Prevention of Chemotherapy-Induced Alopecia

Efficacy of Scalp Cooling

The application of a scalp cooling device is recommended for the prevention of chemotherapy-induced alopecia, with success rates of 50-65% in patients, according to the American Society of Clinical Oncology 1
Scalp cooling causes vasoconstriction and reduces biochemical activity in the scalp and hair follicles, leading to less hair loss, as stated by the European Society for Medical Oncology 1

Scalp cooling should start 20-45 minutes before chemotherapy infusion, continue during infusion, and last 20-150 minutes after infusion, as recommended by the European Society for Medical Oncology 1
For docetaxel monotherapy or combination therapy (75-100 mg/m²), a cooling time of 20 minutes after infusion is sufficient, according to the European Society for Medical Oncology 1

Hematological malignancies, as stated by the European Society for Medical Oncology 1
Cold sensitivity, as stated by the European Society for Medical Oncology 1
Cold agglutinin disease, as stated by the European Society for Medical Oncology 1
Cryoglobulinemia, as stated by the European Society for Medical Oncology 1
Cryofibrinogenemia, as stated by the European Society for Medical Oncology 1
Cold post-traumatic dystrophy, as stated by the European Society for Medical Oncology 1
Whole-brain radiation therapy after chemotherapy, as stated by the European Society for Medical Oncology 1

After completion of chemotherapy, topical minoxidil 5% can support hair regrowth, with a strength of evidence of IV, C, as stated by the European Society for Medical Oncology 1
Biotin (2.5 mg or 2500 mg daily) or orthosilicic acid (10 mg daily) may be considered as initial treatment, but are not generally recommended, with a strength of evidence of IV, C, as stated by the European Society for Medical Oncology 1
In patients with endocrine therapy-induced alopecia (EIA), thyroid function, vitamin D, zinc, and ferritin levels should be checked and corrected if necessary, as stated by the European Society for Medical Oncology 1

Hair typically starts to regrow 2-3 months after completion of chemotherapy, at a rate of about 1 cm per month, as stated by the European Society for Medical Oncology 1
About 65% of patients report changes in color and texture of regrowing hair, as stated by the European Society for Medical Oncology 1
The NCCN guidelines recommend scalp cooling to reduce the incidence of chemotherapy-induced alopecia in patients receiving chemotherapy, as stated by the National Comprehensive Cancer Network 2