Persistent Chemotherapy-Induced Alopecia (pCIA)

Last updated: 6 February 2026. Next review: 6 February 2027

What is persistent chemotherapy-induced alopecia? (pCIA)

Persistent chemotherapy-induced alopecia (pCIA) is a condition where hair loss continues for more than six months after completing chemotherapy.

While hair loss from chemotherapy is usually temporary, pCIA involves incomplete or limited hair regrowth and can sometimes be long-lasting or permanent.

What are the symptoms of pCIA?

Symptoms of pCIA can vary but generally include:

Reduced hair regrowth within the typical 3–6 month timeframe after chemotherapy
Diffuse hair thinning, appearing as overall hair loss across the scalp
Female pattern hair loss-like appearance, with more noticeable thinning at the top of the scalp
Uneven or patchy regrowth in some individuals
Although it is rare, a scarring form of alopecia may develop

Patients may notice that hair grows back more slowly, is finer, or does not return to its previous density.

What causes pCIA?

pCIA is caused by damage to hair follicles during chemotherapy. The exact mechanisms are not fully understood, but certain chemotherapy types are more strongly associated with pCIA:

Taxanes, such as docetaxel and paclitaxel. These are commonly used in breast cancer treatment and target rapidly dividing cells. They can cause more severe or permanent hair follicle damage, especially at higher doses or when used for a longer time.
Bone marrow transplantation: high-dose chemotherapy regimens used in preparation for these transplants carry a higher risk of pCIA.
Patients receiving a combination of chemotherapy drugs, particularly those including taxanes, are at a higher risk of developing pCIA.

Radiotherapy and endocrine therapies may also increase the risk of persistent alopecia. As with chemotherapy, these mechanisms are not fully understood. The following types are thought to be more strongly associated with persistent alopecia:

Endocrine therapies may increase the risk of alopecia which is similar in appearance to male/female pattern hair loss.
Head and neck radiotherapy may also increase the risk of persistent alopecia.

How common is pCIA?

Temporary hair loss occurs with over 60% of chemotherapy drugs. Persistent chemotherapy-induced alopecia is much less common, but data on exactly how many people it affects is not available.

Can pCIA be treated?

Treating pCIA can be challenging, as the hair follicles have sustained lasting damage. Options include:

Topical or oral minoxidil – may help stimulate hair growth and improve hair density, although effectiveness can be limited
Supportive hair care – gentle handling, avoiding heat and harsh chemicals, and use of wigs or scarves

Early consultation with a dermatologist or oncology hair loss specialist can help optimise management and support regrowth where possible.

Additional Information

Visit the Cancer Research website

Visit the Macmillan Cancer Support website

Latest

We're all the same inside
Matt Warder

Trustee
Anne Maton

Senior Fundraising Manager
The Medical Dismissal Study

Invitation to take part in a research study from King's College London on dismissal by healthcare services. Help improve services for long-term conditions like alopecia.

Trichotillomania (hair pulling)

Trichotillomania is a condition characterised by a compulsive urge to pull out one’s own hair, which can lead to noticeable hair loss and emotional distress. Trichotillomania is a body-focused repetitive behaviour (BFRB).
Traction Alopecia

Traction alopecia is a type of hair loss caused by repeated strain or tension on the hair follicles, rather than genetic or immune factors. This condition can occur in anyone who wears their hair pulled back tightly for long periods.
Telogen Effluvium

In telogen effluvium (TE), more hairs than usual enter the resting phase, leading to increased shedding. Instead of losing up to 100 hairs daily, some people may lose up to 300 hairs a day, resulting in noticeable thinning of hair volume.
Lichen Planopilaris (LPP)

Lichen planopilaris (LPP) is a type of scarring alopecia that primarily affects the scalp, most commonly in middle-aged women, although it also occurs in men, young adults, and, rarely, in children.
Chemotherapy Induced Alopecia (CIA)

Chemotherapy-induced alopecia (CIA) is hair loss that occurs as a side effect of chemotherapy treatment for cancer. Chemotherapy drugs target rapidly dividing cells, which includes cancer cells as well as other fast-growing cells in the body — including hair follicle cells.
Frontal Fibrosing Alopecia (FFA)

Frontal fibrosing alopecia (FFA) is a type of scarring hair loss that primarily affects the frontal scalp, including the forehead, eyebrows, and sideburn areas. FFA most commonly affects post-menopausal women, though it can also occur in younger women and men.
Central Centrifugal Cicatricial Alopecia (CCCA)

Central Centrifugal Cicatricial Alopecia (CCCA) is a type of scarring hair loss that begins at the centre of the scalp and gradually spreads outward. It is most common in women of African descent. CCCA permanently damages hair follicles, making early diagnosis and treatment important.
Pattern Hair Loss

Pattern hair loss is the most common type of hair loss. It occurs in both men and women and becomes more common with increasing age. Around 50% of men over 50 and 50% of women over 65 are affected, though it can also start in younger adults and occasionally in early teen years.
Alopecia Areata

Alopecia areata is an autoimmune condition that causes sudden, patchy hair loss on the scalp, beard, eyebrows, eyelashes, or other parts of the body. It affects people of all ages and backgrounds and can vary in severity from small round patches to complete hair loss across the scalp and body.

Common Treatments for Alopecia Areata

Information about common treatments for Alopecia Areata
Alopecia Areata

Alopecia areata is an autoimmune condition that causes sudden, patchy hair loss on the scalp, beard, eyebrows, eyelashes, or other parts of the body. It affects people of all ages and backgrounds and can vary in severity from small round patches to complete hair loss across the scalp and body.
Alopecia and Covid-19 (New Coronavirus)

A statement from Alopecia UK regarding COVID-19 and vaccines.
Pattern Hair Loss

Pattern hair loss is the most common type of hair loss. It occurs in both men and women and becomes more common with increasing age. Around 50% of men over 50 and 50% of women over 65 are affected, though it can also start in younger adults and occasionally in early teen years.
Lichen Planopilaris (LPP)

Lichen planopilaris (LPP) is a type of scarring alopecia that primarily affects the scalp, most commonly in middle-aged women, although it also occurs in men, young adults, and, rarely, in children.
Can I dye my hair when I have alopecia?
Telogen Effluvium

In telogen effluvium (TE), more hairs than usual enter the resting phase, leading to increased shedding. Instead of losing up to 100 hairs daily, some people may lose up to 300 hairs a day, resulting in noticeable thinning of hair volume.
Why does hair sometimes grow back white after alopecia areata?
A Guide to Wigs

Links to our downloaded PDF wig guide, and information on the NHS England wig report.
Responding to the events from the 2022 Oscars

We respond to the events from the 2022 Academy Awards ceremony and the actions of Will Smith