Reactive Management for Hair Changes

General Recommendation

Excessive hair growth and alopecia can cause embarrassment and psychological distress. Patients can be reassured that, in most cases, hair growth will normalise after completion of treatment.1

Treatment Overview

Non-scarring alopecia may occur after 2-3 months of treatment and usually resolves after discontinuation of treatment, although altered hair regrowth is sometimes observed.2 Minoxidil is used to treat non-scarring alopecia in the general population.2 If given to patients receiving targeted therapy, pruritus and hypertrichosis should be monitored.2 Eflornithine cream can be used to treat hypertrichosis.

Scarring alopecia is caused by the inflammation derived from the scalp, facial and chest lesions and can result in permanent hair loss.2 Treatment aims to reduce inflammation and scarring using topical corticosteroids (including shampoos and lotions).2 Strategies to reduce the severity of papulopustular rash should also be implemented.

Treatment of alopecia with non-scarring1,2

  • Minoxidil 2% or 5% twice daily

Treatment of alopecia with scarring1,2

  • Class 1 steroid lotion, shampoo, or foam
  • Antibiotic lotion


  • Minoxidil 2% or 5% twice daily
  • Steroid lotion, shampoo or foam
  • Eflornithine

Multikinase Inhibitor Treatment

Continue with/withhold the selected multikinase inhibitor treatment regimen, as recommended in the current and relevant SPC and according to the patient’s condition.


1Boers-Doets CB. The TARGET SYSTEM. Approach to assessment, grading, and management of dermatological & mucosal side effects of targeted anticancer therapies. ISBN 978-94-92070-00-5. 2014
2Lacouture ME, et al. Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities. Support Care Cancer. 2011; 19:1079-95.

Last update: 22 August 2014