• Ralf Paus, Iain S Haslam, Andrey A Sharov, and Vladimir A Botchkarev.
• Department of Dermatology, University of Lübeck, Lübeck D-23538, Germany. ralf.paus@manchester.ac.uk
• Lancet Oncol.. 2013 Feb 1;14(2):e50-9.

AbstractHair loss can be a psychologically devastating adverse effect of chemotherapy, but satisfactory management strategies for chemotherapy-induced alopecia remain elusive. In this Review we focus on the complex pathobiology of this side-effect. We discuss the clinical features and current management approaches, then draw upon evidence from mouse models and human hair-follicle organ-culture studies to explore the main pathobiology principles and explain why chemotherapy-induced alopecia is so challenging to manage. P53-dependent apoptosis of hair-matrix keratinocytes and chemotherapy-induced hair-cycle abnormalities, driven by the dystrophic anagen or dystrophic catagen pathway, play important parts in the degree of hair-follicle damage, alopecia phenotype, and hair-regrowth pattern. Additionally, the degree of hair-follicle stem-cell damage determines whether chemotherapy-induced alopecia is reversible. We highlight the need for carefully designed preclinical research models to generate novel, clinically relevant pointers to how this condition may be overcome.Copyright © 2013 Elsevier Ltd. All rights reserved.

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