TLDR Hedgehog pathway inhibitors used for skin cancer can cause significant hair loss, which may improve after stopping the medication.
The article discusses the side effects of hedgehog pathway inhibitors, specifically vismodegib and sonidegib/erismodegib, which are used to treat advanced basal cell carcinomas. It reports on a series of 5 patients (4 females, 1 male, median age 51) treated with these drugs who experienced profound hair thinning and increased shedding, with a median onset of 3 months after starting treatment. The pattern of hair loss was diffuse and also affected body hair in four cases. Histopathological examination of scalp biopsies from 4 patients showed a non-scarring process with an increase in telogen hairs, consistent with telogen effluvium. One patient experienced hair regrowth after ceasing treatment, suggesting that the hair follicles may recover when the medication is stopped. The article suggests that alopecia is a class effect of hedgehog pathway inhibitors and emphasizes the importance of counseling patients about this side effect.
24 citations,
November 2013 in “British Journal of Dermatology” Chemotherapy causes hair loss starting soon after treatment begins and recovers about 3 months after ending, while tamoxifen does not significantly affect hair growth.
113 citations,
September 2005 in “Journal of Investigative Dermatology” Applying a special compound can promote hair growth without harmful side effects.
54 citations,
January 2005 in “Journal of The American Academy of Dermatology” Most patients with chronic hair shedding did not progress to permanent hair loss, and one showed improvement with treatment.
194 citations,
May 2000 in “Journal of Investigative Dermatology” The hedgehog signaling pathway is crucial for hair growth but not for the initial creation of hair follicles.
June 2019 in “International journal of dermatology and venereology” The Hedgehog Signaling Pathway is important for skin and hair development and skin cancer treatment, but more research is needed to understand it fully.
1 citations,
March 2019 in “Actas Dermo-Sifiliográficas” New cancer treatments are less harmful to hair but can still cause hair loss, color, shape, and growth changes.
17 citations,
June 2017 in “British Journal of Dermatology” The article concludes that hair loss is a common side effect of drugs treating skin cancer by blocking the hedgehog pathway, but treatment should continue, and more selective drugs might prevent this side effect.
21 citations,
November 2021 in “Cells” Hedgehog pathway inhibitors can treat certain aggressive cancers but face limitations like resistance and side effects.
127 citations,
August 2016 in “The oncologist” Understanding and managing side effects of hedgehog pathway inhibitors can improve treatment for advanced basal cell carcinoma.
