Finding Comfort in Hair Loss Solutions
Tania (a fictitious name to protect her identity) gazes at her reflection in the mirror as a stylist adjusts a wig on her head. She tries on a long, slightly wavy blonde wig and observes how it cascades over her shoulders. Tania is at Enzo Hair Society, a specialised wig and hair system store located in Mexico City. The shop’s walls are lined with shelves showcasing dozens of mannequin heads adorned with various hairstyles—short, long, straight, and curly, in a myriad of shades. Accompanied by her mother, Ana María, Tania browses through the options before selecting one to receive as a donation for a quinceañera celebration, an event that will include other adolescents battling cancer.
One of Tania’s primary concerns is comfort. A little over a year ago, when she commenced chemotherapy and began losing her hair, Ana María purchased a wig for her. Unfortunately, it caused itching and ultimately went unused. Wigs have become a common alternative for those experiencing hair loss due to cancer treatments. Although they may appear straightforward, the design and manufacturing of wigs can significantly influence how they feel and wear. Additionally, some hospitals offer scalp cooling technology aimed at reducing hair loss before it begins, a method employed during specific chemotherapy treatments to help retain some hair. However, access to these options can vary based on factors such as cancer type, treatment plan, availability, and cost.
The Impact of Hair Loss on Daily Life
Hair loss is a side effect of certain oncological treatments, affecting hundreds of thousands of individuals in Mexico. The International Agency for Research on Cancer projected approximately 201,137 new cancer cases in 2024, with over half of those diagnosed being women. Breast cancer is anticipated to be the most prevalent diagnosis, accounting for 34,055 cases.
The loss of hair typically begins a few weeks after initiating specific chemotherapy regimens and is often temporary. Once treatment concludes, hair usually starts to regrow, yet the experience of these months can vary greatly from person to person. Cynthia Villarreal, a medical oncologist specialising in breast cancer and director of the Oncology Institute at TecSalud in Monterrey, has witnessed this phenomenon over the years. Some patients express concern about their hair during initial consultations, while others seem less affected by it compared to the broader treatment. “It’s a very personal matter,” she notes in an interview.
Hair loss can also make a diagnosis more visible, affecting how individuals choose to share their journey with others. A study published in 2021 involving 213 patients who developed chemotherapy-induced alopecia revealed that their relationships, daily activities, and emotional well-being were impacted, with feelings of sadness and anger being common. The effects were not uniform among all participants; younger individuals reported feeling more affected, and differences were noted based on gender, education levels, income, and access to social security. Some patients indicated that the emotional toll of losing hair was even more challenging than losing a breast.
Support Networks and Community Initiatives
For children and adolescents, hair loss also affects their experiences at school. Additional research conducted in Colombia involving patients aged 9 to 12 uncovered instances of children feeling uncomfortable with their appearance, facing bullying and rejection from peers. Lucía has witnessed some of these changes in her 11-year-old daughter, Dulce, who is undergoing oncology treatment. After the onset of hair loss, Dulce became reluctant to leave the house and even avoided looking out the window.
Behind the quinceañera celebration lies Promesas MINOZ ARMY, a group formed by fans of BTS that has been organising celebrations and gathering support for young cancer patients since 2022. They collaborate with the Mexican Association for Assistance to Children with Cancer (AMANC), which assists patients and families facing financial hardships during treatment by providing support such as accommodation, food, transportation, and psychological care.
Guadalupe also arrived at Enzo Hair Society with her daughter Evelyn, who is undergoing treatment for leukemia, to select from the donated wigs. After losing her hair, Evelyn began spending more time in her room, unwilling to let others see her. “It was incredibly hard for her to lose her hair; it severely affected her self-esteem,” recalls her mother.
Leukemia remains the most common diagnosis among childhood cancer cases in Mexico, with an estimated 7,000 new cases annually among children and adolescents. Between 2020 and 2024, nearly half of the newly reported cases pertained to leukemias.
Scalp Cooling Technology: A Step Towards Hair Preservation
For patients like Evelyn, undergoing leukemia treatment, scalp cooling is not recommended. Cynthia Villarreal elucidates that these systems can be employed for many solid tumours, but not for haematological cancers. Outside of these cases, the option to use cooling systems is contingent on the treatment and individual patient assessment.
The continuous cooling system operates using a machine reminiscent of a refrigerator. It connects to a cap worn around the head, circulating cold liquid during treatment to maintain the scalp’s temperature between 2 °C and 5 °C. “The blood vessels supplying the hair follicles constrict due to the cold, which aims to prevent chemotherapy from reaching the scalp, thereby preserving hair,” Villarreal explains.
The cold impacts the body in two significant ways. By temporarily constricting blood vessels, less blood—and consequently a reduced amount of medication—reaches the follicles, which are responsible for hair growth. Additionally, it slows down the activity of the follicular cells, potentially diminishing the chemotherapy’s effect on them. Systems like DigniCap, developed by the Swedish company Dignitana, are one of the options available in Mexico that provide continuous cooling. Other automated devices, such as Paxman and Amma, function on similar principles. Utilising these systems also extends the time a patient spends in the treatment room, as the cap must remain on throughout the infusion and continue cooling the scalp afterwards.
Effectiveness and Challenges of Cooling Systems
A study conducted by Villarreal and her team in Monterrey, involving 76 patients who used DigniCap between 2016 and 2020, found that cooling began 30 minutes before chemotherapy administration and continued for 60 to 120 minutes afterwards, depending on the treatment. This research also indicated that 74% of patients retained enough hair to forgo a wig.
To be effective, the system must be used from the first session and repeated with each chemotherapy treatment. “If a patient undergoes a single session without the cap, hair loss will occur,” she cautions. Throughout treatment, medical teams monitor hair retention and how well patients tolerate the cold; if hair loss becomes excessive or results are unsatisfactory, the treatment may be adjusted or discontinued.
However, utilising this technology does not guarantee complete hair preservation. The specialist advises her patients that they may still experience some hair loss even while the system is in operation, and a favourable outcome means retaining sufficient hair to avoid a wig. The effectiveness varies depending on the chemotherapy regimen, as certain treatments induce more severe hair loss than others. In some cases, nearly 90% of patients can retain sufficient hair.
Even when hair preservation is minimal, some patients choose to persist with the cooling treatment. Villarreal recalls instances where hair loss was more pronounced in certain areas, yet patients opted to continue cooling since they still retained some hair. In her experience, many patients wish to maintain those areas while awaiting hair regrowth post-treatment.
Comfort and Practicality During Treatment
The cold can be uncomfortable. The oncologist advises wearing warm clothing, using gloves or socks, and sipping hot drinks during the session; some individuals may even require pain relief if they develop headaches. In the study, chills and headaches were among the most common complaints, but only three of the 76 patients discontinued the procedure due to intolerable discomfort.
In its early years, concerns arose regarding the safety of scalp cooling. Since the goal was to reduce the chemotherapy reaching the scalp, there were worries about whether this area would be less protected against cancer. However, Villarreal clarifies that accumulated evidence has not indicated a higher risk of metastasis in the scalp for those who have utilised these systems.
Pioneering Cooling Technology in Mexico
Susana Valdez, an administrator specialising in international trade, has played a pivotal role in introducing scalp cooling technology to Mexico. After spending over a decade in the automotive industry, she founded Celeritas Trading and Consulting, initially focused on managing imports. In 2007, while exploring products with potential in Mexico, she visited a Swedish inventions exhibition at Universum, the science museum of UNAM.
Towards the end of her visit, she discovered a cooling system designed to prevent hair loss during chemotherapy. Intrigued, she took down the contact information of Dignitana, the Swedish company developing DigniCap, and reached out shortly thereafter. This initial encounter initiated the process of bringing the equipment to Mexico, which included securing registration with the Federal Commission for Protection against Health Risks (Cofepris). DigniCap made its Mexican debut in 2010, and according to Valdez, it was the first automated continuous scalp cooling system available in the country.
Shortly after its introduction, it began trials with patients. In May 2011, ABC Medical Centre, one of the most prominent private specialty hospitals in