 Hi, my name is Nancy Ainsley. I am a urology research nurse at MD Anderson Cancer Center. I'm going to talk about hair color changes and alopecia, which is a thinning or loss of hair as a side effect to targeted therapies. There are many side effects which may affect your skin and hair while on targeted therapies. These side effects will vary from patient to patient and also vary depending on the type of targeted therapy you are taking. The most common side effects of the skin and hair are hand foot syndrome, rash, photosensitivity, scars and sores that may take longer to heal, splinter-like lines under the fingernails, skin or hair color changes, and alopecia, which is a thinning or loss of hair. Some patients have experienced hair color changes or depigmentation, which is a loss of color while taking targeted therapies. This hair color change or depigmentation is usually experienced with drugs that have a break in therapy, such as a rest period where you take your drug for several weeks, then you have an off period, and then for a couple of weeks, then you resume therapy. As you can see in this photo, this patient had hair color changes during the time that she was on therapy. Then the two weeks that she had a break in therapy, her hair color returned to normal. When she resumed therapy, the loss of color resumed. This is reversible and will return to normal after treatment is discontinued. These hair color changes may affect facial hair such as eyebrows, eyelashes, mustache or beards, as well as hair on the extremities. As you can see in picture E, the loss of color is evident during the cycle of treatment. Returns to normal when patient is off treatment and changes again when treatment is resumed. This can cause a zebra or striping effect on a person's hair. This does not require treatment but may affect the patient's self-image. Alopecia is a thinning or loss of hair. This may involve only thinning or complete loss of hair. It may occur on all parts of the body. It may start immediately or it can occur 7 to 21 days after the start of treatment. Alopecia is almost always temporary. However, when your hair grows back, it may have a different color or texture. To manage alopecia, be gentle when washing your hair. Pat it dry, no vigorous rubbing. Avoid items that could injure your scalp such as a straightening iron or curling iron, brush rollers or curlers or electric hair dryers. Avoid hair dyes or perms to relax the hair. Sleep on a satin pillowcase. A satin creates less friction than cotton. And protect your scalp when outdoors. In summary, communicate with your doctor or nurse when side effects occur that can help evaluate and help to manage your symptoms. Preventive care and management can minimize the severity of symptoms and increase treatment compliance and improve your quality of life while on these therapies.