Permanent chemotherapy induced alopecia : How common is it?

Permanent chemotherapy induced alopecia: 4 in 10 Patients Affected

There are two types of hair loss that follow receipt of a chemotherapeutic agent: temporary chemotherapy induced alopecia (TCIA) and permanent chemotherapy induced alopecia (PCIA) The first type is somewhat expected and most people are aware of the possibility of losing hair with chemotherapy. The second type is thought to be rare and is largely considered an unexpected occurence. PCIA is defined as the failure of the hair to grow back fully by 6 months following the end of chemotherapy.

A Closer Look at PCIA: How common is it really?

Kang et al recently set out to perform a prospective cohort study of 61 consecutive patients ≥18 years of age with postoperative diagnosis of stage I-III breast cancer expected to receive adjuvant chemotherapy at an outpatient breast cancer clinic in Seoul, Korea. The proportion of participants who had PCIA at 6 months and 3 years was 39.5% and 42.3%, respectively. Patients who received a taxane-based regimen were more likely to experience PCIA compared with patients with other types of chemotherapy.


This is a really important study because it teaches us that PCIA may not be anywhere near as rare as we once believed it to be. So many patients who I see are told by their oncology teams that permanent types of hair loss are infrequent and some are not even told of the possibility. If PCIA truly has a frequency as high as 40 %, then counselling about this side effects becomes an even higher priority for oncology teams.


Kang D et al. Permanent Chemotherapy-Induced Alopecia in Patients with Breast Cancer: A 3-Year Prospective Cohort Study. Oncologist. 2018.

Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887

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