Objectives: The aim of this study was to assess the efficacy and safety of hair transplantation in the treatment of endocrine-therapy induced alopecia.
Introduction: Alopecia is one of the most common adverse events caused by numerous anticancer agents. Although alopecia in cancer patients is not a life-threatening event, it has a significantly negative psychological and social impact. Although it has been well documented in chemotherapy and radiotherapy, the incidence of alopecia in patients treated with targeted therapies or endocrine therapy is not anecdotal. Some cases were reported assessing the efficacy of Minoxidil in endocrine-therapy induced alopecia. However, the long term efficacy in this indication is unknown.
Materials / method: Women with breast cancer, suffering from endocrine-therapy induced alopecia, have been grafted with “follicular unit long hair” technique. With this technique a strip of non-shaved hair is harvested from the donor area, segmented into follicular units under stereomicroscope and transplanted into the recipient area.
The efficacy on global hair coverage was assessed by both investigator and patient themselves. In addition, hair density, thickness and growth rate were assessed with a digitalized phototrichogram on the donor area (FotoFinder™).
Results: 10 patients, ranged from 42 to 72 years old, presented male pattern hair loss, emphasizing the hormonal role of endocrine therapy in this type of alopecia.
Hair coverage assessed either by the investigator or by the patient was improved by 50 to 70%.
The long term follow-up, up to 3 years, showed the lasting efficacy of hair transplantation.
Neither transplantation failure nor side effect, except frontal oedema during the 3-4 days after surgery, has been reported.
Conclusion: Endocrine-therapy induced alopecia is not rare. Its clinical pattern is similar to androgenetic alopecia. Hair transplantation has demonstrated its efficacy for the long term treatment of alopecia induced by endocrine therapy. Since no shaving is needed with “follicular unit long hair” technique, this is particularly recommended in women. The advantages of hair transplantation are the long-lasting effect, the poor side effects and the absence of compliance issue.
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