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Reactive management of hair changes induced by multikinase inhibitor treatment

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, 3 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

Table 34. Management of hair changes associated with multikinase inhibitors1-3

Management of hair changes

Alopecia, non-scarring

  • Minoxidil 2% or 5% bid

Alopecia, scarring

  • 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.


  1. Boers-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.
  2. Lacouture ME, et al. MASCC Skin Toxicity Study Group. Support Care Cancer. 2011; 19: 1079-95.
  3. Suchonwanit P. and McMichael A.J. Am J of Clin Dermatol. 2018; 19:853-865.

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