Hair disorders in patients with cancer

J Am Acad Dermatol. 2019 May;80(5):1179-1196. doi: 10.1016/j.jaad.2018.03.055. Epub 2018 Apr 14.


Cytotoxic chemotherapies, molecularly targeted therapies, immunotherapies, radiotherapy, stem cell transplants, and endocrine therapies may lead to hair disorders, including alopecia, hirsutism, hypertrichosis, and pigmentary and textural hair changes. The mechanisms underlying these changes are varied and remain incompletely understood, hampering the development of preventive or therapeutic guidelines. The psychosocial impact of chemotherapy-induced alopecia has been well documented primarily in the oncology literature; however, the effect of other alterations, such as radiation-induced alopecia, hirsutism, and changes in hair color or texture on quality of life have not been described. This article reviews clinically significant therapy-related hair disorders in oncology patients, including the underlying pathophysiological mechanisms, severity grading scales, patient-reported quality of life questionnaires, management strategies, and future translational research opportunities.

Keywords: anagen effluvium; brittleness; cancer patients; catagen effluvium; chemotherapy-induced alopecia; curling; depigmentation; eyebrow alopecia; eyelash alopecia; hair repigmentation; hirsutism; hyperpigmentation; hypertrichosis; hypopigmentation; straightening; trichomegaly.

Publication types

  • Review

MeSH terms

  • Alopecia / etiology
  • Alopecia / prevention & control
  • Antineoplastic Agents / adverse effects*
  • Cryotherapy*
  • Hair Diseases / etiology*
  • Hair Diseases / psychology
  • Hair Diseases / therapy
  • Humans
  • Immunotherapy / adverse effects
  • Molecular Targeted Therapy / adverse effects
  • Neoplasms / therapy*
  • Pigmentation Disorders / etiology
  • Quality of Life
  • Radiotherapy / adverse effects*
  • Severity of Illness Index


  • Antineoplastic Agents