Safety of Alopecia Treatments in Patients With Breast Cancer and High-Risk Women: A Review

July 2025 in “ American Journal of Clinical Dermatology ”

Caitlin A. Kearney, Anna Brinks, Carli D. Needle, Grace Rachko, Amy Kalowitz Bieber, Jerry Shapiro, Mario E. Lacouture, Daniela Majerson, Kristen I. Lo Sicco

alopecia treatments antiandrogens 5α-reductase inhibitors spironolactone androgenetic alopecia ketoconazole low-level light therapy 5-alpha-reductase inhibitors LLLT

TLDR Alopecia treatments like 5α-reductase inhibitors and spironolactone are safe for breast cancer patients and high-risk women.

The review evaluates the safety of alopecia treatments in breast cancer patients and high-risk women, focusing on antiandrogens, 5α-reductase inhibitors, and spironolactone. It concludes that 5α-reductase inhibitors and spironolactone, used for androgenetic alopecia, do not elevate the risk of breast or gynecologic cancers, even for those on endocrine therapies for breast cancer. Additionally, ketoconazole and low-level light therapy are discussed as supportive treatments. The findings indicate that these treatments are generally safe for managing alopecia in this patient group without increasing cancer risk.

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