Minoxidil and Prostaglandin Analogs for Chemotherapy-Induced Alopecia: A Scoping Review.

Abstract

Background: Chemotherapy-induced alopecia (CIA) is common, distressing, and markedly impairs patients' quality of life. Although scalp cooling is the only approved preventive strategy, its effectiveness and accessibility remain limited. Therefore, alternative pharmacologic approaches, such as minoxidil and prostaglandin analogs, have been explored.

Methods: This scoping review aimed to explore the available evidence on minoxidil's efficacy and safety and the potential role of prostaglandin analogs in alopecia. PubMed, Cochrane Library, Medical Online, and Ichushi-Web were comprehensively searched from inception to February 2026. Studies evaluating minoxidil in CIA and prostaglandin analogs in any alopecia type were included. Case reports, case series, and non-human studies were excluded.

Results: Seven studies were included. Five studies evaluated minoxidil in CIA, including two randomized controlled trials and three retrospective studies on prophylactic and therapeutic use, respectively. Prophylactic topical minoxidil did not markedly prevent CIA but was associated with earlier hair regrowth. In contrast, therapeutic use-particularly of oral minoxidil-improved hair density and treatment response. No serious adverse events were reported, although cardiovascular effects remain a concern with oral formulations. Two randomized controlled trials evaluated prostaglandin analogs in non-chemotherapy-related alopecia and showed markedly improved hair density and regrowth. However, no study directly assessed their efficacy in CIA.

Conclusions: Minoxidil may be beneficial for hair regrowth in CIA but shows limited preventive efficacy. Prostaglandin analogs are promising but untested in this setting. Future studies should evaluate their role, particularly in combination with minoxidil, to address the current evidence gap and improve outcomes for patients with CIA.