The Caps

There are two different systems for saving the hair during chemo — machine scalp cooling systems and manual cold cap systems. Until 2016, only manual caps were available to American patients.


Two machine systems, DigniCap® and Paxman, have been cleared by the FDA. These systems are leased by hospitals and clinics and are only available where installed. See our Locations section.

The DigniCap® system was cleared by the FDA in December 2015. The company, based in Sweden, has been installing systems in the U.S. since 2016. In July 2017, they received expanded FDA clearance - their system is now approved to treat both men and women with various solid tumor cancers (not just breast cancer). DigniCap has information on their website regarding medical insurance coverage for the use of their system. https://dignicap.com/insurance/

DigniCap®http://www.dignicap.com                                                                                                                                                                                             
For an extensive discussion of all things DigniCap, in a conversation with a patient and a company representative, tune in to the following podcast. https://thisunmillenniallife.com/no-103-the-scalp-cooling-cold-capping-episode-part-1/
The Paxman Scalp Cooling System was cleared by the FDA in April 2017 and received their expanded FDA clearance in June 2018. Paxman, based in the UK and is now installing their system at numerous U.S. locations.

Paxman Scalp Cooling System — http://www.paxmanscalpcooling.com

Paxman also offers https://coldcap.com, a patient-centric website which can help patients decide if this process is for them, and which also offers support to patients along the journey, from treatment to hair care and more.

Manual Cold Caps are not yet FDA-cleared, and are not stocked at hospitals/clinics. They must be rented privately by patients and brought to chemo as personal property at this time. While the machines are becoming more available, manual caps are still quite commonly used by American patients wishing to save their hair.

A set of manual Cold Caps can be used at any location with the dry ice method. Patients acquire and freeze a number of caps, which are changed at specified intervals to maintain the proper level of cold. Some supportive chemo centers have biomedical freezers (see Locations section) so that dry ice is not needed.

We have vetted the following manual cap providers to the best of our ability and can recommend them based on feedback from patients, doctors and nurses. Please note that patients should always consult their physicians when considering using manual cold caps, and should request success data for their drug regimen as part of their inquiries with the cap suppliers.

  • Penguin Cold Caps were first used in the U.S. in 2005, and have been widely used here for years. They have their own unique design and patented gel to hold temperature as long as possible. Penguin has over 25 years of data and experience and their caps are reported to work with almost all chemo drugs. Of note, in addition to very high success rates with taxanes like TC, they report their success rate may be as high as 60–80% with patients using AC. AC is usually toughest on the hair, and this appears to be a particularly good outcome. 
  • Chemo Cold Caps began in 2012 after the co-founder saved her hair using manual cold caps. CCC uses an Elastogel cap with an outer insulated cover and a special four-point strap to ensure a snug fit. They provide caps, cooler and all needed supplies for each rental. CCC data indicates a very high success rate with the taxanes. Inquire regarding other drugs.
  • Arctic Cold Caps started in 2015, again inspired by a family member who saved her hair using manual cold caps. Arctic also uses an Elastogel cap and provides caps, cooler and all needed supplies for each client. One-on-one training is available. They report excellent results with the taxanes and a number of other drugs. Please inquire for details.
  • Wishcaps began in 2013 after the founder assisted a close friend who saved her hair with manual cold caps. Wishcaps also uses Elastogel caps and provides renters with all needed supplies including cooler, digital timer and laser thermometer. Phone consultations are available to all clients. Wishcaps reports excellent results with the taxanes. Inquire regarding other drugs.
  • Warrior Caps was founded in July 2016 after founder Lisa completed 16 rounds of chemotherapy, keeping most of her hair. The company uses a proprietary cap and provides everything needed for patients to have a successful capping experience. Warrior Caps have been used with high levels of success with even the toughest chemo regimens, including AC.


Additional clinical trials of machine and manual caps are expected to take place and will be posted here when they do.


Patients need a full time helper to cap with manual caps. Most commonly patients use friends or family. With practice before chemo starts, to learn how to fit the caps and change them quickly, this is very doable. Some patients hire a professional capper. This can be very expensive, and professional cappers are not available in all areas. Providers can advise you if they have their own trained cappers for hire in your area. You can also reach out to:

Capping Partners of America, https://cappingpartnersofamerica.com/, has a range of capping and in person or virtual training services including cappers for hire located in NC, SC, VA, GA, FLA, and Chicago, with new locations frequently being added. Cappers may travel to other locations if expense is not an issue. They only work with Penguin Caps. 

Right Arm Inc, https://www.rightarminc.com/, also has a range of capping and training services, again working only with Penguin Caps. Cappers are primarily based in the NYC tri-state greater metro but may also travel to other locations if expense is not an issue. 
 
In the West, Penguin Cold Caps Professional White Glove Services (a separate company from Penguin Cold Caps), https://www.penguincoldcapswgsna.com, offers at home or in-hospital capping training, or full service white glove capping. They serve Northern CA, OR, UT, MT, and Reno/Northern NV. They may also be available to travel to other locations if expense is not an issue.

Insurance Coverage for the process is discussed in our FAQ section. We are not the best source of insurance info (providers are) as we generally are not in contact with patients at the back end of chemo. Providers often know what codes have been successful, what insurers have been covering the process, and what paperwork is needed to file a claim.

Financial Assistance

Financial assistance for patients using machine scalp cooling systems or manual cold caps may be available.

Note: Effective 1/1/22, Medicare will begin reimbursing chemotherapy facilities for the cost of machine scalp cooling for Medicare patients. This is a work in progress and will take some time to be fully implemented; please ask your facility if they are participating. You must get your CAP KIT directly from your facility and not from DigniCap or Paxman to be eligible for this coverage. 

  • Hair To StayNational nonprofit
    Patients with household incomes at or below 300% of the Federal Poverty Level (FPL) should go to www.hairtostay.org/apply-for-a-subsidy and fill out the form you will find there. (The FPL chart is available on their site to help you determine if you qualify to apply.) Note that HairToStay will not reimburse for expenses incurred before you are approved for assistance.
  • The Sue Paxman Fund for MothersNational nonprofit
    Funded by the Paxman Company and administered by Hair To Stay, this fund offers free Paxman Scalp Cooling to 2 ultra low income women per month. Patients must be mothers with children living at home, and whose household income is at or below 200% of the Federal Poverty Level. Contact HairtoStay.org to apply.
  • The Fleener Family Foundation — National nonprofit (Warrior Cap users only)
    The Fleener Family Foundation (info@fleenerfamilyfoundation.org) works exclusively with Warrior Caps to ensure cold cap therapy is available to those in financial need. The Foundation has sole discretion on the application requirements and the distribution of caps based on criteria set by the Officers of the Foundation. US residents with household income at or below 300% of the federal poverty level are encouraged to apply. 
  • Sharsheret — National nonprofit (Breast and Ovarian Cancer patients ONLY) Sharsheret's Best Face Forward 2.0 program offers financial assistance for scalp cooling/cold capping to patients with current breast or ovarian cancer diagnoses who have household income at or below 600% of the federal poverty level. They will reimburse 100% of expenses up to a maximum of $1750. Sharsheret will cover dry ice costs, but will NOT pay for professional cappers/helpers. They can not reimburse for expenses incurred before you are approved for assistance. 
    https://sharsheret.org/resource/best-face-forward-2-0/
  • Cold Capital FundDistrict of Columbia, Maryland and Virginia residents only
    Patients in the defined geography may contact coldcapitalfund@gmail.com to discuss possible assistance with the cost of renting cold caps or using scalp cooling machines at clinics.
  • Hope For HairNorth Carolina residents only
    NC resident patients may go to hopeforhair.org/apply-for-a-subsidy for possible assistance with the cost of renting manual caps or using scalp cooling machines. Eligible patients will have household income at or below 400% of the Federal Poverty Level.
  • Cap and ConquerSoutheast Michigan residents only
    Patients in the defined geography may contact info@capandconquer.org to discuss possible assistance with the cost of renting cold caps or using scalp cooling machines at clinics.
  • Infinite Strength —  Metastatic (stage four) breast cancer patients who reside in the New England and mid-Atlantic states, CT, MA, ME, NH, RI, VT, plus DE, MD, NJ, NY, PA, who are single mothers and have children under 18 living with them and financially dependent on them can apply to https://www.infinitestrength.org/basic-human-needs-grant. In addition to helping with the cost of hair saving therapy, this organization also funds a variety of living expenses for 6 months. 

 

 

 

Some hospitals and clinics have funding support available for patients using cold caps/scalp cooling machines at their facility. Be sure to inquire with your nurse or physician.

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