Presentation, impact and prevention of chemotherapy-induced hair loss: scalp cooling potentials and limitations

Abstract

Background: This article provides an overview of the incidence and severity, presentation and impact of chemotherapy-induced alopecia (CIA), one of the most common and distressing side effects of cancer therapy. Furthermore, prevention of CIA by scalp cooling is described, as well as suggestions for improvement of scalp cooling application and clinical research approaches. Methods: This article focuses on the availability of options to treat CIA and on scalp cooling in particular. It presents an overview of 58 scalp cooling publications and three personal communications, describing its working mechanism, determinants of success rates, side effects and controversies. Results: CIA occurs in many chemotherapy regimens and is nearly always reversible. Up to now, scalp cooling is by far the best method to reduce CIA. Concerns about the protection of malignant cells in the scalp skin by scalp cooling have been proven to be exaggerated. The majority of patients tolerate scalp cooling very well. Scalp cooling is ...