Management of Chemotherapy-Induced Alopecia: A Systematic Review and Meta-Analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Introduction: Chemotherapy‑induced alopecia (CIA) is a common and distressing side effect that can lead to treatment refusal or discontinuation. Objectives: This systematic review and meta‑analysis evaluated the effectiveness, safety, and patient‑reported outcomes of interventions for CIA. Methodology: Following PRISMA guidelines, we searched PubMed, EBSCO, Medline, Google Scholar, Wiley, and Web of Science for relevant randomized and quasi‑experimental trials. Results: Thirteen studies comprising over 1,200 patients were included. Scalp cooling reduced moderate‑to‑severe CIA by more than half. Acceptable hair preservation rates ranged from 75–95% with cooling versus 8–49% in controls. In a meta‑analysis of three trials, cooling increased the odds of maintaining cosmetically acceptable hair over fourteen‑fold (OR 14.42; 95% CI 2.79–74.63; P = 0.001; I² = 62%). A separate meta‑analysis of four trials (N = 262) showed a 90% reduction in the odds of moderate‑to‑severe alopecia (OR 0.10; 95% CI 0.02–0.54; P = 0.007; I² = 70%). Patient‑reported need for wigs fell from 45–84% in controls to 5–33% with cooling. Adverse events were mild (headaches in up to 25%, chills, cold sensation) and led to discontinuation in fewer than 30% of cooled patients. Conclusion: Scalp cooling is a safe, well‑tolerated intervention that substantially mitigates hair loss, achieves high patient satisfaction, and reduces the psychosocial burden of CIA. It should be considered standard supportive care for patients receiving hair‑toxic chemotherapy.
DOI: 10.5826/dpc.160a6843
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7154618449