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Pathobiology of Hair Loss

Posted 2/3/2013

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  This article from Lancet is likely way more than you really want to know--unless you have a scientific bent. It explains the pathobiology of chemo-induced hair loss. In other words, exactly why and how it happens. It mentions the lack of progress made in preventing hair loss and acknowledges the distress experienced by patients around this particular side effect. Some women, in fact, refuse chemo because they would rather take their chances with cancer than lose their hair.

  Most of us swallow hard and try to behave, but really really really hate losing our hair. It helps not one whit to be reminded that it will come back. Yes, it will, but there will be many bald months to endure, and the new hair may look quite a bit different than what we have known and loved. I remember seeing myself with curly gray hair in the mirror and thinking "Yikes! Who is that woman?" I felt as though I were in the witness protection program. My own hair, exactly six years after removing the wig and hats, looks ok--or, at least I had adapted to it--but it is still very different than what I had. But, as I remind myself, it is hair, and no whining is allowed after what we have all gone through.

  Here is the beginning of the article and then a link to read more:

Pathobiology of chemotherapy-induced hair loss

Prof Ralf Paus MD a b , Iain S Haslam PhD b, Andrey A Sharov MD d, Prof Vladimir A Botchkarev PhD c d

Prof MD a b , PhD b, MD d, Prof PhD c d

Summary

Hair 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.

Hair 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.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70553-3/abstract

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