Persistent Chemotherapy-Induced Alopecia: Is It Partially Reversible in Breast Cancer Survivors?

By: Kayci Reyer
Posted: Tuesday, January 18, 2022

According to research presented in JAMA Dermatology, persistent chemotherapy-induced alopecia, a condition known to affect some patients treated for breast cancer, may be at least partially reversible. Taxane-based treatment regimens have been most closely associated with this type of alopecia.

“Ultimately preventing [hair follicle] damage in the first place, through the wider use of hair-protective strategies (eg, scalp hypothermia) and the development of novel approaches (eg, cyclin-dependent kinase 4/6 inhibitors), holds the most promise for curtailing this distressing adverse effect of chemotherapy,” concluded Matthew J. Harries, PhD, of the Salford Royal National Health Service Foundation Trust in the United Kingdom, and colleagues.

The retrospective study included 100 patients with breast cancer who had been diagnosed with persistent chemotherapy-induced alopecia between November 1, 2011, and February 29, 2020. Most patients (n = 92) had undergone taxane-containing treatment regimens, which were associated with more severe alopecia than were regimens without a taxane. Many patients (n = 55) had female pattern hair loss; others had diffuse nonscarring alopecia (n = 39) or male pattern hair loss (n = 6). Cicatricial alopecia occurred in six patients.

A total of 90 patients underwent a trichoscopic examination. Hair shaft diameter variability, increased vellus hairs, and predominant single-hair follicular units were most prevalent among those examined. Among the 18 patients who had scalp biopsies, androgenetic alopecia-like features (n = 14), cicatricial alopecia (n = 2), and combined features from androgenetic and cicatricial alopecia (n = 2) were observed. Topical and oral minoxidil treatments with or without antiandrogen therapy were related to an improvement in hair density.

“Cosmetically significant regrowth was achieved for a significant proportion of patients with topical or systemic treatments, suggesting that persistent chemotherapy-induced alopecia may be at least partly reversible,” the study authors concluded.

Disclosure: For full disclosures of the study authors, visit jamanetwork.com.

JAMA Dermatology