Prevention Of Alopecia Research Articles

Total and longitudinal body dimensions in Ukrainian men with alopecia areata

Annotation. Studying total and longitudinal body dimensions in patients with alopecia areata is important for assessing changes in anthropometric indicators associated with this disease. Studying the sexual characteristics of anthropometric indicators can contribute to improving diagnostic approaches and assessing the risks of developing concomitant pathologies. Analysis of the obtained data will allow integrating anthropological characteristics into a comprehensive strategy for the treatment and prevention of alopecia. The purpose of the study was to establish the characteristics of total and longitudinal body dimensions in young Ukrainian men with alopecia areata. Clinical-instrumental examination (using the ARAMO ASW 300 dermatoscope-trichoscope) and anthropological assessment (in accordance with the recommendations of Shaparenko P. P.) were conducted in 81 young Ukrainian men with alopecia areata. The severity of alopecia areata was assessed according to Shutskiy I. V. The control group included the total and longitudinal body dimensions of 82 practically healthy young Ukrainian men of the same age group, obtained from the database of the Scientific Research Center of the National Pirogov Memorial Medical University, Vinnytsya. Statistical analysis of the results was performed using the licensed software package “Statistica 6.0” with non-parametric evaluation methods. In contrast to practically healthy individuals, young Ukrainian men with alopecia areata, regardless of overall status or severity levels (Grades 1, 2, and 3), demonstrated significantly greater or tendencies toward greater values for body mass (12.57-20.96 %), body surface area (4.26-12.56 %), acromial height (1.84-2.45 %), and digit anthropometric points (3.40-5.42 %). Additionally, significantly lower values were observed for pubic height (5.23-6.85 %) and trochanteric height (13.07-14.28 %). These findings indicate that, compared to practically healthy individuals, men with alopecia areata have shorter lower limbs and longer upper limbs and torso, which manifests as a “subpathological” constitutional type. No significant differences or trends in total and longitudinal body dimensions were identified among groups of patients with varying degrees of alopecia areata severity. Thus, the findings suggest both genetic predisposition (changes in longitudinal body dimensions) and the influence of environmental factors (changes in body mass) in the development of this multifactorial disease.

Elucidating causal relationships of diet-derived circulating antioxidants and the risk of non-scarring alopecia: A Mendelian randomization study.

Previous observational studies revealed controversy about the effect of circulating antioxidants on risk of alopecia. In the present study, we investigated the causal relationships between diet-derived circulating antioxidants and 2 non-scarring alopecia using Mendelian randomization (MR). Instrumental variables for antioxidants (lycopene, retinol, ascorbate, β-carotene, α-tocopherol, and γ-tocopherol) were selected from published studies. Data for alopecia areata (AA) and androgenetic alopecia (AGA) was obtained from the FinnGen study project (R9 released in 2023), including 195 cases and 201,019 controls for AGA and 682 cases and 361,140 controls for AA. We used the inverse variance weighted method as the primary MR method. Three additional methods were used as sensitivity analysis to validate the robustness of the results. We found a causal relationship between absolute β-carotene levels and AGA risk (P = .039), but not with AA (P = .283). The results of Wald ratio showed a protective effect of absolute β-carotene levels against AGA, with per 0.1 ln-transformed β-carotene being associated with a 76% lower risk of AGA (OR: 0.24, 95% CI: 0.06-0.93). Based on the fixed effects inverse variance weighting results, we found that α-tocopherol was protective against both AGA (P = .026) and AA (P = .018). For each unit increase in α-tocopherol, the effects of change in AGA and AA were 0.02 (95% CI: 0.00-0.61) and 0.10 (95% CI: 0.01-0.67), respectively. The results did not reveal any other causal relationships. Our study identified 3 causal associations of antioxidants with the risk of non-scarring alopecia. These results provide new insights into the prevention of non-scarring alopecia through diet.

Cold prevention of alopecia during chemotherapy: Real clinical practice.

e24132 Background: Alopecia is one of the most common visible adverse effects of anticancer drug therapy. The incidence of grade 2 alopecia can be as high as 90% in patients getting anthracyclines or taxanes. Decreased scalp temperature causes vasoconstriction which limits the flow of chemotherapeutic agents into the scalp and reduces the metabolism of hair follicle cells at the time of maximum concentration of cytotoxic agents in plasma. This leads to a decrease in the antimitotic and antimetabolic effects of chemotherapy. ORBIS II scalp cooling device has been successfully implemented in comprehensive oncology centers. However, the results of large-scale studies are still lacking which delays application of this technology in clinical practice. The aim of our study was to evaluate the efficacy and safety of alopecia cold prophylaxis using ORBIS device in a regional referral center in Russia. Methods: Between 22 June 2022 and 13 December 2023 101 patients (100 women and 1 man) were treated using ORBIS II in the Department of Chemotherapy N1, City Clinical Cancer Hospital N1, Moscow. Various combinations of chemotherapeutic agents depending on cancer type were administered. Breast cancer was the most common type (63), followed by ovarian (15), uterine (9), lung (6) and cervical cancer (3). Other primaries were represented by 1 patient each: pancreatic, rectal, gastric, fallopian tube and colon cancer. Totally 431 scalp cooling procedures were performed including 261 (61%) in breast cancer and 78 (18%) in ovarian cancer patients. Outcomes were evaluated using the CTCAE/CTCAE V5.0 toxicity criteria. We evaluated the development of 1 grade alopecia (hair loss of less than 50% and not requiring a wig) as a positive result. On the contrary, a negative result was registered in patients with grade 2 alopecia, namely hair loss of 50% or more and/or requiring a wig. Results: Grade 1 alopecia was experienced by 61% of patients and the other 39% had grade 2 alopecia. Notably, the highest incidence of grade 2 alopecia was observed in patients who received doxorubicin 60 mg/cm2 + cyclophosphamide 600 mg/cm2 once every 21 days (9.9%). Taxane-based regimens had a 21% incidence of grade 2 alopecia, while platinum-containing regimens had a 11% incidence. No serious adverse events occurred during the application of cold prophylaxis. The procedure was well-tolerated by all patients. Conclusions: The use of a cold helmet is an effective method of preventing chemotherapy-induced alopecia. Our analysis yielded a success rate of 61%, which is comparable to the worldwide data range of 50% to 80%.

Alopecia prevention during chemotherapy: from the benchmark to real clinical practice. A prospective study

Background. Alopecia is one of the main side effects of anticancer chemotherapy and has a significant impact on patients’ appearance, quality of life, social adaptation and mental health of cancer patients. Estimated number of new cancer diagnosis increases annually alongside with the proportion of patients receiving chemotherapy. That means an annual increase in the global burden of chemo-induced alopecia and associated negative consequences. The development of various methods for the prevention of alopecia in cancer patients has continued for decades. However, convincing data have been obtained only for the scalp hypothermia method. In this point, the Paxman company’s cooling systems (UK) – the Orbis and Orbis II devices – have been most widely studied. Despite the fact that Orbis devices were approved in Russia more than 10 years ago, since then just a small amount of real clinical practice has been accumulated and questions regarding the effectiveness of scalp hypothermia in patients with variable cancers still remain open.
 Aim. Analysis of local clinical practice with scalp hypothermia via the Orbis II device for the prevention of alopecia in patients receiving various chemotherapy regimens.
 Materials and methods. An open, prospective, single-center study included patients with various cancer types who were indicated for chemotherapy. Orbis II device was used for prophylactic hypothermia. The severity of alopecia was assessed according to the CTCAE version 5.0 at baseline and during anticancer therapy.
 Results. From June 2022 to May 2023, scalp cooling procedures were performed in 51 patients, of them 78% of all procedures were performed in female cancers: breast tumors – 109 (52.2%) procedures, ovarian cancer– 33 (15.8%), and cervix cancer – 22 (10.5%). The effectiveness of scalp hypothermia in preventing of severe alopecia was 73%.
 Conclusion. Scalp cooling can be considered as an effective method for the prevention of chemotherapy induced alopecia. Further studies are needed to assess larger patient populations to identify favorable and negative factors that affect potency of the hypothermia.

The Efficacy of Paxman Scalp Cooling System in Preventing Hair Loss in Breast Cancer Patients Receiving Chemotherapy in Western India - Multi-centre Retrospective Cohort Study.

Chemotherapy-induced alopecia (CIA) is the most common side effect of systemic treatment in breast cancer patients. Scalp cooling gained worldwide acceptance in preventing or mitigating CIA in patients undergoing chemotherapy. The objective of this study was to evaluate the efficacy and safety of the Paxman scalp cooling system (PSCS) in Indian breast cancer patients. This is a multi-centre, retrospective-observational study including patients registered from 1st March, 2019 to 30th April, 2021 undergoing chemotherapy for breast cancer by using PSCS. The primary end-point was the incidence of CIA after completing cycles of chemotherapy. A total of 91 female patients were enrolled in the study, with a median age of 53 years (IQR: 44-62 years). The prevention of alopecia (grade 0 and grade I) was seen in 81%, while more than 50% hair loss (grade 2) was seen in 16.48% after completion of treatment. The univariate analysis results showed that CIA was significantly higher in patients who received anthracyclines (OR: 2.69; 95% CI: 1.04-6.958; P = 0.041) and in patients with a post-infusion cooling time of >150 minutes (OR: 8.409; 95% CI: 2.295-30.787; P = 0.001). The incidence of grade 2 (>50% hair loss) alopecia was 81.3% in patients <6 weeks and was 18.8% at >6 weeks of start of chemotherapy (P < 0.0001). No adverse events were reported in 71.4% of patients, and the most common adverse event was headache (18.7%). PSCS is an effective and well-tolerated treatment modality for preventing CIA among breast cancer patients undergoing chemotherapy.

Combatting ageing in dermal papilla cells and promoting hair follicle regeneration using exosomes from human hair follicle dermal sheath cup cells.

Dermal papilla cells (DPCs) undergo premature ageing in androgenetic alopecia and senescent alopecia. As critical components of hair follicle reconstruction, DPCs are also prone to senescence invitro, resulting in a diminished hair follicle inductivity capacity. Dermal sheath cup cells (DSCCs), a specific subset of hair follicle mesenchymal stem cells, intimately linked to the function of DPCs. The primary objective of this research is to investigate the anti-ageing effect of exosomes derived from DSCCs (ExoDSCCs ) on DPCs. Exosomes were utilized to treat H2 O2 -induced DPCs or long-generation DPCs(P10). Our findings demonstrate that ExoDSCCs(P3) promote the proliferation, viability and migration of senescent DPCs while inhibiting cell apoptosis. The expression of senescence marker SA-β-Gal were significantly downregulated in senescent DPCs. When treated with ExoDSCCs(P3) , expression of inducibility related markers alkaline phosphatase and Versican were significantly upregulated. Additionally, ExoDSCCs(P3) activated the Wnt/β-catenin signalling invitro. In patch assay, ExoDSCCs(P3) significantly promoted hair follicle reconstruction in senescent DPCs. In summary, our work highlights that ExoDSCCs(P3) may restore the biological functions and improve the hair follicle induction ability of senescent DPCs. Therefore, ExoDSCCs(P3) may represent a new strategy for intervening in the ageing process of DPCs, contributing to the prevention of senile alopecia.

Electric hand warmer versus observation to avoid discomfort during scalp cooling for chemotherapy-induced alopecia prevention: a randomized study

Chemotherapy-induced alopecia (CIA) is a challenge in the management of cancer patients. Scalp cooling (SC) leads to reduction in CIA, however it is associated with significant adverse events, leading to 3–13% discontinuation rates. This pilot study evaluated the role of Electric Hand Warmers (EHW) on thermal (TC), sensorial (SCo) and general comfort (GC) in patients with breast cancer (BC) undergoing chemotherapy and SC to reduce CIA. Patients were randomly assigned to EHW use or observation. TC, SCo and GC were evaluated after each chemotherapy infusion. Favorable outcomes in both TC and SCo defined a positive result on GC. We analysed the impact of age, alopecia, chemotherapy regimen and EHW use in the different comfort scales using a Logistic Regression (LR) model. Forty women with early breast cancer were randomly assigned to EHW (n = 20) or observation (n = 20) during neo(adjuvant) chemotherapy. Median age was 53 years. In the EHW arm, favorable thermal response was reported by 79% versus 50% in the control arm (odds ratio [OR] 3.79, p < 0.001). SCo was satisfactory in 82% in the EHW arm versus 74% in the control arm (OR 1.62, p = 0.1). Overall, 73% in the EHW arm had favorable GC versus 44% in the control arm (OR 3.4, p < 0.001). Age, alopecia, and chemotherapy regimen did not impact on comfort measures. Conclusion: Our study suggests that the use of an EHW has a consistent favorable impact on TC and GC of BC patients under SC technology to prevent CIA.

35P Prospective study assessing the efficacy and safety of a scalp cooling device for the prevention of alopecia in breast cancer patients undergoing (neo)adjuvant chemotherapy

35P Prospective study assessing the efficacy and safety of a scalp cooling device for the prevention of alopecia in breast cancer patients undergoing (neo)adjuvant chemotherapy

An Innovative Approach to Scalp Segmentation in Pediatric Brain Radiotherapy: An Atlas-Based Study.

This study aims to develop an atlas-based method for segmentation of the scalp in pediatric patients that received brain radiotherapy. The study focuses on the development of a model that utilizes CT scans of pediatric medulloblastoma (MB) patients who underwent craniospinal-irradiation (CSI) and a boost in the posterior cranial fossa (PCF). A team of experts created the Alopecia_Hope (A_H) contouring protocol on the CT scan using the 2018 EPTN consensus-based atlas and by defining for the manual adjustments the anatomic bone landmarks to differentiate between the scalp and the facial and neck skin. Using RayStation version 12A-SP1, the system was running his latest available software version at the time of study. Automated scripts were created to identify bone tissue and skin as a subtraction volume between bone and body. The soft tissue CT window was then manually used to increase or decrease the thickness of the skin, following the landmarks outlined in the protocol. The entire head scalp was defined as WScalp (WS), and a duplicate and reduced version was also defined as PCFScalp (PCFS). We randomly chose 40 patients to create both WS and PCF atlas with RayStation and 8 patients were used as testers for both volumes, the patients with major bone changes after neurosurgery were excluded. The contouring time was recorded, the mean time was calculated, and the contouring results were analyzed by experts. Standard similarity metrics of 3D DICE similarity coefficient and mean distance to agreement (MDA) were calculated. A total of 52 patients were selected for the study, with a median contouring time of 19 minutes using the guidelines, the A_H protocol and automatic scripting. Three patients were excluded. Of the 8 testers, including both volumes (WS and PCFS), the mean contouring time for the expert operator was 17.5 min. While the contouring undergone by the automatic atlas was 11 min and the mean time of the expert correction was 4.5 min. Considering the work done by the atlas is in background, this resulted in a time savings of 80% for the operator. Table 1 contains mean and one standard deviation data for the metric, both WS and PCFS tested. Atlas-based self-segmentation and the Alopecia_Hope protocol offer a more efficient and accurate method to identify specific areas of the scalp that may be affected by post-radiotherapy hair loss. This study demonstrates the effectiveness and efficiency in reducing radiotherapy workload and improving accuracy, with possible future application in the prevention of permanent alopecia and in improving the quality of life of patients undergoing whole brain radiotherapy.

Development and evaluation of finasteride niosomes targeting to hair follicles for the management of androgenic alopecia

Finasteride, a selective Type II 5α-reductase inhibitor, has been approved as an oral drug for the treatment and prevention of androgenetic alopecia (AGA). The daily administration of finasteride by oral route may lead to various undesirable systemic side effects. In the present study, finasteride niosomes (FIN-NIS) as a dermal topical delivery system were developed evaluated in vitro/in vivo in an attempt to overcome the limitations of the oral administration of finasteride, enhance the retention of finasteride into hair follicles, and cause fewer adverse effects. FIN-NIS were prepared by ethanol injection method and characterized for particle size, entrapment efficiency (EE), in vitro release and in vitro skin retention. Testosterone-induced AGA mice model was used to evaluate the therapeutic effect of FIN-NIS. The results show that the particle size of FIN-NIS was about 260 nm with a good loading capacity, and the EE was greater than 90%. FIN-NIS had the sustained-release effect to some extent. Compared with the hydroethanolic solution of finasteride (FIN-hydroethanol) and finasteride suspension (FIN-suspension), FIN-NIS showed higher drug concentration in the excised rat skin, especially in the hair follicle area. The drug accumulation of FIN-NIS in the hair follicles was 20 times higher than that of FIN-hydroalcohol. In addition, FIN-NIS was more effective to promote hair regeneration in AGA mice than FIN-suspension, and the effectiveness of FIN-NIS even exceeded that of minoxidil. In conclusion, FIN-NIS could become a promising dermal topical delivery system for enhancing the performance of finasteride for the management of AGA and avoiding the possible risk of systemic side effects associated with oral administration.

Hair loss: alopecia fears and realities for survivors of breast cancer-a narrative review.

Breast cancer is the leading cause of cancer among women, with over 2.3 million women being diagnosed in 2022. In addition to the emotional and physical toll that comes with a new cancer diagnosis, treatments such as chemotherapies, endocrine therapies, and radiation therapies may cause undesirable side effects. Side effects from cancer treatments can be detrimental to the quality of life of patients and their support systems. This narrative review consolidates current research on the impacts of alopecia on breast cancer survivors and provides a comprehensive overview of the various preventative options and treatments available. Current literature on alopecia and breast cancer was searched using PubMed and Google Scholar. The search strategy utilized a combination of keywords related to breast cancer, alopecia, body image, and alopecia prevention and treatment. Retrievable and English articles from January 2000 to April 2024 were included in the review. Women with breast cancer cited alopecia, or hair loss, as the third-most undesirable side effect from chemotherapy, only trailing behind nausea and vomiting. Other studies have further supported this notion, expressing that alopecia negatively impacts patients' body image, social functioning, and sense of self. Further research has indicated that alopecia could hinder individuals from accessing essential cancer therapies. Breast cancer patients use a variety of coping strategies for cancer treatment-induced alopecia, including preventive measures, treatments to accelerate hair regrowth, camouflaging tools, and psychosocial supports. Alopecia, as a result of cancer treatment, has many significant and distressing effects on breast cancer patients. Customized interventions may help breast cancer patients feel more comfortable about themselves, after experiencing chemotherapy-induced alopecia. These findings indicate the need for further research on preventative options and treatments for cancer treatment-induced alopecia.

Prospective Study Investigating the Efficacy and Safety of a Scalp Cooling Device for the Prevention of Alopecia in Women Undergoing (Neo)Adjuvant Chemotherapy for Breast Cancer.

The prevention of chemotherapy-induced alopecia still represents an urgent need for every day clinical practice. In this regard, this prospective single-center study included breast cancer (BC) patients who underwent a scalp cooling device (Dignicap®) during (neo)adjuvant chemotherapy with the aim to evaluate the efficacy and safety of this device in preventing alopecia. One hundred and seventy-eight patients (median age 43 years) were enrolled. The chemotherapy regimen included anthracycline and taxane-based chemotherapy (68.1%), docetaxel and cyclophosphamide (25.8%), anthracycline and taxane-based plus carboplatin (3.9%), and paclitaxel alone (2.2%). In 25.3% of cases, a dose dense schedule was used. Overall, the success rate was 68.0%: 100% in paclitaxel alone, 87.0% in docetaxel-cyclophosphamide, 59.5% in anthracycline and taxane, and 71.4% in the sequential regimen plus carboplatin group (anthracycline and taxane-based chemotherapy versus taxane-based chemotherapy, p ≤ 001. No difference in terms of hair preservation between dose-dense or standard schedule was found (p = 0.557). Early discontinuation of the scalp cooling was observed in 50 patients (28.1%). Although 138 patients (77.5%) experienced adverse events, 70.2% of patients were satisfied with this device. In conclusion, this large prospective study confirmed the helpful effect of the scalp cooling system in preventing alopecia in BC patients also undergoing sequential anthracyclines and taxane-based chemotherapy.

New Advances in Supportive Care: Chemoprotective Agents as Novel Opportunities in Geriatric Oncology.

To explore the effectiveness of trilaciclib and ALRN-6924 in the prevention of cancer chemotherapy-induced toxicity in older patients. New chemoprotective agents are necessary because age is the main risk factor for chemotherapy complications that account largely for the poorer outcome of cancer in the elderly. Trilaciclib and ALRN-6924 cause a reversible block of the proliferation of normal cells through cell cycle arrest (CCA). With this mechanism, they may prevent the toxicity of cycle-active cancer treatment including neutropenia, anemia, thrombocytopenia, lymphopenia, mucositis, and alopecia. Myelopoietic growth factors may prevent neutropenia in the aged, but they may cause severe bone pain, may aggravate thrombocytopenia and anemia, and may cause myelodysplasia and acute leukemia as a late complication. The prevention of thrombocytopenia, anemia, mucositis, and alopecia is unsatisfactory at present. These complications may jeopardize the treatment outcome as they require a reduction of treatment dose/intensity and because many patients find the resulting symptoms intolerable. In three studies of patients with extensive disease small cell lung cancer (ES-SCLC), trilaciclib reduced the severity and duration of neutropenia and thrombocytopenia as well as the need for blood transfusions. In addition, it produced a significant expansion of T-cell clones. Trilaciclib received FDA approval for the prevention of chemotherapy-induced myelosuppression in patients with ES-SCLC. ALRN-6924 is currently studied in phase II study of ES-SCLC. In a phase IB of 38 patients, ALRN-6924 prevented myelosuppression to an extent comparable with trilaciclib. Both drugs proved as effective in patients 65 and older as they were in the younger ones. In an "ex vivo" study, ALRN-6924 protected the epithelial stem cells of hair follicles from taxanes and promised to prevent alopecia. The possibility that CCA of tumor cells may reduce the effectiveness of cycle-active chemotherapy is a major concern. For this reason, the use of trilaciclib, an inhibitor of CDK 4/6, should be limited to tumors with inactivated RB1, and the use of ALRN-6924, an inhibitor of P53, should be limited to tumors with inactivated P53. Chemotherapy-related toxicities limit dose intensity and contribute to significant morbidity and mortality in elderly cancer patients. Trilaciclib and ALRN-6924 are of particular interest to geriatric oncologists because of their novel mechanism of action. Ameliorating chemotherapy-induced toxicities holds the promise of transforming the practice of geriatric oncology by enabling chemotherapeutic regimens that are currently not feasible for this patient population. Specifically, these agents may prevent chemotherapy-induced neutropenia and thrombocytopenia, perhaps the most life-threatening complications of cytotoxic chemotherapy, thereby obviating the need for the use of rescue strategies such as hematopoietic growth factors. In addition, these agents offer the potential for broad tissue protection from other chemotherapy-related toxicities, including mucositis, diarrhea, and alopecia, which historically have been poorly managed. Importantly, by preventing a spectrum of chemotherapy-related toxicities, these agents may permit the administration of chemotherapy at full-dose intensity, prevent functional decline, and grant maintenance of resilience to older cancer patients. As a result, the successful prevention of chemotherapy-induced side effects may not only mitigate the costs of care but also improve patient outcomes and quality of life. Finally, chemoprotective strategies offer the opportunity to apply geriatric principles to clinical trials of cancer treatment. In particular, they may allow the testing of prolongation of "active life expectancy" as a major goal of clinical trials in elderly patients. They may also enable novel and more practical forms of clinical trials. By assessing the risk of chemotherapy-related toxicity with the Chemotherapy Risk Assessment Scale for High Age Patients (CRASH) or the Cancer and Aging Research Group (CARG) instruments, these agents may permit researchers to utilize patients as their own controls and endorse the approval of supportive care drugs based upon the risk profile of individual patients.

Hair Safe Study: Effects of scalp cooling on hair preservation and hair regrowth in breast cancer therapy—A prospective interventional study.

12093 Background: Chemotherapy (CT) is a frequent and well established treatment in women with breast and gynecological tumors. Alopecia is one of the most common side effects of CT seriously impairing patient quality of life and body image. While other CT associated side effects can be controlled by supportive treatment strategy, adequate preventive measures for alopecia have been lacking. New evidence supports the efficacy of scalp cooling for alopecia prevention during CT. The aim of this study was to investigate preventive scalp cooling (SC) for chemotherapy-induced-alopecia in breast cancer patients undergoing standard adjuvant or palliative chemotherapy. We also analysed the impact of SC on hair regrowth after chemotherapy-induced-alopecia. Methods: This was a non-randomized, 2-arm interventional study conducted at the Department of Obstetrics and Gynecology, Medical University Innsbruck. Breast cancer patients receiving any chemotherapy associated with alopecia (i.e. taxane or anthracycline-based chemotherapy) were allocated either to an intervention group receiving SC or to a control group (no SC). SC during chemotherapy was applied by the Paxman scalp cooling system. The primary endpoint was hair preservation (HP) which was assessed by experts and patients using the CTCAE score and analysed during and after completion of chemotherapy. The secondary endpoint was hair regrowth (HR) after 3 and 6 to 9 months post chemotherapy. Results: The study population included 128 patients. The majority, namely 88 (69%) patients were assigned to the intervention group (CAP) and received SC, 40 patients were allocated to the control group (NCAP). HP was significantly higher in the group receiving SC than in the NCAP by patients’ self-evaluation (24% vs. 0%; P = 0.001) and experts’ assessment (72% vs. 0%, P ≤ 0.001). HR was comparable between both groups. Using the patients’ evaluation 50% of patients with taxane monotherapy had a grade 1 alopecia compared to 17% of patients with an anthracycline-taxane CT (50% vs 17%, P = 0.018). Drop-out rate was 13% in CAP and 5% in NCAP group. Main reasons for drop-out were hair loss and patients’ requests. Conclusions: Our study demonstrates that SCsignificantly reduced or avoided chemotherapy-induced-alopecia in breast cancer patients undergoing chemotherapy, especially in patients who received taxane-monotherapy. SC was a safe procedure without severe adverse events. Therefore, SC can be highly beneficial for patients receiving specific chemotherapy and the option should be made available to as many patients as possible. No significant effect was noted regarding regrowth after chemotherapy in the SC group.

Low temperature mitigating the paclitaxel-induced damages in mouse cell and hair follicle model

Scalp cooling is currently the most approved treatment to prevent alopecia due to chemotherapy for cancer. Few reports can be available, and the mechanisms involved in scalp cooling were unclear. The present work tries to reveal a preliminary inhibitory mechanism of scalp cooling on paclitaxel-induced alopecia. The results found that low temperature enhanced local vasoconstriction to 0.32 (dimensionless diameter, @ 22°C) and the vascular diameter presented an oscillating attenuation, which led to the concentration reduction of chemotherapeutic drugs transported by blood flow. Cooling significantly rescued M-HFK cells treated by paclitaxel, and the lower temperature for the better protection due to weakening the cytotoxicity in some extent. Cell cycle results showed that the G0/G1 phase was arrested at low temperature (i.e. 22°C), which was beneficial to mitigate the effect of paclitaxel on the G2/M phase cycle and finally made the cell cycle return to normal. Also, cold stimulation significantly increased the concentration of HSP70 more than 3 times (@22°C for 2h) compared with that of the control group, which means low temperature can protect cells from stresses. Furtherly, Cooling reduced the number of PH3+ and Caspase-3+ cells in the hair follicle, and effectively inhibited the cell apoptosis in the vitro hair follicle and alopecia in the mice experiments. The current work provides a basis for deeply understanding the chemotherapy-induced alopecia prevention with scalp cooling.

Hair safe study: Effects of scalp cooling on hair preservation and hair regrowth in breast cancer patients receiving chemotherapy - A prospective interventional study

Hair safe study: Effects of scalp cooling on hair preservation and hair regrowth in breast cancer patients receiving chemotherapy - A prospective interventional study

Reversal of Alopecia by Insulin Therapy in Uncontrolled Type 2 DM

Diabetes mellitus is a chronic metabolic disease that results in micro-vascular and macro-vascular complications. Further, uncontrolled hyperglycemia can damage blood vessels and alters the anagen and telogen phases of hair growth leading to alopecia. We report a case of a 54-year-old woman diagnosed with type 2 diabetes mellitus (DM) and hypertension suffering from hair loss on the right side of scalp without any signs and symptoms of scalp inflammation. All the possible causes such as lipid profile, side effects of hypoglycemic agents and anti-hypertensive therapy, trichotillomania, and dermatological diseases were ruled out. Here, we emphasize that damaged blood vessels that hinder oxygen supply and nutrients to hair follicles could be the reason behind alopecia in DM patients. Furthermore, insulin plays an important role in cell proliferation and regrowth of hair follicles. It was also noted that patients’ response to glycemic control was remarkable, and timely initiation of insulin in patients with DM and alopecia restores normal hair growth. Still, more extensive research is required in this field, which will ultimately be helpful in the prevention of alopecia in DM patients.

Microalgae, Tetraselmis tetrathele has Alopecia Prevention and Scalp Improvement

Microalgae, <i>Tetraselmis tetrathele</i> has Alopecia Prevention and Scalp Improvement

Randomized study of electric hand warmer (EHW) versus observation to avoid discomfort during scalp cooling for chemotherapy-induced alopecia (CIA) prevention.

12108 Background: CIA has been reported as the most disturbing adverse event of cancer treatment by most women receiving chemotherapy. Many strategies have been tested to minimize CIA, among which scalp cooling has proven high effectiveness. However, discontinuation rates of this technology vary from 3% to 13%, mostly due to headache, cold sensation and pain. EHW could be used to mitigate these side effects, produce heat on demand and a warming sensation. The primary objective of this study is to evaluated the impact of EHW device on the general comfort of breast cancer patients while on scalp cooling during chemotherapy treatment. Methods: Patients were randomly assigned to EHW use or observation. Thermal, sensory and general comfort were measured with pragmatic questionnaires after each chemotherapy infusion: neutral or hot as favorable thermal responses; comfortable and very comfortable as favorable sensory responses; finally, favorable outcomes in both thermal and sensory comfort questionnaires defined a positive result on the general comfort. We evaluated the impact of age (≤ or &gt; 50 years), alopecia (grade 0 or 1/2), chemotherapy regimen (with or without taxanes) and EHW use (yes or no) in the different comfort scales using Logistic Regression (LR) models. Results: Forty women with early or locally advanced breast cancer were assigned to EHW (n = 20) or observation (n = 20) during neo(adjuvant) chemotherapy. Median age was 53 years, 67.5% concluded university education, 52.5% had comorbidities. Most patients had stage II disease (55%), largely ER/PR+ HER2- disease (67.5%), followed by triple negative (22.5%), and HER2+ (10%). Most frequent regimen was ACdd-Tdd (42.5%). Thirty-one patients (77.5%) continued scalp cooling during entire chemotherapy regimen (alopecia &lt; grade 3). A favorable thermal response was seen in 79% of EHW applications as compared to 50% in control arm (odds ratio [OR] 3.79, P &lt;.001). Sensory comfort was satisfactory in 82% of EHW applications as compared to 74% with control (OR 1.62, P =.1). General comfort was favorable in 73% of EHW applications as compared to 44% in control arm (OR 3.4, P &lt;.001). Age, alopecia grade and taxane use did not significantly impact on comfort measures. Conclusions: Our study suggests that an EHW has a consistent favorable impact on thermal and general comfort of breast cancer patients under scalp cooling technology to prevent CIA. This simple device can improve patient´s quality of life and eventually avoid scalp cooling discontinuation due to discomfort.

The Prevention of Alopecia Induced by Chemotherapy by Enhancing Self-Esteem and Reducing Distress. Observational Study between the Level of Distress from Chemo-Induced Alopecia and Self-Esteem in Patients Belonging to the Oncology Department of the Bat Health Authority, Italy

The general goal we have set ourselves is to statistically determine the degree of correlation between chemo-induced alopecia distress and self-esteem as the different degree of alopecia varies. To obtain a representative sample, we decided to perform a cluster sampling, in which the clusters of units were the women affected by the neoplastic disease. 50 female patients who belonged to the oncology day-hospital department of the Local Health Authority Barletta, Italy. The Nurse has a particularly important role in the patient's care path, as he remains in close contact with him in the various moments of the diagnostic-therapeutic process. For many patients it may be easier to relate to the nurse rather than to other health professionals. For this reason, in the assistance, the nurse is placed at the center of the humanization process, entrusting him with many of the planned interventions.