Evaluating disparities in counseling and resources for chemotherapy-induced hair loss: qualitative analysis of a survey-based approach

Abstract Purpose Chemotherapy-induced alopecia (CIA) is a distressing side effect of cancer treatment that significantly impacts patients’ quality of life. Despite the availability of interventions such as scalp cooling and topical treatments, many patients report inadequate counseling and limited access to these resources. This study aimed to evaluate disparities in CIA-related counseling and resource access, with particular attention to how socioeconomic and demographic factors shape the patient experience. Methods We conducted a mixed-methods, cross-sectional survey study of 101 adults who had received chemotherapy and experienced hair loss. Participants were recruited through online cancer support networks. Thematic analysis was performed on open-ended responses to identify key patient-reported themes. Results Thematic analysis revealed 11 key patient-identified themes, including emotional distress, provider influence, financial barriers, and a strong desire for autonomy in decision-making. Conclusion This study highlights substantial gaps in CIA-related counseling and access, with disparities influenced by employment, income, and education. Early, empathetic, and comprehensive counseling plays a pivotal role in patient satisfaction and access to care. Standardizing CIA education and improving resource availability may help reduce inequities and improve patient outcomes.