Everviolet Chats: Bethany Hornthal, Co-Founder & Executive Director of HairToStay

We’re honored to feature Bethany Hornthal, Co-Founder and Executive Director of HairToStay, in our latest Everviolet Chats. HairToStay is the first and only national nonprofit dedicated to making scalp cooling accessible to more cancer patients — a treatment proven to help preserve hair and dignity through chemotherapy. In this conversation, Bethany shares the story behind founding HairToStay, the impact scalp cooling has had on thousands of lives and the power of community support. With HairToStay’s annual fundraiser, Does the Bay Walk & Cold Plunge, happening October 4 at Crissy Field in San Francisco, we’re especially excited to spotlight their mission and invite our community to get involved.
✨ To read more about Bethany’s journey and the mission of HairToStay, explore our full Everviolet Chats interview below.

You’ve had such a dynamic career in advertising, consulting and nonprofit leadership. What inspired you to co-found HairToStay, and how did your path intersect with Patsy Graham’s?

I was a part of the team working with UCSF to bring scalp cooling to the U.S. and get FDA approval. It was a long process and once it was finally achieved, I realized that patients could be sitting next to each other at an infusion center and one could afford to do scalp cooling and preserve their hair and the other— because of their financial situation— could not. This struck me as a terrible outcome and deeply unfair. My initial goal was to help make this therapy available to all who wanted the option to preserve their hair and with it their sense of self, privacy and well-being. Meanwhile, Patsy Graham, a breast cancer survivor in Texas, had created her own non-profit following, her own use of cold capping, called Cold Caps Assistance Projects (CCAPS), and began by subsidizing patients in Texas. Patsy and I decided to join forces, and we launched HairToStay in April 2016, with a goal of building a national subsidy program.

For those who may be new to the concept, can you explain how scalp cooling works and why it can be so impactful for people undergoing chemotherapy?

Cooling the scalp during chemotherapy is thought to prevent hair loss by affecting two cellular processes: (1) Blood flow to hair follicle cells is reduced, therefore exposing them to less chemotherapy medications, and (2) the rate of cellular metabolism is slowed, thereby leaving them less vulnerable to chemotherapy. The cap is worn during and after chemo. It is very cold and not incredibly comfortable, but quite effective at mitigating hair loss. In cases where some percentage of hair loss occurs, the cooling cap helps the health of the hair and bolsters regrowth, often faster than if scalp cooling is not used.

Hair loss is often one of the most visible and emotional side effects of cancer treatment. What does preserving one’s hair mean for patients’ sense of identity and confidence?

Chemotherapy-induced alopecia is one of the most dreaded adverse effects experienced by cancer patients. The fear of losing one's hair is acute for many, and chemo cuts an agonizing experience. Up to 8% of female cancer patients may decline life-prolonging chemotherapy to avoid developing alopecia. So we sometimes say that we are not just saving hair, in certain cases, we are saving lives! Your hair is your crown, so much more than a superficial worry. For so many women, the first concern is ‘will I look sick?’ Some have young children at home, others work in the public sphere, and many want to choose when and with whom they share their diagnosis. Being able to keep one’s hair at such a scary and chaotic time has incredible power and gives patients agency and a sense of control at a very difficult moment in their lives. We hear from moms with young kids who want to protect their children who might be scared to see mom bald or in a head scarf, patients who were able to walk down the aisle at a child’s wedding, or go on a job interview without fear of looking unwell. In everyday life,patients can go to the gym, shopping, out to dinner, and interact with family and friends without having their diagnosis enter the room with them.

HairToStay has awarded more than $4.6 million in subsidies, helping thousands of patients access scalp cooling. What has been the most rewarding part of seeing this kind of impact?

We have a robust catalogue of testimonials and speak to patients every day, who reiterate how impactful scalp cooling was for their cancer experience. Speaking to patients and hearing their stories is deeply moving and rewarding. We even have a team member who was a recipient and is a young cancer thriver!

Can you share a story or moment that illustrates how HairToStay has changed someone’s journey through cancer?

There are so many…being a new grandma, some of the most poignant calls I get are from young women – here is one testimonial that gave me a lump in my throat:

“I was 6 months pregnant with my 4th baby at age 39 when I was diagnosed with Triple Negative Breast Cancer (stage 2). Due to how aggressive my cancer was, I couldn’t postpone chemo and had to start infusions in my third trimester. The cold capping process allowed me to keep about 75% of my hair, and also keep my sense of self. It was one less thing to worry about during my postpartum recovery. Thanks to HairToStay, I was able to afford cold capping. Without the subsidy, the cost would have been prohibitive for us. Thank you”

Nonprofits often face the challenge of balancing resources with growing demand. What have been some of the biggest hurdles you’ve faced in expanding HairToStay nationwide?

We have always been the first and only national nonprofit organization dedicated to helping low-income cancer patients afford scalp cooling. We give out subsidies to patients in all 50 states. As your readers know, our healthcare system is not particularly equitable or standardized. I had originally imagined that insurance coverage for scalp cooling would happen within a year or 2 or even 3, and then our subsidies might not be necessary. Now we are 10 years out and coverage is really only just beginning. Covid was a challenging time for everybody and the current environment of layoffs and changes to medicare and social security are concerning. To date we have provided well over 7500 subsidies of up to $1500 and expect to grant 1500 in 2025 alone. Funding is of course our biggest issue. We get tremendous support from the Haircare industry, the scalp cooling suppliers, foundations and individual donors, but I would say grant writing and fundraising with our small but mighty team keeps us busy!

Partnerships with the haircare and healthcare industries have been vital to your work. Why is collaboration so important in making treatments like scalp cooling more accessible?

Haircare professionals, manufacturers and distributors across the country partner with HairToStay to raise funds for our subsidy program, and heighten awareness about scalp cooling so that stylists never have to do another 'chemo cut'. They are the ‘firs responders’ and know more than anyone how important one’s hair is to sense of self and being out in the world. They are incredibly generous partners and a joy to work with.

How do you see the future of scalp cooling evolving — both in terms of awareness and affordability?

That is the million-dollar question, there is some state legislation in New York and Louisiana that comes into effect in 2026 along with some new insurance codes, but given our current political climate, we are unsure of how this will unfold. Sadly, we are seeing more and younger patients apply for our subsidies. Some of this is due to social media and general awareness of scalp cooling. We were featured in a 2024 CNN segment, and this came about because one of the CNN anchors — Sara Sidner— had been diagnosed with breast cancer and used scalp cooling. Our hope is that anyone who wants to have the option can, and that insurance will cover enough of the cost…but we don’t see the need for our subsidies going away any time soon.

WATCH: CNN Champions For Change segment 

You’ve dedicated much of your career to social impact. What advice would you give to others who want to create meaningful change in healthcare or patient advocacy?

It’s a wild ride and a lot of hard work, but if you see a need and have the energy and resources to make a difference in someone’s life during the worst moment in their life, there is a tremendous feeling that you have done something meaningful. My grandfather always used to say, “You’ve got to give to get.” He was right.

“Beauty of Change” is our motto at Everviolet. What does that phrase mean to you in the context of your work and your mission with HairToStay?

Scalp cooling is a revolutionary therapy. Our tag line at HairToStay is ‘Helping Cooler Heads Prevail’— that of course, is a cheeky nod to our mission, but also we are trying to be the ray of hope in an otherwise challenging time in a person’s life. At first blush, sometimes people think, ‘why worry about your hair, when fighting cancer,’ but for so many, keeping one’s hair goes far beyond the outward appearance. Hair is a defining feature and for many, so integral to their identity. Whether it’s feeling good in your skin or looking in the mirror and seeing yourself, beauty is in the eye of the beholder during such a difficult time, and looking and feeling your best is priceless when going through an acute illness. 

We invite the Everviolet community to participate in the HairTostay Does the Bay Walk & Cold Plunge at Chrissy Field, Saturday, October 4th, 10-1. Join us for a festive celebration, bagels, treats and libations, music, haircare gift bags and so much more. Enjoy a meaningful morning walk (and possibly a plunge)— in community— to raise funds for HairToStay, so we can continue to never say no to an eligible patient. Bring your children, dogs, parents, partners, colleagues, neighbors, friends and family to join our mission to help cooler heads prevail.

We promise to bring our trademark creativity, color and flair. All we need is you!!