perms to curl or straighten hair
    • Parabens (such a methylparaben and propylparaben) that are commonly used as preservatives
    • Sodium laurel sulfate is a foaming agent and will remove natural oils in the hair
    • Silicones that are used to tame or “de-frizz” the hair work by coating the hair strands.
  • Limit brushing or combing of hair to once or twice a day. It’s recommended that you use a wide tooth comb.
  • Avoid hair accessories such as rubber bands and headbands that pull on the hair.

Will Insurance Cover DigniCap® Treatments?

Dignitana will be working with health insurors with the hopes of gaining coverage. Some carriers that cover the cost of wigs have considered scalp cooling similarly and provided some reimbursement.  We hope this will become more standard practice in the future.

Are there grants or scholarships available to aid in paying for the DigniCap® System?

Dignitana is in the process of setting up a Patient Assistance Program to help subsidize DigniCap® treatment costs for patients with financial need  More information about that program will be made available soon. In the meantime, many medical facilities have subsidy programs already in place for patients with financial need and may be able to help offset the cost of Dignicap treatment.  Check with your provider and infusion center staff to see if you may qualify for financial assistance..

Has the DigniCap® Scalp Cooling System received FDA Clearance?

Yes. For the first time ever the FDA has given clearance to a scalp cooling system that can reduce or eliminate chemotherapy-induced hair loss for breast cancer patients: The DigniCap® Intelligent Scalp Cooling System.

How is DigniCap® different from other scalp cooling treatments

The DigniCap® System is the first scalp cooling system to be cleared by the FDA for the treatment of women with breast cancer in the U.S. The DigniCap® System incorporates a number of features and technological advances that combine to improve the patient experience. The cooling cap has two dedicated temperature regulation sensors in each cap that monitors scalp temperature and a third safety sensor to ensure that the scalp temperature never falls below 32ºF (OºC). Also, the cooling cap is fitted once at the start of treatment and remains on until completion.

The system also employs special clinicians to operate the system for each of its patients. The clinicians are all well-versed and knowledge on the system, and allows hospital employees to continue to do their own jobs without being overwhelmed by learning a new technology.

For a detailed comparison of the DigniCap® System and manual scalp cooling approaches click here.

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