One of the most important things to avoid during your scalp cooling journey is knotting, tangling and in some cases matting. A tangle in your hair normally is irritating but not a big deal. Unfortunately, during scalp cooling, it can become a problem.

Chemo has a very drying effect on your scalp and hair, which can mean your hair can become difficult to care for while you are scalp cooling. Dry and damaged hair (particularly if it is colour treated or bleached) is particularly susceptible to tangling, and when your hair is also shedding a small tangle can quickly become a big knot or even a mat.

There are a few simple things that you can do to help to avoid the situation all together –

– It is really important that you brush (if it is straight or wavy) or finger comb (if it is curly or coily) your hair every day, preferably in the morning and in the evening. This will remove loose strands of shed hair. Shed hair that isn’t removed is the primary reason that knotting occurs, as the loose hairs get tangled in with retained hairs.

– When washing your hair avoid circular lathering motions, and absolutely do not pile your hair on top of your head and rub, like you see in shampoo adverts. The dryness of your hair in combination with the shampoo and the friction of your hair rubbing against itself can be a one-way street to matting. Smooth shampoo and conditioner through your hair, and try to be as gentle as possible.

– Use lots of conditioner and spray in conditioner. A detangler spray can help too. Try to keep your hair in the best possible condition, as it will make it a little easier to care for during the scalp cooling process. It will also ensure that your retained hair is as healthy as possible going forward.

– Sleeping on your hair can lead to tangles that develop overnight. Try a silk pillow case or sleep cap. Silk will cause less friction on your hair as you move around in your sleep than cotton. This should help to prevent additional knotting from happening, as can a loose plait if your hair is long enough, or a silk lined sleep cap.

– If your hair is long and in bad condition it may be worth considering cutting it to shoulder length or in to a bob. Damaged hair has a much rougher cuticle than healthy hair, which can act like the little hooks in Velcro and will make your hair much more likely to grab on to itself and tangle. By cutting away the most damaged areas, which is often the ends as it is older and more damaged, it can make your hair a lot easier to manage.

As you progress through your treatments, you may notice that your hair feels less greasy than it usually would despite less washing, or that you feel you can wash it even less frequently. The reason for this is the chemo drugs drying out your hair, scalp and skin. This will also often lead to hair that is more likely to tangle, even if it was in pristine condition before you started treatment. This means that sometimes, no matter how careful you are, knotting can happen.

For some the knotting can be really extreme and the hair can become matted and fused together. This usually occurs after washing the hair, or a patient wakes up to a knotted mass. The friction of hairs rubbing together, and in the case of washing the hair, the addition of the shampoo, the dry and brittle hair begins to fuse together. This is what is known of as Bird’s Nest Syndrome and sadly in this extreme situation the hair cannot be untangled and can only be resolved by cutting out the affected area.  

Luckily, more often than not, with patience, a lot of conditioner or oil and some help, less extreme knots can be detangled –

– As silly as it sounds, try not to panic, pulling at the knot can make it worse.

– It is often easier for a friend or hairdresser to tackle the tangles as they can see what they are working on.

– Use a pure natural oil such as olive, argan or almond, or conditioner, and a detangling brush or comb and start at the bottom of the hair.

– Slowly and methodically try to detangle the hair.

– When you start to make some progress, you can move further up the hair.

– It may be that snipping the worst affected areas may be necessary, and if the hair has mated and fused together there may be no choice but to cut it out.

– Be patient, it can take a lot of time, and it is always worth trying to detangle before resorting to cutting. If you do need to cut some of the hair out, it is best to go to the hairdresser and explain the situation – they will be able to give you a cut that can salvage as much length as possible on your hair, rather than resorting to a buzz cut.

Keeping your hair in the post possible condition and following our hair care advice will give you the best likelihood of avoiding difficult knotting. And if for whatever reason, or no reason at all, you do encounter problems, firstly good luck, and secondly the advice above will hopefully help you to tackle the issue in the most effective way.