Persistent Chemotherapy-Induced Alopecia (pCIA)

What is persistent chemotherapy-induced alopecia? (pCIA)

Persistent chemotherapy-induced alopecia (pCIA) is a condition where hair loss continues for an extended period (more than 6 months) after the completion of chemotherapy.

Unlike temporary hair loss, which is a common side effect of chemotherapy that usually resolves within a few months after treatment ends, pCIA involves incomplete hair regrowth which can persist indefinitely.

What are the symptoms of pCIA?

The pattern of loss can vary from person to person but there is reduced hair regrowth. Hair does not grow back within the typical timeframe of 3-6 months after completion of chemotherapy. Some regrowth might occur, but it is less than expected. Often, this appears as a general (diffuse) thinning of the hair. Sometimes, hair regrowth is in the pattern of female pattern hair loss, with more marked thinning on the top of the scalp. Sometimes the regrowth is uneven, giving the appearance of patchy loss. Rarely, a scarring type of alopecia can develop.

What causes pCIA?

Persistent chemotherapy-induced alopecia is caused by damage to the hair follicles during chemotherapy. While the exact mechanisms aren’t fully understood, the following types of chemotherapy are associated with an increased risk of pCIA:

Taxanes: Drugs like docetaxel and paclitaxel, which are used to treat breast cancer, are particularly associated with pCIA. These drugs target rapidly dividing cells, including those in hair follicles, leading to hair loss. Taxanes are known to cause more severe and sometimes permanent damage to hair follicles. Higher doses and prolonged exposure to these drugs can cause more extensive damage to hair follicles. Patients receiving a combination of chemotherapy drugs, particularly those including taxanes, are at a higher risk of developing pCIA.

Bone marrow transplantation chemotherapy treatments can also cause pCIA.

How common is pCIA?

The exact incidence of pCIA is not known. Temporary hair loss occurs with over 60% of chemotherapy drugs. Persistent chemotherapy-induced alopecia is much less common.

Can pCIA be treated?

Treating persistent chemotherapy-induced alopecia (pCIA) can be challenging, as the condition involves persistent damage to hair follicles. Topical minoxidil can help stimulate hair follicles to produce hair growth, although its effectiveness for pCIA may be limited. It may result in some improvement in hair density but it is not always effective for everyone. Sometimes, minoxidil given as a tablet can be tried if topical minoxidil is not sufficiently helpful.

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What is persistent chemotherapy-induced alopecia? (pCIA)

What are the symptoms of pCIA?

What causes pCIA?

How common is pCIA?

Can pCIA be treated?

Further reading