Is hair loss a common side effect of Melanoma treatment? How can it be managed?

Hair loss can happen with some melanoma treatments, but how often it occurs depends on the specific therapy you’re receiving. Targeted therapies (BRAF/MEK inhibitors) often cause hair thinning or patchy loss, while classic full scalp baldness is less typical outside of traditional chemotherapy. ^[1] Immunotherapies can also lead to immune‑related hair changes such as alopecia areata or vitiligo‑like effects, although this is less common and varies by individual. [PM9] Conventional chemotherapies can cause more generalized hair loss across the scalp and body, but they’re used less frequently in modern melanoma care. ^{[2] [3]}

Which melanoma treatments are linked to hair loss?

• Targeted therapy (BRAF/MEK inhibitors)

  • Vemurafenib, dabrafenib (BRAF inhibitors) and cobimetinib, trametinib, binimetinib (MEK inhibitors) can cause partial alopecia (hair thinning or patchy loss). ^[1] Changes in hair texture and color (such as straight-to-curly or graying) and folliculitis may also occur. ^[1]
  • Protocols combining these agents (e.g., vemurafenib + cobimetinib, encorafenib + binimetinib) list alopecia as a recognized side effect. ^{[4] [5] [6] [7]}

• Immunotherapy (e.g., PD‑1/CTLA‑4 inhibitors)

  • Cutaneous immune-related effects can include alopecia areata, lichenoid and vitiligo-like reactions, generally less frequent but documented in melanoma populations. [PM9]

• Chemotherapy

  • Chemo attacks fast-growing cells and can cause hair loss on the scalp and body; the degree depends on drug type and dose. ^[2] Hair loss during chemo is widely recognized and discussed in clinical education resources. ^[3]

• Real-world safety signals

  • Across modern melanoma drugs, pharmacovigilance data report alopecia among skin-related adverse events, more frequently tagged with targeted therapies. [PM8]

What does hair loss look like with melanoma therapy?

• Partial thinning or patchy areas are typical with BRAF/MEK inhibitors, sometimes with mild discomfort of hair follicles. ^{[4] [5] [6] [7]}
• Texture or color changes may accompany targeted drugs. ^[1]
• Diffuse shedding across scalp/body is more common with traditional chemotherapy. ^[2]
• Immune-pattern hair loss (alopecia areata) may present as round patches and can be linked to immune activation. [PM9]

Can hair loss be prevented?

• Scalp cooling (cold caps) during chemotherapy can lower the risk of hair loss for many solid-tumor regimens. [PM18] Studies show significant risk reduction of chemotherapy-induced alopecia using scalp cooling, with no serious safety signals in trials. [PM18]
• Topical minoxidil (2%) has not consistently prevented chemo hair loss in trials, though it may help regrowth after treatment. [PM18]

Note: Scalp cooling is primarily studied for chemotherapy; its role with intermittent targeted therapy protocols is sometimes referenced, but applicability varies and should be discussed with your oncology team. ^{[5] [4] [6] [7]}

Managing hair loss and caring for your scalp

• Gentle hair and scalp care
  • Wash every 2–4 days with mild, fragrance‑free shampoo; rinse well and pat dry. ^[8]
  • Use soft brushes and avoid tight styles, harsh treatments, and hot tools to reduce breakage. ^[8]
• Comfort measures and head coverings
  • Soft beanies, cotton or bamboo fabrics, and well‑fitted wigs can reduce irritation and boost confidence. ^{[9] [10]}
  • If choosing a wig, consider getting fitted before major shedding so style and color can be matched. ^[10]
• Scalp cooling support
  • If you’re receiving chemo, coordinating cold-cap use and proper hair care during cooling improves outcomes. ^[8]
• Dermatology referral
  • For immune‑related alopecia areata or troublesome scalp symptoms, early evaluation helps tailor treatments (topical steroids, immunomodulators) and maintain cancer therapy when possible. [PM9]

When to talk to your care team

• New or worsening hair loss, scalp pain, or folliculitis during targeted therapy warrants review to adjust supportive care and rule out other causes. ^[1]
• If you plan scalp cooling, ask about suitability with your specific regimen and timing before the first chemo session. [PM18] Oncodermatology programs offer pretreatment counseling and preventive strategies for dermatologic side effects. ^{[11] [12]}

Key takeaways

• Hair loss with melanoma treatment varies by therapy: targeted drugs often cause partial thinning/patchiness; chemo can cause more diffuse loss; immunotherapy can occasionally trigger immune‑pattern alopecia. ^{[1] [2]} [PM9]
• Evidence supports scalp cooling to help prevent chemo‑related hair loss, while gentle scalp care and appropriate head coverings improve comfort and appearance. [PM18] ^{[8] [9] [10]}
• Early discussion with your oncology and dermatology teams helps personalize prevention and treatment for hair changes. [PM9] ^{[11] [12]}

If you need help navigating resources or support services, you can also explore patient-friendly programs and educational materials offered by cancer centers. ^{[9] [10]}