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Chemotherapy-induced alopecia

Aimee S Payne, MD, PhD
Hope S Rugo, MD
Mario E Lacouture, MD
Section Editors
Reed E Drews, MD
Maria Hordinsky, MD
Deputy Editor
Diane MF Savarese, MD


Alopecia is a transient and usually (although not always) reversible consequence of cancer chemotherapy that can be psychologically devastating [1]. For some patients, the emotional trauma may be so severe as to lead to refusing or delaying treatment that might otherwise be beneficial [2-8]. Recovery generally requires a period of several months to a year, amplifying the psychological impact of the disease and its treatment.

A general overview of the anatomy and physiology of hair growth, the effects of chemotherapy on the hair follicle, and possible means for preventing or minimizing chemotherapy-induced alopecia are discussed here.


The hair shaft is a layered structure that consists of three major components. The medulla, the innermost layer, is surrounded by the cortex and cuticle. The hair fiber is the product of the hair follicle, which is composed of three main parts when viewed in longitudinal section (figure 1) [9]:

The lower portion, which extends from the base of the hair follicle to the insertion of the arrector pili muscle. This lower portion, in turn, is comprised of several major components:

The hair bulb, which contains the dermal papilla and hair matrix. The dermal papilla controls the number of matrix cells, which determines hair fiber size [10]. Melanocytes, which are responsible for hair color, are present among the matrix cells of the hair bulb.


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Literature review current through: May 2017. | This topic last updated: May 10, 2017.
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