Shedding, for many people, is the most dreaded part of scalp cooling. Hair loss can be distressing, messy, tiresome and for many it strikes fear into their hearts that scalp cool isn’t working, but it is important to know that shedding is an inevitable and completely normal part of the scalp cooling process.

Here’s a guide on everything you need to know, what to expect and how to cope with it.

Shedding happens to everyone – at some level, anyone who chooses to scalp cool needs to expect shedding.  For the vast majority of people this will start between 14 and 21 days after their first treatment, as the chemo’s effect on the follicles begins to show. Scalp cooling will protect your follicles and will minimise hair loss, but it can’t save every hair.

Shedding doesn’t mean that scalp cooling won’t work for you – many people, whether they are anticipating shedding or not, will panic that scalp cooling isn’t going to work for them when shedding starts. This is not the case. Even those who have the best outcomes will experience shedding.

The most shedding is likely to occur after rounds 2 and 3 – this can vary a little and depends on the drugs you are taking, but for the majority, the shedding will be at its worst after your second and third cycles. Mostly, after this, it will slow down, but it is likely that you will see some level of hair loss every day.

Shedding isn’t the same for everyone – there can be big differences in the amount of shedding depending on your drug regimen. Those receiving anthracycline-based regimens including, doxorubicin, epirubicin and cyclophosphamide, need to expect more hair loss than those receiving taxane based therapies such as docetaxel or paclitaxel. To find a realistic indication of the kind of hair retention you can expect, enter your drug details in to our decision-making guide.
Shedding can also vary from person to person, even on the same regimen and those with thick hair may see more shedding, just because they have more hair in the first place.

Shedding isn’t a result of having done something wrong – shedding won’t happen because you didn’t follow the rules and there is nothing that you could have done to stop it from happening. The only thing you can do to increase your likelihood of hair retention is prepare your hair and fit your cap as well as possible (watch our tutorial videos for more guidance). It can be so distressing to see hair falling out, but it is so important that you continue to brush your hair daily and wash your hair regularly enough to keep it manageable. Not actively removing your shedding hair can lead to tangling and even matting. Brushing your hair will not remove hairs that weren’t already shed.

Shedding will likely change if you swap drugs – for those changing from one to drug to another, there may be an increase in shedding for a short while. This is your follicles and body adjusting to the change in drug. It will likely happen 14 to 21 days after the first treatment on the new drug, but it can happen sooner too.

Deal with shedding in a way that works for you – for some people seeing hair and having it falling out is really distressing. Don’t be afraid to tie your hair up loosely, which can help to catch stray hairs, wear a sleep cap at night for the same reasons or even wear a hair net when you are at home.
Seeing hair in the shower or on your brush can also be tough, while others may find it useful to compare the amount they are losing day to day. For those that struggle you may want to keep a plastic bag by the shower and scoop up the hair and throw it out straight away, so you don’t have to dwell on it.
Some people have found it so tough that they decide to cut their hair off, but continue to scalp cool. This gives the benefit of faster regrowth, without the hair loss they find so traumatic.
Whatever you find works for you, go with it.

Shedding and regrowth can happen at the same time – it may seem counterintuitive, but you will likely see hair loss happening as new hair also starts to grow. The two processes absolutely can happen at the same time.

Normal shedding will still happen throughout scalp cooling – everyone loses around 100 hairs a day due to the normal, healthy hair growth cycle. This will continue through scalp cooling. It can be really hard to remember what normal shedding looks and feels like after your chemotherapy, but keep in mind that some daily shedding is complete normal for everyone.

Post treatment shedding is also normal – unfortunately things won’t return to normal as soon as you finish chemo, so you need to expect shedding to continue for a little while. It can take many weeks for the drugs to work their way out of your system and 8 to 12 weeks of shedding isn’t unusual. If shedding persists for longer than this is may be worth speaking to your doctor as other factors can affect hair retention, including low haemoglobin levels and anaemia.


No matter how much you anticipate shedding, it can be so hard to cope with. But remember this is normal, you’ve done nothing wrong and it won’t last forever. Hang in there