Best treatment for central centrifugal cicatricial alopecia

CCCA- A Common Cause of Hair Loss

Last updated Feb 13, 2020

Hair loss is a common concern that affects millions of Americans. Statistics show that more than 35 million men and 21 million women have some form of hair loss. Losing those precious tufts can bring social anxiety and distress to many. For others, hair loss could be a sign of a deeper medical issue. For some, that issue could be Central Centrifugal Cicatricial Alopecia or CCCA. CCCA hair loss is commonly seen in women, and sometimes men, of African descent. This is one of the top reasons why African- Americans seek dermatologic evaluation.

CCCA starts on the crown or central part of the scalp and moves outward in a gradual, circular motion. For some people, CCCA spreads rapidly. The condition creates scarring that destroys the hair follicles, causing permanent hair loss. 

What causes CCCA?

The exact cause of CCCA is unclear but is thought to be due to a variety of factors. These include a history of intense heat, tight hairstyles, or the application of chemical relaxers and dyes. These hair grooming practices could have occurred as far back as during childhood or teenage years. CCCA can also be triggered by the naturally curly shape of African hair follicles. CCCA affects some individuals with no history or tight or harsh hairstyles. Therefore, we believe that there is also be a genetic component triggering the disease. It often affects multiple family members.

What are the symptoms of CCCA?

People with CCCA often have burning, itching, burning, tenderness, or tiny bumps on the scalp. These usually occur on the top of the head and gradually spreads outwards. In the early stage, there may be no visible hair loss or the hairs may be fragile, short, and broken. Your dermatologist will need to examine your hair and scalp to confirm CCCA. A biopsy or scalp sample is necessary to confirm the condition. The sample is viewed under a microscope to confirm scarring and amount of inflammation. 

How can I treat CCCA hair loss?

As CCCA is a complex disorder, the treatment regimen fights hair loss from multiple approaches. If addressed early, you and your dermatologist can stem the tide and slow down the rate of hair damage. In the early stages, hair follicles may recover. Unfortunately, most patients visit a doctor when there is extensive damage. Therefore, all that could be done is treatments to prevent further hair loss. These treatments include: 

Easing inflammation

Inflammation is a common symptom and the first step is to reduce those signs as quickly as possible. Your dermatologist will prescribe medicated creams to apply directly to the scalp. Oral anti-inflammatory pills may also help, giving your scalp some much-needed relief. 

Lifestyle changes

It’s important to look at practices that may have damaged hair or caused CCCA. From there, make simple changes to the way you treat and groom your hair. Reducing or eliminating the use of heat and chemical hairstyles can help reduce damage and stop inflammation. This includes the excess use of relaxers and harsh hair products. Patients may also need to discontinue braids and other styles that pull on and damage hair follicles. 

Injections may help

Scalp injections with steroids treat the problem area. Steroid injections can reduce inflammation for a longer period, while slowing down hair loss. 

Once the process is halted and there is no active inflammation, you may consider platelet rich plasma injections (PRP). PRP uses your body’s own growth factors to increase the blood supply in the area that could be damaged due to scarring and inflammation. In the three-step process, blood is first extracted from the arm. The blood is spun in a centrifuge to separate into layers. The platelet-rich plasma layer is then drawn and injected into the affected areas of the scalp. Initial research shows an 84% increase in hair growth for those with varying forms of alopecia. However, there still needs to be further research to validate the uses of PRP as a long-term solution.

Hair transplantation

In some cases, hair transplantation is a possible solution to CCCA hair loss. Follicular Unit Extraction is the most popular method, leaving minimal scarring. It’s a three-step process that involves collecting hair follicles from another part of the body, creating recipient sites in the scalp, and then installing the hair similar to planting a seed. Studies on the long-term effects of hair transplantation have shown promising results. 

Try light therapy

Using low-level laser light, light therapy may be an effective form of treatment. The laser energy penetrates the scalp tissues. The tissues respond with improved circulation and hair growth. Laser light therapy is a painless, non-invasive method to improve hair growth. Some patients experience as much as a 39% improvement in hair growth using light therapy.

Can hair grow back with CCCA?

Unfortunately, CCCA is progressive. This means that it spreads over time. As a result, we cannot restore scarred hair follicles. If you catch the issue early, you can regrow some hair but in the very late stages, regrowth is unlikely. However, the good news is that treatments can slow or stop  the decline of your follicles. Further treatments like lasers and hair transplants can help stimulate growth, but may be slower than the rate of natural hair growth.

When should I seek treatment for hair loss?

If you think you have CCCA, or any other type of hair loss or alopecia, make an appointment ASAP with Dr. Ife Rodney, a double board-certified dermatologist and hair loss expert! Time is of the essence when it comes to hair loss. As a result, great results are possible with early intervention.

Eternal Dermatology is located in the Maple Lawn community in Fulton Maryland- 5 minutes from Columbia MD and Laurel MD. We serve Montgomery County, PG County and Howard County MD and surrounding areas.

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