Center for Dermatology and Hair Diseases, Wallisellen, Zurich, Switzerland.
Curr Opin Support Palliat Care. 2010 Dec;4(4):281-4. doi: 10.1097/SPC.0b013e3283409280.
Few dermatologic conditions carry as much emotional distress as chemotherapy-induced hair loss. Forty-seven percent of female patients consider hair loss the most traumatic aspect of chemotherapy, and 8% would decline chemotherapy because of fear of hair loss. A number of agents have been evaluated on the basis of the current understanding of the underlying pathobiology.
Among the agents that have been evaluated, topical minoxidil was able to reduce the severity or shorten the duration but could not prevent hair loss. The major approach to minimize chemotherapy-induced hair loss is by scalp cooling, although most published data on scalp cooling are of poor quality. Because chemotherapy-induced toxicity has been associated with nutritional status, nutritional assessment and support might confer beneficial effects. Several experimental approaches to the development of pharmacological agents are under evaluation including: anti-oxidants, cytokines and growth factors, cell cycle and proliferation modifiers, and inhibitors of apoptosis.
At present, no approved pharmacologic treatment of chemotherapy-induced hair loss exists. The incidence and severity of the condition are variable and related to the particular chemotherapeutic protocol. Fortunately, chemotherapy-induced hair loss is mostly reversible, and appropriate hair and scalp care and temporarily wearing a wig may be the most effective coping strategy.
很少有皮肤科疾病像化疗引起的脱发那样带来如此大的情绪困扰。47%的女性患者认为脱发是化疗最具创伤性的方面，8%的患者因为担心脱发而拒绝化疗。基于对潜在病理生物学的现有理解，已经评估了许多药物。
在已经评估的药物中，局部米诺地尔能够减轻脱发的严重程度或缩短脱发时间，但不能预防脱发。减少化疗引起的脱发的主要方法是头皮冷却，尽管头皮冷却的大多数已发表数据质量较差。由于化疗诱导的毒性与营养状况有关，营养评估和支持可能会产生有益的效果。正在评估几种开发药理药物的实验方法，包括：抗氧化剂、细胞因子和生长因子、细胞周期和增殖调节剂以及凋亡抑制剂。
目前，尚无批准用于治疗化疗引起的脱发的药物。脱发的发生率和严重程度是可变的，与特定的化疗方案有关。幸运的是，化疗引起的脱发大多是可逆的，适当的头发和头皮护理以及暂时佩戴假发可能是最有效的应对策略。
