Multiple Drugs
June 2017
in “
Reactions Weekly
”
diffuse alopecia chemotherapy carboplatin cyclophosphamide docetaxel doxorubicin epirubicin fluorouracil paclitaxel hormonal therapy tamoxifen trastuzumab anastrozole letrozole minoxidil non-scarring alopecia hair follicle units sebaceous glands miniaturization end-stage fibrous tracts alopecia areata antiestrogen hormonal therapy Rogaine
TLDR Some breast cancer treatments caused long-term hair loss in women, similar to a condition called alopecia areata.
In a retrospective study, 10 women aged 46-72 who had breast cancer developed diffuse alopecia after being treated with a combination of chemotherapy drugs (carboplatin, cyclophosphamide, docetaxel, doxorubicin, epirubicin, fluorouracil, paclitaxel) and hormonal therapy (tamoxifen, trastuzumab, anastrozole, letrozole). The hair loss persisted for more than 6 months after stopping the chemotherapy, with varying degrees of hair regrowth; one woman experienced complete regrowth after using minoxidil. Histopathology showed non-scarring alopecia with preserved hair follicle units, sebaceous glands, miniaturization, and end-stage fibrous tracts. The study suggests that chemotherapy can induce alopecia with a clinical and histopathologic appearance similar to alopecia areata, and that antiestrogen hormonal therapy may also contribute to hair loss.