Chemotherapy-induced alopecia

Few dermatologic conditions carry as much emotional distress as chemotherapy-induced hair loss. Forty-seven percent of female patients consider hair loss the most traumatic aspect of chemotherapy, and 8% would decline chemotherapy because of fear of hair loss. A number of agents have been evaluated on the basis of the current understanding of the underlying pathobiology.

Among the agents that have been evaluated, topical minoxidil was able to reduce the severity or shorten the duration but could not prevent hair loss. The major approach to minimize chemotherapy-induced hair loss is by scalp cooling, although most published data on scalp cooling are of poor quality. Because chemotherapy-induced toxicity has been associated with nutritional status, nutritional assessment and support might confer beneficial effects. Several experimental approaches to the development of pharmacological agents are under evaluation including: anti-oxidants, cytokines and growth factors, cell cycle and proliferation modifiers, and inhibitors of apoptosis.

At present, no approved pharmacologic treatment of chemotherapy-induced hair loss exists. The incidence and severity of the condition are variable and related to the particular chemotherapeutic protocol. Fortunately, chemotherapy-induced hair loss is mostly reversible, and appropriate hair and scalp care and temporarily wearing a wig may be the most effective coping strategy.