It all started with two words scribbled on a napkin: scalp cooling. Bethany Hornthal remembers that when her friend and famed breast cancer surgeon, Dr. Laura Esserman, first wrote it down, Hornthal thought, “it sounded like some kind of tribal ritual.” After all, it was 2009, and scalp cooling as a treatment to prevent and mitigate hair loss during chemotherapy really only existed in Europe at that point. By the end of lunch, Hornthal had agreed to help find the funds for scalp cooling’s first clinical trial stateside. 

“At the end of 2015, we got the FDA clearance to bring an automated scalp cooling machine to the United States,” says Hornthal. Rather quickly, she realized her work was far from over. “It felt clear to me that it would be horrible to be in an infusion center and see two people in chairs and one with a cap on their head because they could afford it and the other without it because they could not.”

So, Hornthal co-founded HairToStay, the first and only nonprofit dedicated to expanding access to scalp cooling to low-income cancer patients. To date, HairToStay has awarded more than $5,134,000 in subsidies to more than 8,195 recipients who would otherwise have been unable to afford to save their hair. 

Both K18 and HairToStay share a deep understanding that hair is more than just hair. It’s a precious part of our identity. A way of expressing ourselves. A source of confidence when how you move through the world—and how the world sees you—changes without warning.

Our global community truly showed up for the #k18hairflipchallenge. Each and every hair flip is going to make a real difference in someone's life. K18 is honored to donate $100,000 to HairToStay. 

Today, Hornthal shares more about her personal hair journey and why scalp cooling must be accessible for everybody. “Unfortunately, none of us escape without being affected by someone very close to us, if not ourselves, being diagnosed with cancer,” says Hornthal. 

a mission a long time in the making

Hornthal got her start working in Silicon Valley but eventually found her way to the nonprofit space, raising money for issues she truly cared about. Cancer had always been a concern of hers.

“Both of my grandmothers were diagnosed with breast cancer. One died of breast cancer, and it's definitely in my family,” says Hornthal. She decided it was time to get involved in something that scared the hell out of her, raising funds for critical trials for cancer prevention and treatment. 

when hair is life or death

At least 8% of women will turn down chemo because they're afraid of losing their hair, according to an NIH breast cancer study.

“We know that there are people out there who absolutely would be risking their lives by not doing chemo for the sole reason of hair loss,” says Hornthal. 

The scalp cooling subsidies that HairToStay helps provide impacts not just the person who received it, but the people who care for them. Being able to come out of cancer treatment looking like yourself should not just be a privilege for those that can afford it. “We have so many women who have small children at home, and they are worried about traumatizing their children by not looking like themselves,” says Hornthal. 

Hornthal considers haircare professionals the first responders, often the first to know when a client is about to go through chemo. As awareness around scalp cooling spreads, they might also be the first to tell them that there are clinically proven ways to save their hair. 

the hidden costs of chemo

Scalp cooling is roughly $400 per infusion. Many cancer treatments are 4-6 infusions (sometimes more) so [between $1,500 and $3,000 total]. And this is just for scalp cooling. For uninsured patients, the total cost for a full course of chemo (drugs, fees, hospital bills) can be anywhere from $10,000 to well over $200,000.

“Since many of our recipients are very low income, they need their jobs,” says Hornthal. “We have many women who talk about how cancer enters the room before they do when their head is shaved or they're wearing a scarf or a wig.” 

Maintaining a job while in the middle of cancer treatment is hard enough, but getting one and trying to maintain your privacy? That can be complicated. “Your diagnosis should be the thing that you can tell people if you want to…but shouldn't have to,” says Hornthal. “90% plus percent of people that have said [saving their hair] has really helped them have a sense of well-being during going through treatment when losing control of just about everything is something that's part of this diagnosis.”

the personal trauma that changed her life

Hornthal hasn’t had cancer herself, but she has experienced unfathomable loss. At just 12 years old, both her parents were killed in a plane crash. “I became an orphan instantly,” says Hornthal. “There's something about that experience of your identity changing, and at the same time you don't have privacy, you can't control any of that. Your life is forever changed.” 

As she started working with women recently diagnosed with cancer, she resonated with their struggles, their grief, the way one moment could seemingly turn a life upside down. Her own journey had given her a critical perspective on what truly matters. “So I thought, [scalp cooling] is one little thing that I can do to make somebody's journey a little less overwhelming,” says Hornthal. She remembers almost every story of every woman HairToStay has helped. The ones that made it through and the ones that didn’t. 

“For me, hair has always been important,” says Hornthal. “I have curly hair. Even as a very little girl, I remember my mother putting it up in rollers.”

Through the work of HairToStay, thousands have been able to keep their curls, their signature braids, the length they’ve been growing out for years. Hornthal has seen the resilience of those faced with impossible circumstances firsthand. 

To learn more about HairToStay or support their mission, visit HairToStay.org.