Aprile 2022 - N° 49
Giornale Italiano di Tricologia
Chemotherapy-induced alopecia Nicolò Rivetti, MD Vigevano and Milano The extent of the problem For a cancer patient, chemotherapy-induced alopecia is one of the most shocking aspects of the therapy. It is estimated that 58% of patients even consider it the most worrying adverse event of chemotherapy, even, for many women, more difficult to cope with than the loss of a breast. About 65% of chemotherapy patients experience hair loss during therapy. This aspect has a very significant impact on the patient's life, as it affects the image of his own body, sexuality and self-esteem, so that about 8% of cancer patients refuse chemotherapy if there is risk of hair loss.
The severity of hair loss (understood as risk and quantity) is related to: - Drugs: hair loss depends on the dosage, category, number of drugs used (for multi-chemotherapies the risk is increased) and on the type of administration (generally a higher incidence is observed in the case of intravenous therapies than to oral chemotherapy, which however is much less common). - Subjective factors: such as the patient's age, associated pathologies, pre-existence of any type of alopecia, nutritional and hormonal status.
Another important psychological aspect of hair loss should also be emphasized: chemotherapyinduced alopecia represents every day a sort of “reminder“ of the patient's disease, further worsening their mood.
What are the timelines? Generally, alopecia occurs within 1-3 weeks of starting chemotherapy; regrowth, on the other hand, is expected after 3-6 months from the suspension of chemotherapy, even if some patients experience faster regrowth (1-2 months from the suspension of treatment, or, sometimes, even during chemotherapy).
A small percentage of patients, however, see hair loss as a positive sign that therapy is working. This interpretation of the problem should certainly be encouraged.
Why does hair fall out? Chemotherapy drugs target cells that replicate more actively but are not specific for cancer cells. They affect all cells that reproduce very quickly, including those of the hair follicle. Considering that most of the hair is in the ana47
