Expert Advice: Why Minoxidil Beats Biotin for Cancer-Related Hair Loss

To ensure that hair loss treatments do not compromise primary cancer care, oncodermatologist Brittany Dulmage, MD, stresses the necessity of proactive communication between patients and their oncology teams. Before adding any over-the-counter vitamin or supplement to their regimen, she recommends that patients seek a formal review to determine both the efficacy and the safety of the product in the context of their specific treatment plan.

Watch the first part of the interview with Dr Dulmage here.

Navigating Drug-Drug Interactions

One of the most significant risks of unmonitored supplementation is the potential for drug-drug interactions. Dulmage explains that the body—specifically the liver and kidneys—must metabolize everything a patient consumes. Because these are the same pathways used to process critical cancer therapies, a "natural" supplement can inadvertently interfere with the metabolism of prescribed medications. This can lead to decreased drug efficacy or, conversely, an increase in toxic side effects. To mitigate this, she points to the clinical pharmacist on the oncology team as an invaluable resource for vetting supplements for potential biochemical conflicts.

The Myth of the "Hair Vitamin"

In her clinical experience, Dulmage finds that broad hair, skin, and nail vitamins rarely provide the results patients hope for. From a dermatological standpoint, there is little high-quality evidence to support these supplements for the majority of cancer patients. The one notable exception is iron. If a patient experiences significant hair shedding, Dulmage will screen their iron levels; if—and only if—a deficiency is clinically proven, will she recommend targeted iron supplementation. Otherwise, she advises against the "umbrella" approach of general hair vitamins.

A Validated Alternative: Topical Minoxidil

For patients looking for a reliable, safe alternative to manage hair loss, Dulmage suggests topical minoxidil (available over the counter as a foam or solution). Unlike oral supplements that must pass through the digestive system and bloodstream, topical minoxidil has a long history of safety and efficacy without systemic interference.

Key benefits include:

• No Drug Interactions: It does not interfere with the metabolism of oncology medications.
• Safety Profile: It is safe for both men and women and poses no additional risk to those with underlying cancers (with the standard exceptions of patients who are pregnant or breastfeeding).
• Proven Results: It is backed by years of data, offering a clinical foundation that most over-the-counter supplements lack.

Read the full interview with Dr Dulmage here.