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Lung Cancer. 2010 Aug 9. [Epub ahead of print]

Perception of alopecia by patients requiring chemotherapy for non-small-cell lung cancer: A willingness to pay study.
Bernard M, et al

Abstract

OBJECTIVE: Chemotherapy-induced alopecia may have a substantial impact on the quality of life (QOL) of lung cancer patients, but very few data are available. The aim of this study was to assess the perceived impact of alopecia based on a “willingness to pay” (WTP) approach. METHODS: We conducted a prospective multicenter WTP study of patients receiving chemotherapy for non-small-cell lung cancer (NSCLC). The perceived impact of alopecia was assessed with a visual analogue scale (VAS; 0: no impact, 10: major impact), and from the patients’ willingness to pay for chemotherapy that had the same efficacy, dosing schedule and tolerability as the standard treatment but that cut the risk of alopecia from 40% to 5%. RESULTS: Among the 135 patients enrolled in this study, the mean score on the VAS for the perceived likely impact of alopecia was 4.4+/-0.3. The mean WTP for a 3-week chemotherapy cycle reducing the risk of hair loss from 40% to 5% was euro83.4+/-10.2 (euromedian 37.5), representing 2.1% of total income, while 27% of patients were unwilling to pay anything. There was a significant association between WTP and gender, annual incomes, but not with marital status, level of education or occupations. CONCLUSION: Hair loss appears to be an important outcome for patients receiving chemotherapy for NSCLC. Women and patients with high annual incomes were more willing to pay. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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Br J Dermatol. 1990 Apr;122 Suppl 35:21

Pigmentary changes of the ageing skin.Ortonne JP.

In subjects older than 25-30 years the number of enzymatically active melanocytes … decreases by about 10-20% per decade, with exposed skin having approximately twice as many pigment cells as unexposed skin. Chronic exposure to sunlight may stimulate the epidermal melanocyte system rather than accelerating chronological ageing. The number of melanocytic naevi declines with age. Despite the decreased melanocyte density, photoaged skin has irregular pigmentation and, frequently, there is hyperpigmentation. This may be due to greater positivity of dopa of chronically irradiated melanocytes. Heterogeneity in skin colour in exposed areas of skin is due to uneven distribution of pigment cells, a local loss of melanocytes, and a modification in the interactions between melanocytes and keratinocytes. The most common pigmented lesions in sun-exposed skin include ephelides, actinic lentigo, pigmented solar keratoses and seborrhoeic keratoses, and lentigo maligna. ..snip.. Greying of the hair is due to progressive loss of melanocytes from the hair follicles. In vivo and in vitro studies are necessary to increase overall understanding of the processes involved and to improve treatment of the pigmentary changes in ageing skin.

edited for hairloss blog