Why Do Not All Chemotherapy Patients Lose Their Hair? Answering an Intriguing Question

The document explains that not all chemotherapy patients lose their hair because of factors such as the varying mitotic rates of hair follicles, the influence of age on cell division rates, and the presence of androgenetic alopecia (AGA). While temporary alopecia is common and hair can regrow, permanent alopecia can occur, particularly with high-dose busulfan and cyclophosphamide regimens, and may be linked to genetic variants like those in the ABCB1 gene. A study by Sengelov et al. found that only 44% of patients experienced alopecia with a docetaxel and cisplatin regimen. The phase of the hair cycle during chemotherapy affects whether hair loss occurs as anagen effluvium (AE) or telogen effluvium (TE), and AGA may influence the type of hair loss experienced. The conclusion is that while hair dystrophy is likely in all chemotherapy patients, not all will experience immediate hair shedding, and the extent of hair loss may be influenced by AGA, with women potentially experiencing more intense AE and men with severe AGA experiencing less AE and delayed full hairlessness. The effect of chemotherapy on cancer cells in relation to hair loss is still unclear.