Treatment of Chemotherapy Induced Alopecia

<jats:p>Chemotherapy-induced alopecia (CIA) is one of the most visible and psychologically distressing adverse effects of cytotoxic cancer therapy. Although traditionally regarded as a transient and fully reversible condition, increasing recognition of persistent chemotherapy-induced alopecia (pCIA) has challenged this paradigm. This review summarizes the epidemiology, psychosocial burden, follicular pathobiology, and clinical spectrum of CIA, with particular emphasis on taxane- and alkylating agent-associated follicular stem cell injury. Current preventive and therapeutic strategies are critically discussed, including scalp cooling, topical and low-dose oral minoxidil, prostaglandin analogues for chemotherapy-induced madarosis, antiandrogen integration in endocrine therapy-related overlap phenotypes, and procedural adjuncts such as low-level light therapy, platelet-rich plasma, and hair transplantation. A stepwise clinical algorithm is proposed to guide management across active chemotherapy, early post-treatment recovery, and persistent hair loss beyond 6 months. Future approaches should integrate molecular risk stratification, patient-reported outcome measures, and multidisciplinary oncodermatology care to transform CIA from an inevitable consequence of treatment into a preventable and actively manageable condition.</jats:p>