6 insights to understand, manage CCCA – a common cause of hair loss

More than 35 million men and 21 million women in the U.S. have some form of hair loss. Eternal Dermatology & Aesthetic Center understands the profound impact hair loss can have on one’s sense of self and well-being. What is to blame for hair loss varies, as there are myriad causes and factors. CCCA stands out as a significant contributor, particularly among those of African descent. As a double board-certified dermatologist with a highly diverse patient base, Dr. Ife Rodney has the experience to properly evaluate and manage this condition, which stands for “Central Centrifugal Cicatricial Alopecia.” 

Our team in Colombia, Maryland, is pleased to share the following six aspects of CCCA with you to better support your understanding of this condition and potential treatment/management options:

1 – A distinctive form of hair loss

CCCA is a chronic and progressive form of scarring alopecia. In fact, it is the most common type of scarring alopecia among women of African descent. Alopecias are a group of inflammatory hair disorders that destroy follicles and replace them with scar tissue. When scarring ensues, it can lead to irreversible/permanent hair loss. It most commonly originates on the crown or center of the scalp. Without treatment, it can progress outward in a circular (centrifugal) pattern. 

2 – Risk factors for CCCA

While the specific cause of CCCA is not well-understood, several factors have been implicated in the onset and progression of this condition. These factors include: 

• A history of styling with intense heat
  
• Certain hairstyles that place excessive tension on the scalp
  
• Products such as chemical relaxers and dyes
  
• A family history – We treat generations of family members with CCCA who have no history of tight hairstyles or use of harsh products and styling techniques.
  
• Follicle shape – naturally tight and coiled follicles tend to be more vulnerable to irritation and damage

3 – How CCCA manifests

In addition to its distinctive pattern of hair loss, spreading outward from the center of the head, many of our patients with CCCA describe changes in how their scalp feels. They may experience intense burning, itching, and tenderness accompanied by acne-like bumps. Early in the disease process, there may be no visible loss of hair. You may notice that the strands seem fragile, broken, or short. 

4 – Determining your needs

Dr. Rodney cannot treat what she does not understand. So, while CCCA does have characteristic signs, she needs to examine your strands and scalp to confirm the presence of CCCA. She must also determine the nature or severity of CCCA. From there, she will recommend the most appropriate treatment options for you. A comprehensive evaluation generally involves a thorough medical review and consultation. Be prepared to discuss things like when you first started to have symptoms, your hair care and styling habits, and other lifestyle factors. Dr. Rodney also physically examines your scalp to assess the pattern and severity of hair loss. A biopsy may be required for a definitive diagnosis. A small sample of tissue is analyzed under a microscope to identify scarring and other characteristics of CCCA. Lastly, blood tests can help us to understand medical conditions that may be responsible for your thinning hair and bald patches. 

5 – Treatment options 

With prompt treatment, we can stem the tide of hair loss/damage and even help follicles to recover. The first step is generally to ease inflammation as soon as possible. We do this with a prescription medicated cream that is applied topically, directly to the affected areas of the scalp. Medications that work systemically may also help (such as oral anti-inflammatories taken in pill or tablet form). Depending on the root cause of CCCA, changes in your styling, hair care, and grooming practices can make a big difference. For instance, it’s important to either reduce or avoid any harsh heat, chemicals, or styles that pull excessively at the scalp. Injections of steroids and/or platelet-rich plasma (PRP) can reduce inflammation and encourage natural healing of scarred and inflamed areas, respectively. In some cases, Dr. Rodney may recommend an advanced and minimally invasive alternative to traditional hair transplantation: Follicular Unit Extraction. Some of our patients have experienced a 39% improvement in hair growth with low-level laser light therapy. Laser energy stimulates blood flow and hair growth. 

6 – Outlook

How CCCA affects the hair depends on factors such as natural texture. For instance, those with very tightly-coiled hair tend to be at greater risk of scarring and permanent hair loss. Fortunately, Dr. Rodney has considerable experience evaluating and caring for patients with all sorts of hair types. She appreciates how nuanced the condition can be and recommends management strategies accordingly. Treatments can slow or stop the destruction of hair follicles and also stimulate growth, albeit at a potentially slower rate than natural hair growth. 

Eternal Dermatology & Aesthetic Center encourages you to maintain regular check-ups, so we can stay ahead of potential damage. CCCA is easier to treat before it spreads and follicles become scarred, which leads to irreversible hair loss. Routine visits to our office in Columbia, MD, allow us to identify emerging issues and address them promptly. There are also opportunities for us to monitor how well any treatments or interventions are working. Do not ignore the signs of CCCA. Contact us today at (301) 479-6544 to schedule your consultation. 

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