Persistent Chemotherapy-Induced Alopecia: Updates in Diagnosis and Treatment
April 2026
in “
Actas Dermo-Sifiliográficas
”
chemotherapy-induced alopecia PCIA busulfan taxanes noninflammatory alopecia hair shaft thickness trichoscopic evaluation adjuvant antiestrogen therapy scalp cooling therapies topical minoxidil oral minoxidil spironolactone trichoscopic follow-up chemotherapy hair loss hair regrowth hair thickness hair loss prevention Rogaine
Persistent chemotherapy-induced alopecia (PCIA) occurs when hair regrowth is absent or incomplete beyond 6 months after chemotherapy, with an incidence ranging from 0.9% to 43%. Drugs like busulfan and taxanes are commonly associated with PCIA, which is characterized by noninflammatory alopecia and reduced hair shaft thickness. Trichoscopic evaluation is vital for predicting hair regrowth outcomes, especially in patients on adjuvant antiestrogen therapy. Scalp cooling therapies can prevent hair loss without increasing metastatic risk, improving quality of life. Topical and low-dose oral minoxidil show promise in promoting hair regrowth, while spironolactone may also be beneficial, though not yet studied as monotherapy for PCIA. Standardizing treatment response measures with trichoscopic follow-up is crucial for managing PCIA effectively.
