Chemotherapy-Induced Alopecia Beyond Cytotoxicity: Hair Follicle Immune Privilege Collapse and JAK-STAT Signaling

The review discusses chemotherapy-induced alopecia (CIA), emphasizing that it involves not only direct cytotoxic damage but also immune-mediated mechanisms similar to alopecia areata (AA). The collapse of hair follicle immune privilege and the JAK-STAT signaling pathway are central to CIA's pathogenesis. Janus kinase inhibitors (JAKi) show promise in managing hair loss by modulating immune responses, but they carry risks such as immunosuppression and potential cancer exacerbation. The review suggests that targeted therapies, including topical JAKi formulations, could offer safer alternatives by enhancing drug delivery to hair follicles while minimizing systemic side effects. Future research should focus on balancing immune modulation with hair follicle protection to improve treatment outcomes for cancer patients experiencing CIA.