Cold Gloves and Socks for Chemotherapy

If you’ve ever held ice in your bare hands or worn the wrong shoes out in snow, you likely know the sting of frozen fingers and toes. But applying ice to your hands and feet (cold therapy) during chemotherapy may help to reduce neuropathy — a side effect of some chemo medicines used to treat breast cancer. You may experience neuropathy if you're being treated with Abraxane, carboplatin, Halaven, vinorelbine, Taxol, Taxotere, or vincristine.

Neuropathy is nerve damage that leads to pain, tingling, numbness, and weakness. Neuropathy often starts in your fingers and toes, but can spread, leading to problems with walking and using your hands. To reduce these symptoms, some people use cold gloves and socks when receiving chemo. 

Cold or cooling therapy (sometimes called cryotherapy) involves cooling a person’s hands and feet using ice or ice packs. When it's cold, blood vessels get smaller, which slows down how fast cells work. This means less of the chemo reaches the nerves in your hands and feet, which helps protect them from getting hurt. It also helps reduce muscle cramps by slowing down the nerve signals and making the muscles react more slowly.

Several small studies of people who used different methods of icing their hands and feet during chemo for breast cancer suggest it may help protect against neuropathy symptoms. For example, a study in the Annals of Medicine & Surgery found that people who wore cold gloves and socks during chemo had less numbness in their hands and feet than people who didn’t receive cold therapy; they also reported fewer severe symptoms and a better quality of life after chemo. Another study found that people who used frozen gloves and socks for 90-minutes during weekly chemo had greater sensitivity to touch and temperature. 

Still, other studies have found cold therapy did little to prevent neuropathy from chemotherapy. A 2020 review article in the Journal of Oncology Pharmacy Practice concluded that while there are no side effects from cold therapy, the results of studies looking at cold therapy for neuropathy are mixed. Larger studies are needed to determine who might benefit most from cold therapy.

An added bonus of cold therapy during chemo is that it might help to protect you from nail damage and pain — another side effect of chemotherapy. But just as with cold therapy for neuropathy, more research is needed to know who’s most likely to benefit. One study that looked at people who received cold therapy during chemo found that some people experienced serious nail problems despite cold therapy while others either had mild symptoms or no symptoms at all. Some people believe that cold therapy may also be able to reduce skin-related side effects from chemo, such as redness, peeling, swelling, or blisters, but again more research is needed.

There’s no standard practice for how to use cold gloves and socks with treatment because current studies are small and some have mixed results, according to Eleonora Teplinsky, MD. Teplinsky is the head of Breast and Gynecologic Medical Oncology at Valley Health System in Paramus, New Jersey, and an assistant professor of medicine at Icahn School of Medicine at Mount Sinai. At her practice, she recommends her patients try using cold gloves and socks for about 15 to 30 minutes before chemo, during chemo, and for 15 to 30 minutes after. 

“The cooling products are used on the day of taxane chemotherapy and don’t need to be used on the other days,” she says. “They should be started as chemotherapy starts rather than waiting to start once symptoms develop.”

Cancer treatment centers may have different methods for implementing cold therapy. Excessive use of cold therapy may lead to skin damage, so it's important to get clear instructions from your oncologist on how long to apply the cold therapy before, during, and after chemotherapy.

If you’re interested in using cold gloves (sometimes called frozen or ice pack gloves or mittens) and socks, you’ll likely need to bring them with you each time to go for chemo. While some healthcare facilities may provide cooling garments, most require patients to purchase their own. A good place to start is to ask your oncology provider or breast cancer navigator. 

Cold gloves are designed to cover the entire hand, including the fingers and wrist, and come with pockets for frozen gel packs. Similarly, cold socks or booties cover the whole foot top and bottom and have pockets for frozen gel packs. Sometimes the gloves and socks have a strap to help keep the cold inside. 

Cold gloves and socks are most commonly purchased online. Amazon has the largest selection. Insurance does not cover these products. 

If you’re unable to purchase these cooling products, or if they will not arrive in time for treatment, you can create your own version. Cover your hands and feet with socks to make the cold more tolerable. Use ice packs or large Ziploc bags filled with ice on the top and bottom of your hands and feet and an ace bandage to secure it all. This will achieve the same result, but it will require a bit more creativity and help.

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  Bring a cooler filled with extra ice or gel packs to minimize interruptions during cold therapy. 

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  Pack extra layers. Wearing socks on your hands and feet before putting on cooling gloves and socks can make the cold more bearable. A blanket or shawl may also help you feel more comfortable during cold therapy.

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  Regularly replace ice or gel packs. For the best results, replace the gel packs inside gloves or socks every 30 to 45 minutes to maintain optimal freezing temperatures.

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  Ask a loved one or member of your treatment team for help changing your ice and gel packs.  This can be hard to do by yourself with cold hands. 

Some people find cold therapy to be too uncomfortable or painful. Researchers are currently exploring other options to prevent neuropathy:

Compression therapy uses compression stockings, wraps, or mechanical air devices to apply pressure to the arms and legs. By using tight-fitting compression, the blood vessels get smaller. This helps stop the flow of chemo to the nerves in your arms and legs. Just as with cold therapy, the less chemo to the nerves, the less chance of neuropathy. One study of people with breast cancer receiving chemo found both cooling and compression helped reduce neuropathy.

Exercise may be even more effective than cold therapy at reducing symptoms of neuropathy. One study found that people with breast cancer who completed an at-home exercise program experienced less numbness in their hands and feet after chemo compared with those who received cold therapy during chemo. The exercise program involved 15 to 30 minutes of stretching, balance, and strength training, 5 days a week, for 12 weeks. The third group, which did not participate in exercise or use cold therapy, experienced the most severe symptoms.