Prevention and Treatment of Chemotherapy-Induced Alopecia
Keywords:
hair loss, chemotherapy, treatment, alopeciaAbstract
Background: Chemotherapy-induced alopecia (CIA) is one of the most dramatic side effects of chemotherapy. Currently no guidelines are available for its prevention and treatment. Several devices and drugs are used, but results are often disappointing.
Aims: Our aim is to analyze drugs and devices proposed in the literature for prevention and treatment of CIA induced by cytotoxic drugs and to discuss the evidenced-based opinion.
Methods and Results: Scalp cooling is the only agent that has been approved by the US Food and Drug Administration for CIA prevention. Minoxidil and bimatoprost should not be used during chemotherapy administration, but they can be used after chemotherapy discontinuation to obtain greater regrowth.
Conclusions: Therapy should always be modulated for the patient and no fixed protocol should be used. Trichoscopy and trichogram could be useful tools in supporting this treatment.
References
Balagula Y, Rosen ST, Lacouture ME. The emergence of supportive oncodermatology: the study of dermatologic adverse events to cancer therapies. J Am Acad Dermatol. 2011;65(3):624-635. https://doi.org/10.1016/j.jaad.2010.06.051
Trüeb RM. Chemotherapy-induced hair loss. Skin Ther Lett. 2010;15(7):5-7.
Rubio-Gonzalez B, Juhász M, Fortman J, Mesinkovska NA. Pathogenesis and treatment options for chemotherapy-induced alopecia: a systematic review. Int J Dermatol. 2018;57(12):1417-1424. https://doi.org/10.1111/ijd.13906
Paus R, Haslam IS, Sharov AA, Botchkarev VA. Pathobiology of chemotherapy-induced hair loss. Lancet Oncol. 2013;14(2):e50-e59. https://doi.org/10.1016/S1470-2045(12)70553-3
Miteva M, Misciali C, Fanti PA, Vincenzi C, Romanelli P, Tosti A. Permanent alopecia after systemic chemotherapy: a clinicopathological study of 10 cases. Am J Dermatopathol. 2011;33(4):345-350. https://doi.org/10.1097/DAD.0b013e3181fcfc25
Breed WPM, van den Hurk CJG, Peerbooms M. Presentation, impact and prevention of chemotherapy-induced hair loss: scalp cooling potentials and limitations. Expert Rev Dermatol. 2011;6(1):109-125. https://doi.org/10.1586/edm.10.76
Macduff C, Mackenzie T, Hutcheon A, Melville L, Archibald H. The effectiveness of scalp cooling in preventing alopecia for patients receiving epirubicin and docetaxel. Eur J Cancer Care (Engl). 2003;12(2):154-161. https://doi.org/10.1046/j.1365-2354.2003.00382.x
Prochilo T, Huscher A, Andreis F, et al. Hair loss prevention by a scalp cooling device in early breast cancer patients: the Poliambulanza preliminary experience. Rev Recent Clin Trials. 2019;14(1):66-71. https://doi.org/10.2174/1574887113666181120111104
Shin H, Jo SJ, Kim DH, Kwon O, Myung SK. Efficacy of interventions for prevention of chemotherapy-induced alopecia: a systematic review and meta-analysis. Int J Cancer. 2015;136(5):e442-e454. https://doi.org/10.1002/ijc.29115
Betticher DC, Delmore G, Breitenstein U, et al. Efficacy and tolerability of two scalp cooling systems for the prevention of alopecia associated with docetaxel treatment. Support Care Cancer. 2013;21(9):2565-2573. https://doi.org/10.1007/s00520-013-1804-9
Kanat O, Ertas H, Caner B. Platinum-induced neurotoxicity: a review of possible mechanisms. World J Clin Oncol. 2017;8(4):329-335. https://doi.org/10.5306/wjco.v8.i4.329
Breed WPM, van den Hurk CJG, Peerbooms M. Presentation, impact and prevention of chemotherapy-induced hair loss: scalp cooling potentials and limitations. Expert Rev Dermatol. 2011;6(1):109-125. https://doi.org/10.1586/edm.10.76
Komen MM, Smorenburg CH, van den Hurk CJ, Nortier JW. Factors influencing the effectiveness of scalp cooling in the prevention of chemotherapy-induced alopecia. Oncologist. 2013;18(7):885-891. https://doi.org/10.1634/theoncologist.2012-0332
Grevelman EG, Breed WP. Prevention of chemotherapy-induced hair loss by scalp cooling. Ann Oncol. 2005;16(3):352-358. https://doi.org/10.1093/annonc/mdi088
Soref CM, Fahl WE. A new strategy to prevent chemotherapy and radiotherapy-induced alopecia using topically applied vasoconstrictor. Int J Cancer. 2015;136(1):195-203. https://doi.org/10.1002/ijc.28961
Rathman-Josserand M, Genty G, Lecardonnel J, et al. Human hair follicle stem/progenitor cells express hypoxia markers. J Invest Dermatol. 2013;133(8):2094-2097. https://doi.org/10.1038/jid.2013.113
Patel A, Levi JR, Brook CD. Should excess topical decongestant use raise a red flag? Rhinitis medicamentosa and opioid use disorder. Ann Otol Rhinol Laryngol. 2020;129(2):164-169. https://doi.org/10.1177/0003489419880576
Lockey RF. Rhinitis medicamentosa and the stuffy nose. J Allergy Clin Immunol. 2006;118(5):1017-1018. https://doi.org/10.1016/j.jaci.2006.06.018
Rodriguez R, Machiavelli M, Leone B, et al. Minoxidil (Mx) as a prophylaxis of doxorubicin-induced alopecia. Ann Oncol. 1994;5(8):769-770. https://doi.org/10.1093/oxfordjournals.annonc.a058986
Duvic M, Lemak NA, Valero V, et al. A randomized trial of minoxidil in chemotherapy-induced alopecia. J Am Acad Dermatol. 1996;35(1):74-78. https://doi.org/10.1016/S0190-9622(96)90500-9
Rossi A, Anzalone A, Fortuna MC, et al. Multi-therapies in androgenetic alopecia: review and clinical experiences. Dermatol Ther. 2016;29(6):424-432. https://doi.org/10.1111/dth.12390
Rossi A, Fortuna MC, Caro G, et al. Monitoring chemotherapy-induced alopecia with trichoscopy. J Cosmet Dermatol. 2019;18(2):575-580. https://doi.org/10.1111/jocd.12687
Glaser DA, Hossain P, Perkins W, et al. Long-term safety and efficacy of bimatoprost solution 0.03% application to the eyelid margin for the treatment of idiopathic and chemotherapy-induced eyelash hypotrichosis: a randomized controlled trial. Br J Dermatol. 2015;172(5):1384-1394. https://doi.org/10.1111/bjd.13443
Jimenez JJ, Yunis AA. Vitamin D3 and chemotherapy-induced alopecia. Nutrition. 1996;12(6):448-449. https://doi.org/10.1016/S0899-9007(97)85081-2
Wang J, Lu Z, Au JL. Protection against chemotherapy-induced alopecia. Pharm Res. 2006;23(11):2505-2514. https://doi.org/10.1007/s11095-006-9105-3
Jimenez JJ, Alvarez E, Bustamante CD, Yunis AA. Pretreatment with 1,25(OH)2D3 protects from Cytoxan-induced alopecia without protecting the leukemic cells from Cytoxan. Am J Med Sci. 1995;310(2):43-47. https://doi.org/10.1097/00000441-199508000-00001
Hidalgo M, Rinaldi D, Medina G, Griffin T, Turner J, Von Hoff DD. A phase I trial of topical topitriol (calcitriol, 1,25-dihydroxyvitamin D3) to prevent chemotherapy-induced alopecia. Anticancer Drugs. 1999;10(4):393-395. https://doi.org/10.1097/00001813-199904000-00007
Gröber U, Holzhauer P, Kisters K, Holick MF, Adamietz IA. Micronutrients in oncological intervention. Nutrients. 2016;8(3):163. https://doi.org/10.3390/nu8030163
Fink M. Vitamin D deficiency is a cofactor of chemotherapy-induced mucocutaneous toxicity and dysgeusia. J Clin Oncol. 2011;29(4):e81-e82. https://doi.org/10.1200/JCO.2010.31.5317
Arul Vijaya Vani S, Ananthanarayanan PH, Kadambari D, Harichandrakumar KT, Niranjjan R, Nandeesha H. Effects of vitamin D and calcium supplementation on side effects profile in patients of breast cancer treated with letrozole. Clin Chim Acta. 2016;459:53-56. https://doi.org/10.1016/j.cca.2016.05.020
Wood LA. Possible prevention of adriamycin-induced alopecia by tocopherol. N Engl J Med. 1985;312(16):1060. https://doi.org/10.1056/NEJM198504183121613
Martin-Jimenez M, Diaz-Rubio E, Gonzalez Larriba JL, Sangro B. Failure of high-dose tocopherol to prevent alopecia induced by doxorubicin. N Engl J Med. 1986;315(14):894-895. https://doi.org/10.1056/NEJM198610023151416
Perez JE, Macchiavelli M, Leone BA, et al. High-dose alpha-tocopherol as a preventive of doxorubicin-induced alopecia. Cancer Treat Rep. 1986;70(10):1213-1214.
Davis ST, Benson BG, Bramson HN, et al. Prevention of chemotherapy-induced alopecia in rats by CDK inhibitors. Science. 2001;291(5501):134-137. https://doi.org/10.1126/science.291.5501.134
Purba TS, Ng'andu K, Brunken L, et al. CDK4/6 inhibition mitigates stem cell damage in a novel model for taxane-induced alopecia. EMBO Mol Med. 2019;11(10):e11031. https://doi.org/10.15252/emmm.201911031
Jimenez JJ, Wong GH, Yunis AA. Interleukin 1 protects from cytosine arabinoside-induced alopecia in the rat model. FASEB J. 1991;5(10):2456-2458. https://doi.org/10.1096/fasebj.5.10.2065892
Jimenez JJ, Sawaya ME, Yunis AA. Interleukin 1 protects hair follicles from cytarabine (ARA-C)-induced toxicity in vivo and in vitro. FASEB J. 1992;6(3):911-913. https://doi.org/10.1096/fasebj.6.3.1740239
Shirai A, Tsunoda H, Tamaoki T, Kamiya T. Topical application of cyclosporin A induces rapid-remodeling of damaged anagen hair follicles produced in cyclophosphamide administered mice. J Dermatol Sci. 2001;27(1):7-13. https://doi.org/10.1016/S0923-1811(01)00097-4
Jimenez JJ, Yunis AA. Protection from 1-beta-D-arabinofuranosylcytosine-induced alopecia by epidermal growth factor and fibroblast growth factor in the rat model. Cancer Res. 1992;52(2):413-415.
Botchkarev VA, Komarova EA, Siebenhaar F, et al. p53 is essential for chemotherapy induced hair loss. Cancer Res. 2000;60(18):5002-5006.
Published
Issue
Section
License
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.