How to get a good cap fit
Good cap fit scalp cooling
People often ask us: What is the best way to get a good cap fit? Firstly it’s really important to work with your nurse or healthcare assistant to help them to get the best cap fit for you. Take a look at our guidance below to get a good overview of what to expect and how you can help with comfort and best fit.
Your nurse or health care assistant should be trained and up-to-date.
Every hospital or health care provider and scalp cooling manufacturer have a duty to ensure that staff who are handling scalp cooling are trained and up-to-date with techniques and protocol. Scalp cooling manufactures do offer a host of training and support to hospitals, however it is up to each hospital how often they train their staff.
It is our recommendation that you can also be up-to-date with how to help get a good fit and ensure that you are interactive by telling your nurse or health care assistant straight away if something doesn’t feel right.
Many women have given us feedback that they felt their cap needed to be altered or tighter or that something was not quite right but they didn’t speak up. It may be the case that you have the best fit possible, however, it’s always best to ask your nurse or health care assistant to check.
The cap is on your head and so only you can know how it feels. Remember that the putting on of a cold cap is a two-way experience. Your nurse or health care assistant will fit it and you need to give feedback.
In this section we will take you through everything you need to know about cold caps to get a good fit.
What are the different types of cold caps?
At the time of writing there are two types of systems that are commonly used.
Refrigerated cooling system – that continuously pumps liquid coolant through a cold cap to help to lower the temperature of the scalp
Manual system gel cap – a cold cap that is filled with a cold gel that is precooled in a freezer or frozen ice system. This type of cap needs to be changed several times during treatment.
The cold cap
A cold cap is the name commonly given to the helmet shaped cap system that is worn as part of scalp cooling treatment. Caps come in a range of sizes – a good cap fit is essential to best support effective scalp cooling.
There are two basic parts to most systems:
Refrigerated cooling system
Inner cap – The inner cap is attached directly to the refrigerated cooling system that circulates a coolant around the cap to maintain a consistent cool temperature. For example the Paxman inner cap maintains a temperature of around -1 Celsius (note – the scalp only lowers to a temperature between 18 to 21 degrees Celsius).
The inner cap is placed directly onto the hair and scalp.
The cap can be detached for a limited amount of time during treatment for comfort breaks.
Designs vary depending on manufacturer.
Outer cap – the outer cap is placed over the inner cap and helps to create a snug and secure fit of the inner cap. Additionally, outer caps help to insulate the inner caps, helping to aid a constant cool temperature.
The cold cap is worn for some time before, during and after your chemotherapy treatment.
Designs vary depending on manufacturer and models.
Top tips for a good cold cap fit
Based on using a refrigerated cooling system (machine):
Try on before first appointment – Try to arrange a cap fitting prior to your first scalp cooling and chemotherapy treatment. This can help reduce anxiety and help you to feel organised. However, you may find that your hospital is reluctant to do this and then you may have to push for this to be done.
Pre- treatment cap fitting – If your hospital does arrange a pre-treatment cap fitting arrive with your hair prepared. Your hair usually needs to be clean and tangle free. If a pre-treatment cap fitting is not available don’t panic. Arrive a bit earlier then your appointment time and work with your nurse or health care assistant to ensure your cap fits well.
Work together – Getting a good cold cap fit is a matter of being interactive with your nurse or health care assistant. It’s worth knowing this in advance as many patients have said that they were concerned that the nurse wasn’t well trained because they seemed to ask them (the patient) to help a lot with the cap fitting. In fact, a well-trained professional will ask you lots of questions to ensure the best fit.
Hair root that needs to be cooled not the hair length – It is well worth understanding that it is only the roots of the hair that need to be cooled. With this in mind hair length will often hang out below the cap – this is normal.
Try on a variation of sizes – Unless it is very clear that you cap fits well your nurse or health care assistant should try on a variation of sizes (at least 2) to compare caps in order to get the best fit.
Forehead protection and comfort – It has become highly recommended by patients and scalp cooling manufacturers (e.g. Paxman) that a fabric hair band or gauze can be placed on the forehead (not the hair) to help reduce cold discomfort and protect the fragile nerve endings along the hair line and forehead. The fabric hair band should be placed a few millimetres below the forehead and below the base of the ears. You may have to help hold this in place as the outer cap is fitted.
Check with your manufacture.
Inner and outer caps need to be fitted for you to feel the outcome – There is an inner and outer cap. It is not until the outer cap is fitted that you can get the true feeling of whether the cap is a good fit.
Crown area – Many studies show that the crown area is the key place to get a good cap fit. There should be close ‘contact’ with the hair on the scalp, meaning that the cap needs to fit firmly in this area.
Firm not extreme – Whilst the cold cap will be very snug it doesn’t need to be overly tight. One important tip is to ensure that there is not a ‘bubble’ or feeling of ‘bounce’ between the inner and outer cap. If this is the case it may be that the inner cap is too small or the outer cap is too tight and pushing the inner cap up.
Gauze for comfort – For added comfort ask to have gauze placed under your chinstrap, by your ears, cheeks and forehead to act as a soft cushion.
Gauze or a surgical cap may also be used to protect your scalp if needed. For example if you have an area of thinning hair/baldness.
Note the cap size – Many women have reported that it took quite some time to try on different inner cap sizes and then practice getting a good final fit once the outer cap is also added. Also, once a cap size is allocated your nurse or health care assistant should make a note to ensure that the correct size will be made available when it is your appointment.
Kindly note – manual caps systems – If you are having a manual system this won’t be necessary, as the caps do not tend to vary in size.
You may need to change cap size during treatment – Many people experience the total mass of their hair reducing. In other words some hair loss is to be expected. With this in mind, if your hair thins you may need to go down a cap size.
No bare skin exposure – Bare skin should not come in contact with the scalp. Therefore a surgical cap or gauze might be used to protect the scalp.
For example if there are substantial areas where the skin on the scalp is exposed to the cold cap. Examples of this are: if a lot of hair has thinned or for a man who has male pattern baldness and is wearing a cold cap to protect the areas where hair does grow.
Wellbeing – take a look in our section Comfort and wellbeing during scalp cooling, for additional ideas for comfort and ease.
Next planned review: February 2022