What are the Effective Approaches to Prevent Hair Loss During Chemotherapy?


One of the most common side effects of cancer treatment, chemotherapy-induced hair loss (CAHD), can cause serious trauma not only physically but also psychologically for patients. In this article, we provide information about current methods and scientifically based approaches developed to prevent or reduce the effects of chemotherapy-induced hair loss.

Mechanism of Chemotherapy-Induced Hair Loss (CAHD)
Post-chemotherapy alopecia occurs as a result of the sudden cessation of cellular division of hair follicles, especially in the anagen phase. Chemotherapeutic drugs such as anthracyclines, taxanes, alkylating agents and topoisomerase inhibitors are the main agents that cause CAHD. CAHD usually begins within the first two weeks after chemotherapy and complete hair loss can occur within 1-2 months. This process can cause patients to lose their ability to recognize themselves, to withdraw from social life and even to refuse treatment.

Approaches to Preventing CBSD
1. Scalp Cooling
Cooling the scalp is one of the most proven and FDA-approved methods for preventing CBSD. Cooling reduces blood flow in the scalp, preventing chemotherapy agents from reaching the hair follicles. Clinical studies have shown a protective effect of up to 50%, especially in taxane and anthracycline-based treatments.

2. Topical Vasoconstrictors
Adrenoreceptor agonists prevent chemotherapeutic agents from reaching the area by constricting the blood vessels in the scalp. This method, which has been shown to be effective in preclinical studies, is not yet in widespread clinical use, but it is promising.

3. Topical Minoxidil
Minoxidil, which supports hair growth by shortening the hair cycle and encouraging the transition to the anagen phase, is recommended especially for accelerating hair growth after treatment. It is not recommended for use before chemotherapy.

4. Topical Calcitriol
Calcitriol, a derivative of vitamin D, can support follicle health by regulating cell proliferation. Some studies have reported positive effects on CBSD.

5. Bimatoprost / Prostaglandin F2α Analogs
Bimatoprost is an agent used in eye drop form that promotes eyelash growth. It has been shown to be effective in post-chemotherapy eyelash loss, but its effect on the scalp is still being investigated.

6. Platelet-Rich Plasma (PRP)
PRP applications can support the regeneration of hair follicles thanks to the growth factors it contains. It is a promising method, especially in the recovery process after CBSD.

7. Photobiomodulation
Low-level laser treatments stimulate cell metabolism and promote hair growth. It is considered a complementary method in the prevention or treatment of CBSD.

8. Antioxidants
Antioxidants such as vitamin E, N-acetyl cysteine, selenium and zinc, which are used to reduce oxidative stress during chemotherapy, have been reported to reduce hair loss.

Alternative and Complementary Approaches
Studies with animal models have shown that cytokines such as keratinocyte growth factor (KGF), epidermal growth factor (EGF) and fibroblast growth factor (FGF) can prevent CBSD. However, their clinical use has not yet been put into routine practice. Supportive treatments such as herbal products, anti-inflammatory agents and biological peptides are still in the experimental stage.

Psychological Support and Counseling
Hair loss causes not only aesthetic concerns in patients but also serious psychological devastation. It is important to support the patient during this process, provide psychological counseling and suggest temporary solutions such as wigs and hair prostheses.

Conclusion
Hair loss due to chemotherapy is a side effect that seriously affects the patient's quality of life. However, thanks to cooling systems, topical treatments, biological agents and complementary methods developed today, it has become possible to reduce or prevent this effect. Creating a customized treatment plan for each patient is of great importance both in terms of reducing hair loss and increasing compliance with treatment.

The support received from centers that follow current scientific approaches in this regard will contribute to both the physical and mental well-being of patients.

Prepared by: Dermatologist Fatma Yıldız
Ankara Life Polyclinic