Permanent Chemotherapy Induced Alopecia




Every year well over 1/2 million patients undergo chemotherapy in the United States. About 65 % of these patients will lose hair as hair loss is a common side effect of chemotherapy. There are two main types of hair loss that occur in patients undergoing chemotherapy: TCIA AND PCIA


The first type of hair loss that I would like to explain  is hair loss that happens within weeks of starting the chemotherapy and then lasts several months before growing back. This is known as temporary chemotherapy induced alopecia ("TCIA"). 


The second type is uncommon and occurs when patients fail to regroth their hair back to the level it was before undergoing chemotherapy. If hair has not grown back after chemotherapy by the 6 month after chemotherapy, we call this permanent chemotherapy induced alopecia (PCIA).

PCIA in Breast Cancer Patients

A number of studies have highlighted the possibility of PCIA in women with breast cancer treated with various chemotherapeutic agents, especially drugs known as taxanes (Docetaxel and paclitaxel are part of this group of drugs). The exact mechanisms by which they cause permanent hair loss are unclear although injury to the bulb as well as follicular stem cells are thought to be relevant. Adjuvant anti-estrogen hormonal therapy may be an important cofactor in many women with PCIA. A similar PCIA presentation has been reported in patients undergoing bone marrow transplantation. The scalp is predominantly affected in women with PCIA although a minority may have eyebrow, eyelash and body hair loss as well.

We don't really know yet how to best treat PCIA. However, the most common treatments described in the research literature are oral and topical minoxidil. Both seem to provide benefit to at least a proportion of patients. Other treatments are not known to provide benefit.

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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