Why Do Not All Chemotherapy Patients Lose Their Hair? Answering an Intriguing Question

Beard Alopecia: An Updated and Comprehensive Review of Etiologies, Presentation and Treatment

“…The extent of hair loss depends not only on the potency and duration of the drug, but also on the phase of the hair cycle in which the hair follicle is in, the presence of underlying hair disorders such as AGA, and the type of hair. Scalp and beard hairs likely have the fastest rate of hair growth and are thus prone to the toxic effects of chemotherapy [127]. An anecdotal report from Rebora and Guarrera details decreased black and white beard hair density following treatment with docetaxel for approximately 2 months, but most white hairs continued to grow throughout therapy.…”

“…However, once plucked, they were found to be dystrophic hairs. This may be due to white hairs' broader shafts when compared to pigmented hairs which prevent the whole shaft from being affected, thus decreasing hair dystrophy [127]. In a study by Chiewchanvit et al investigating mucocutaneous complications of chemotherapy in 74 Thai patients, 77.8% of patients experienced beard hair loss, with one report of beard hair pigment changes with therapy [128].…”

“…Later findings include yellow dots, vellus-like hairs, pigtail hairs, and eventually, scattered regrowing hairs which appear as circle hairs with possible pigment abnormalities [126]. Chemotherapy-induced alopecia typically reverses in patients following cessation of therapy; however, some patients experience permanent or persistent alopecia or experience a change in hair features such as pigmentation and texture [126,127]. The only FDA-approved preventative treatment for chemotherapy-induced alopecia is scalp cooling.…”