Perilous consequences of chemotherapy induced alopecia in afflicted cancer survivors: A comprehensive state of the art review

Abstract

Due to researchers’ great efforts during previous and current centuries to cure cancer, a remarkable increase in the number of cancer survivors has been observed. However, side effects of chemotherapeutic agents greatly affect the quality of life of cancer cases, usually referred to as cancer stigma, the most psychologically traumatizing of which is chemotherapy-induced alopecia (anagen effluvium). Unfortunately, there is no preventive protocol for chemotherapy-induced alopecia to date. The only suggested technique is vasoconstriction by scalp cooling during and after chemotherapy sessions to minimize the absorption of cytotoxic agents within the hair follicle area; a technique that is not very effective and most patients declared that they still need camouflage for their alopecia. Our review of literature revealed that research is defective in the point of prevention and rapid treatment of anagen effluvium, yet, some research was conducted to prevent anagen effluvium by different mechanisms, including: vasoconstriction, immunomodulation and alteration of cellular signaling pathways. More research is needed to determine the most effective mechanism and build an efficacious protocol for preventing anagen effluvium. This article will discuss the different mechanisms of action possible to prevent and/or treat chemotherapy-induced alopecia and whether the incorporation of any of the selected drugs into certain types of nanoparticles as drug delivery systems for successful hair follicle targeting so as to achieve the desired prophylactic and/or therapeutics outcomes.