CCCA Patient Handout

Central centrifugal cicatricial alopecia (CCCA) is a very common cause of alopecia or hair loss in women of African descent. Hair loss from CCCA occurs primarily in the central (crown) part of the scalp. The hair loss radiates outward in a centrifugal or circular pattern and is usually gradual although some people experience a rapid progression of the hair loss. Symptoms of CCCA can vary and may include itching, burning, tingling, pain or no symptoms at all.  CCCA causes destruction of the hair follicles and scarring leading to permanent hair loss. CCCA is the most common type of cicatricial (scarring) alopecia.

What is the cause of CCCA?

The exact cause of CCCA is unknown. Though previously thought to be solely related to the use of hot combs, excessive heat and hot oils on the scalp, chemical relaxers, and excessive tension from braids, tight hair rollers, weaves or extensions, the current thought also points to heredity (genetics or family history) playing a role. When scalp samples (biopsies) from people affected by CCCA are examined under a microscope, inflammation and scarring is typically present around the hair follicles.

What treatments are available for CCCA?

It is best to treat CCCA early before permanent hair loss develops. As the disease progresses, hair follicles may scar beyond the point of repair. Treatment options include:

  1. Topical anti-inflammatory medication, like steroid ointments.

  2. Oral anti-inflammatory agents, like antibiotic pills.

  3. Corticosteroid scalp injections- These will be performed once a month for up to 6 months.

  4.  Topical minoxidil ( Rogaine) – In an ointment or solution that will be applied to the scalp once a day. This medication should be used long term, and may initially result in temporary shedding of the hair.

  5. Hair Supplements

  6. Platelet Rich Plasma (PRP)- is a cutting-edge procedure where your blood is drawn in office, the red blood cells are separated out, and the plasma containing platelets and growth factors are injected back into the scalp. Recommend at least a  series of three treatments spaced a month apart.

  7. Hair transplantation – may be considered in patients with permanent hair loss in whom scalp inflammation is absent or well controlled.

*Gentle hair grooming practices such as natural (chemical and heat-free) hair styles, reduced frequency of relaxers, and limited styling products, are also recommended in order to prevent inflammation and further  hair breakage.

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