Glossary
Hypertrichosis: abnormal and excessive hair growth
Pericardial: referring to the pericardium, defined by the Cleveland Clinic as a fluid-filled sac surrounding the heart and the roots of the major blood vessels that extend from the heart.
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Minoxidil May Safely Aid in Hair Growth for Patients with Breast Cancer
January 9, 2025
Alex Biese
Alex Biese
A nationally-published, award-winning journalist, Alex Biese joined the CURE team as an assistant managing editor in April 2023. Prior to that, Alex's work was published in outlets including the Chicago Sun-Times, MTV.com, USA TODAY and the Press of Atlantic City. Alex is a member of NLGJA: The Association of LGBTQ+ Journalists, and also performs at the Jersey Shore with the acoustic jam band Somewhat Relative.
Low-dose oral minoxidil, the hair growth drug which is the active ingredient in Rogaine, may be safe and effective for patients with breast cancer.
Among patients with breast cancer, low doses of the oral hair growth drug minoxidil — the active ingredient in over-the-counter Rogaine — taken during or after cancer treatment is associated with hair regrowth in patients and were not found to cause any serious heart-related side effects requiring additional therapies or hospitalization.
Researchers, led by a team from NYU Langone Health, published their findings in a research letter in the Journal of the American Academy of Dermatology.
“Based on these findings, minoxidil has been shown to be safe for patients while also being effective,” said co-senior author Dr. Kristen Lo Sicco, associate professor in the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine, in a news release issued by NYU Langone Health. “The effectiveness of minoxidil may therefore help patients restore their sense of self and some control in a situation where it has been visibly taken away.”
Alopecia, or hair loss, is a common problem for patients with breast cancer who receive treatment with chemotherapy, researchers explained. While 5 milligrams or less of oral minoxidil daily is a promising off-label treatment for alopecia, concerns persist regarding potential cardiovascular side effects, particularly among patients who have received treatment with anthracyclines or Herceptin (trastuzumab), they reported.
The retrospective analysis of patients with breast cancer prescribed low-dose oral minoxidil for alopecia between Nov. 16, 2012, and June 19, 2023 — including 51 patients with a median age 67 years, of whom 25 (49%) received chemotherapy and 26 (51%) underwent surgery and/or radiation alone. Investigators found that all patients had improvement or stability of alopecia after three to six months of low-dose minoxidil, with no significant difference in treatment effectiveness between patients who underwent chemotherapy and those who did not.
At six months or longer, three patients who underwent chemotherapy reported worsening alopecia, with two of those patients having corroborating physician assessments, all three having had prior taxane exposure and two also receiving doxorubicin and cyclophosphamide.
Researchers reported that 29 patients (56.9%), experienced 44 side effects, with no significant difference in side effects between groups and the majority of side effects (61.4%) being hypertrichosis. No pericardial or life-threatening side effects were reported.
CURE spoke with Lo Sicco and co-lead author Devyn Zaminski, a medical student at NYU Grossman School of Medicine, via email about the findings.
CURE: For patients with breast cancer, what do you believe is the big takeaway from these findings?
Lo Sicco: Women are already often held to a different standard compared with men without hair. It creates an additional vulnerability for someone who has already endured so much. Our hope is that this study will help to expand the treatment options for breast cancer survivors.
Zaminski: Hair loss can be a persistent and sometimes long-lasting external reminder of a woman's breast cancer experience. We hope that breast cancer survivors feel empowered in knowing there is a safe and effective solution for treating hair loss — offering relief without adding to the stress and challenges they have already endured.
What separates these findings from previous research on this topic?
Lo Sicco: Low dose oral minoxidil's (LDOM) efficacy in treating chemotherapy-induced alopecia as well as other types of alopecia that breast cancer survivors suffer from has already been proven. Given oral minoxidil can cause pericardial effusions, typically at high doses that are used to treat recalcitrant hypertension, our main question was whether breast cancer survivors who were exposed to cardiotoxic chemotherapy drugs in their breast cancer treatment regimen increased the risk of severe side effects when using LDOM to treat their alopecia. This study shows the safety of LDOM in breast cancer survivors, including those who used potentially cardiotoxic drugs in their chemotherapeutic regimen.
Given these findings, what sorts of conversations addressing hair loss should patients with breast cancer have with their care team?
Lo Sicco: This is a great question that we have asked ourselves too! Our next question to explore in research is, can we safely use LDOM throughout one's chemotherapy regimen and help prevent chemotherapy induced alopecia (CIA)? Currently, most providers wait until the chemotherapy course has been completed. While not a focus of this study, we also want patients and providers to recognize the significant role that scalp cooling can play in helping to prevent CIA as well.
Why is addressing hair loss important for the overall well-being and quality of life of patients with breast cancer?
Lo Sicco: Studies have shown that alopecia is associated with poorer quality of life as well as psychosocial conditions, including anxiety and depression. Those suffering from cancer still want to feel like themselves and alopecia often robs people of feeling normal. Board certified dermatologists are uniquely equipped with the skill set to treat this patient population and in doing so, helping to restore their identities.
Zaminski: Studies indicate that some women opt for less effective breast cancer treatments out of fear for hair loss side effects. This alone speaks to the profound impact hair loss can have on an individual's emotional and physical well-being. We hope our findings can help better address the needs of breast cancer survivors and improve their quality of life after treatment.
Is there anything else you would like the CURE readership to know about this topic?
Lo Sicco: Yes, and thank you for asking! Cranial prostheses or wigs are another very important part of someone's alopecia treatment plan. Unfortunately, insurances often deny coverage for cranial prostheses for many types of alopecia. Fortunately, we can help to advocate as individuals! The @alopeciajusticelague (AJL) is working alongside NAAF (National Alopecia Areata Foundation) to empower constituents to advocate for coverage of wigs as a piece of durable medical equipment under Medicare, just as a breast prosthesis would be for someone going through breast reconstructive surgery. Please visit the AJL page and take less than one minute to sign up for our digitized advocacy form, in collaboration with NAAF!
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