Loading
Several drugs have been put on the scalp to stop chemotherapy hair loss before it starts: minoxidil lotion, vitamin D analogues, and others. The trials were done and they did not work. Scalp cooling remains the only method cleared by a regulator to prevent it.
This record exists so that the question is answered rather than left open, because it is the first thing people ask and the answer is unwelcome. A meta-analysis of interventions to prevent chemotherapy-induced alopecia (Shin et al., International Journal of Cancer 2015) pooled 8 randomised and 9 controlled trials covering 1,098 participants. Scalp cooling significantly reduced the risk of alopecia, with a relative risk of 0.38 (95 per cent confidence interval 0.32 to 0.45); topical 2 per cent minoxidil and the other interventions tested did not significantly reduce it.
The individual failures are worth naming. Topical minoxidil was tested for prevention in a randomised trial of 48 women receiving doxorubicin (Rodriguez et al., Annals of Oncology 1994): 88 per cent and 92 per cent of patients in the two arms had severe alopecia, a difference that was not significant. Topical calcipotriol, a vitamin D analogue that protects rodent hair follicles, was tested in a randomised controlled trial in women receiving CMF chemotherapy (Bleiker et al., British Journal of Dermatology 2005) and had no detectable effect on any measure: the proportion with minimal hair loss, shed rates, plucked telogen and fractured hair counts, the shape of shed and plucked hair, regrowth or hair density. An earlier phase 1 study of topical calcitriol found that all 14 patients developed moderate alopecia and that eight developed a toxic rash where the drug had been applied.
Newer topical calcitriol formulations reached phase 1 in taxane-treated patients and were reported as safe, with alopecia of less than 50 per cent in 8 of 23 patients at week 7, but no phase 2 or phase 3 trial of it has been registered. AS101, a tellurium compound, prevented alopecia as an incidental finding in a 44-patient trial designed to test marrow protection, and no trial of it for hair has been registered since. The practical conclusion for a reader is that minoxidil is a treatment for hair that is slow to return, not a shield for hair you still have, and that the only prevention with a regulator behind it is cooling.
Each of these aimed to make the follicle temporarily less vulnerable, by pushing it out of the dividing phase or by local cell-cycle arrest, so that a drug circulating in the blood would do it less damage. Scalp cooling takes the other route, reducing how much of the drug arrives.
Query for this technology: (TITLE:"Creams and lotions tried to prevent chemotherapy hair loss" OR ABSTRACT:"Creams and lotions tried to prevent chemotherapy hair loss") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Creams and lotions tried to prevent chemotherapy hair loss, not a curated reading list.
Shares Anagen effluvium (chemotherapy hair loss), Minoxidil for persistent chemotherapy- and endocrine-therapy hair loss, Scalp cooling (cold caps: DigniCap, Paxman), Toxicity and quality of life are undervalued and the tags complementary, supportive-care, hair-loss.
Shares Anagen effluvium (chemotherapy hair loss), Scalp cooling (cold caps: DigniCap, Paxman), Toxicity and quality of life are undervalued, Cytotoxic chemotherapy and the tags complementary, supportive-care, hair-loss.
Shares Scalp cooling (cold caps: DigniCap, Paxman), Docetaxel, Doxorubicin, Toxicity and quality of life are undervalued and the tags complementary, hair-loss.
Shares Minoxidil for persistent chemotherapy- and endocrine-therapy hair loss, Scalp cooling (cold caps: DigniCap, Paxman), Docetaxel, Doxorubicin and the tags complementary, supportive-care.
Shares Minoxidil for persistent chemotherapy- and endocrine-therapy hair loss, Toxicity and quality of life are undervalued and the tags complementary, supportive-care, hair-loss.
Shares Minoxidil for persistent chemotherapy- and endocrine-therapy hair loss, Toxicity and quality of life are undervalued and the tags complementary, supportive-care, hair-loss.
Shares Minoxidil for persistent chemotherapy- and endocrine-therapy hair loss, Toxicity and quality of life are undervalued and the tags complementary, supportive-care, hair-loss.
Shares Minoxidil for persistent chemotherapy- and endocrine-therapy hair loss, Toxicity and quality of life are undervalued and the tags complementary, supportive-care, hair-loss.