Expert Consensus for Prevention, Diagnosis and Management of Persistent Chemotherapy-Induced Alopecia

September 2025 in “ PubMed ”

Azael Freites‐Martínez, Zoé Apalla, Jerry Shapiro, Matilde Iorizzo, Lidia Rudnicka, Kristen Lo Sicco, Vasiliki Nikolaou, Rodrigo Pirmez, Anita Takwale, Davide Fattore, Brittany Dulmage, Bianca Maria Piraccini, Sergio Vañó‐Galván, Mario E. Lacouture, V. Sibaud, Michela Starace

persistent chemotherapy-induced alopecia pCIA non-scarring alopecia hair follicle stem cells taxanes thiotepa anthracyclines scalp cooling devices topical minoxidil low-dose oral minoxidil bicalutamide oral finasteride dutasteride minoxidil Propecia Avodart

TLDR Prevent persistent hair loss after chemotherapy with scalp cooling and early minoxidil use.

This Delphi study establishes guidelines for managing persistent chemotherapy-induced alopecia (pCIA), emphasizing early intervention with topical or low-dose oral minoxidil and recommending scalp cooling as a preventive measure. It advises against using 5-α-reductase inhibitors in hormone receptor–positive breast cancer patients due to recurrence risks. The study involved 15 dermatologists and achieved consensus on 47 out of 62 statements, focusing on the definition and prevention of pCIA. It highlights the need for further research and collaboration between oncologists and dermatologists to improve diagnosis and treatment, ultimately enhancing the quality of life for cancer survivors.

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