Radiation- and Chemotherapy-Induced Permanent Alopecia: Case Series

The document reported on an observational case series involving 11 patients who developed permanent alopecia following chemotherapy, radiotherapy, or both, particularly after conditioning for bone marrow transplantation. Scalp biopsies indicated reduced follicular densities and miniaturization without scarring or inflammation. The study suggested that permanent alopecia can result from high doses of radiation (with 43 Gy causing permanent hair loss in 50% of patients) and certain chemotherapeutic agents, although not all patients are affected. Factors like serum busulfan concentration may play a role in the development of chemotherapy-induced permanent alopecia (CIPAL). The study called for further research to identify causative factors and preventive measures, noting that options like dose reduction and scalp hypothermia might help prevent CIPAL. The document emphasized the distress caused by permanent alopecia and the need for strategies to minimize its occurrence.