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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Safety First: A Comprehensive Review of Nutritional Supplements for Hair Loss in Breast Cancer Patients

by
Andrea Sechi
1,†,
Stephano Cedirian
2,3,†,
Tullio Brunetti
2,3,*,
Federico Quadrelli
2,3,
Fernanda Torres
4,
Antonella Tosti
5,
Fabio Rinaldi
6,
Daniela Pinto
6,
Rolando Bolognino
7,
Angelo Valerio Marzano
1,8 and
Bianca Maria Piraccini
2,3
1
Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20120 Milan, Italy
2
Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy
3
Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
4
Private Practice, Rio de Janeiro 22410-000, Brazil
5
Fredric Brandt Endowed Professor of Dermatology, Miller School of Medicine, University of Miami, Miami, FL 33146, USA
6
Human Microbiome Advanced Project (HMAP), 20129 Milan, Italy
7
Sapienza University of Rome, Unitelma Sapienza, 00185 Rome, Italy
8
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Nutrients 2025, 17(9), 1451; https://doi.org/10.3390/nu17091451
Submission received: 18 March 2025 / Revised: 20 April 2025 / Accepted: 23 April 2025 / Published: 25 April 2025
(This article belongs to the Section Nutrition Methodology & Assessment)
Versions Notes

Abstract

Among the distressing side effects of cancer treatments, hair loss is one of the most disturbing for the quality of life and adherence to therapy in breast cancer patients. Many patients take nutritional supplements to prevent hair loss or enhance regrowth. Based on their mechanism and timing of use, nutritional supplements could be divided into safe, cautious, debated, and contraindicated categories. Non-contraindicated supplements generally include safe supplements like vitamin D, which is not known to interfere with cancer treatments. Those that are contraindicated include phytoestrogens and compounds affecting estrogen pathways because of the risk of stimulating tumor growth in cancers sensitive to estrogen. Antioxidants like tocotrienols and resveratrol are given judiciously because of potential interference with cancer therapies dependent on reactive oxygen species. Supplements debated, including nicotinamide, folate, and iron, pose a risk by promoting cellular proliferation or altering the tumor microenvironment. Biotin is nontoxic but interferes with blood test results and is thus difficult in cancer monitoring. Evidence regarding nutritional supplements’ safety and efficacy in this context is conflicting. Management by an oncologist is required along with more studies to clearly establish the safety parameters and efficacy guidelines.
Keywords: hair loss; telogen effluvium; chemotherapy-induced alopecia; breast cancer; targeted therapy; immunotherapy; safety profile hair loss; telogen effluvium; chemotherapy-induced alopecia; breast cancer; targeted therapy; immunotherapy; safety profile

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MDPI and ACS Style

Sechi, A.; Cedirian, S.; Brunetti, T.; Quadrelli, F.; Torres, F.; Tosti, A.; Rinaldi, F.; Pinto, D.; Bolognino, R.; Marzano, A.V.; et al. Safety First: A Comprehensive Review of Nutritional Supplements for Hair Loss in Breast Cancer Patients. Nutrients 2025, 17, 1451. https://doi.org/10.3390/nu17091451

AMA Style

Sechi A, Cedirian S, Brunetti T, Quadrelli F, Torres F, Tosti A, Rinaldi F, Pinto D, Bolognino R, Marzano AV, et al. Safety First: A Comprehensive Review of Nutritional Supplements for Hair Loss in Breast Cancer Patients. Nutrients. 2025; 17(9):1451. https://doi.org/10.3390/nu17091451

Chicago/Turabian Style

Sechi, Andrea, Stephano Cedirian, Tullio Brunetti, Federico Quadrelli, Fernanda Torres, Antonella Tosti, Fabio Rinaldi, Daniela Pinto, Rolando Bolognino, Angelo Valerio Marzano, and et al. 2025. "Safety First: A Comprehensive Review of Nutritional Supplements for Hair Loss in Breast Cancer Patients" Nutrients 17, no. 9: 1451. https://doi.org/10.3390/nu17091451

APA Style

Sechi, A., Cedirian, S., Brunetti, T., Quadrelli, F., Torres, F., Tosti, A., Rinaldi, F., Pinto, D., Bolognino, R., Marzano, A. V., & Piraccini, B. M. (2025). Safety First: A Comprehensive Review of Nutritional Supplements for Hair Loss in Breast Cancer Patients. Nutrients, 17(9), 1451. https://doi.org/10.3390/nu17091451

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