Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming?

Chemotherapy-induced alopecia (CIA) affects around 65% of cancer patients undergoing chemotherapy. The only FDA-approved method for preventing CIA is scalp cooling, which reduces the local concentration of chemotherapeutic agents in the hair follicles. However, its high costs limit its use. Other interventions being tested include portable and non-portable scalp cooling systems, topical agents to prevent hair loss, and treatments to stimulate hair regrowth after hair loss, such as topical and oral minoxidil, photobiomodulation therapy (PBMT), and platelet-rich plasma (PRP) injections. Topical Calcitriol, a form of Vitamin D, has been shown to stimulate hair growth and reduce alopecia in 8 out of 23 female patients undergoing taxane-based chemotherapy. Keratinocyte Growth Factor (KGF) has been found to significantly reduce hair fall and increase the number of terminal hairs when injected into the scalp. Minoxidil has been shown to stimulate hair growth and reduce the alopecic period from 137 days to 87 days. Bimatoprost, a synthetic analog of prostaglandin F2α, has been shown to promote eyelash regrowth after CIA. A study involving 54 patients showed that 67% showed improvement after treatment with oral spironolactone combined with topical minoxidil. A topical lotion, CG428, made from botanical products was shown to promote hair density and thickness in breast cancer survivors with CIA. However, more extensive research is needed to confirm the effectiveness of these treatments and assess potential adverse effects.