The Different Causes of Hair Loss: Central Centrifugal Cicatricial Alopecia

Contrary to what some may have you believe, hair loss does not have a single “one-size-fits all” treatment.  While it is true that the majority of hair loss, in both men and women, results from common genetic pattern baldness, or androgenetic alopecia, there are actually many other conditions that can cause similar symptoms, and each requires their own specific form of treatment.  That’s why our own hair restoration specialists, Dr. Edmond Griffin and Dr. Ashley Curtis, always insist that every case of hair loss, or alopecia, requires its own complete diagnosis.  Last month, in our blog, we discussed one of the alternative causes of hair loss, a condition called frontal fibrosing alopecia.  This time, we’ll explore a related form of hair loss called central centrifugal cicatricial alopecia.

The Different Causes of Hair Loss Central Centrifugal Cicatricial Alopecia

When it was first noticed in the 1950’s (and first clinically documented in 1968) central centrifugal cicatricial alopecia, or CCCA, was called “hot comb alopecia,” because it was believed to be caused by styling practices that involved the application of petrolatum followed by a stove-heated iron comb.  The original theory was that the hot petrolatum would travel down to the hair root and burn the follicle, which would result in repetitive injury and scarring.  However, it was later discovered that CCCA also often affected men and women who had no history of using such styling techniques.  Even today, the underlying causes of CCCA are not entirely understood.  It is theorized that pressure exerted on the internal root sheath causes damage, which in turn causes inflammation and eventual scarring.  African Americans are believed to be at an increased risk either because of the curled hair shaft, distinct styling practices, moisturizing hair products, or chemical processing techniques.

As with other forms of scarring alopecia, like frontal fibrosing alopecia and traction alopecia, CCCA replaces healthy hair follicles with scar tissue, resulting in permanent and irregular hair loss.  The condition is characterized primarily by its presentation: “central” because it usually begins at the central (sagittal) midline of the scalp, and “centrifugal” because it radiates symmetrically in a circular pattern as it progresses.  The affected hair follicles become inflamed, so there may be noticeable tenderness, and there may even be noticeable redness and pustules in the scarred area, depending on the sensitivity of the skin.  The condition occurs most commonly in African-American women who are in their twenties and thirties, but can affect both men and women of other ethnicities and ages as well.

If left untreated, CCCA will most likely continue to spread and cause further hair loss, but if the condition is caught early there are things that may be done.  At The Griffin Center, we have had a great deal of success using injections of intralesional steroids to calm the inflammation that causes the hair loss and bring its progression under control.  We can also custom formulate blended topical prescription hair loss medications to help encourage growth.  Depending on the extent of the damage, hair transplantation surgery may also be able to correct particularly advanced cases if the patient is a suitable candidate.

If you are concerned about your own hair loss, or are interested in learning more about the many hair restoration options that we offer, follow us on Facebook, Twitter, and Google+ to get the latest news or contact The Griffin Center of Hair Restoration so that we can schedule an appointment for a full consultation.