Information and Solutions for Men and Women

Central Centrifugal Cicatricial Alopecia

Can hair braiding cause central centrifugal cicatricial alopecia type of hair loss?

Formerly known as hot-comb alopecia, this type of hair loss was once thought to only occur in black women as a result of years of using heated metal combs to straighten the hair. As it was discovered in men and black and white women who did not use these heated combs the condition was renamed follicular degeneration syndrome to reflect that the epithelial cells on the inner hair root sheath appeared to be prematurely shed. Later it was designated central centrifugal cicatricial alopecia (CCCA) to encompass the typical course of the condition and the fact that not all follicles showed sheath degeneration. 23

Regardless of these clarifying name changes, CCCA is still much more prevalent in black women, and other grooming practices are also thought to be associated with CCCA (e.g., chemical straighteners and braiding). However, there is little clinical or microscopic evidence that conclusively links all of these suspected grooming causes with CCCA and in fact stopping these styling techniques or products does not appear to change the course of the disease. Some researchers suggest that CCCA may just be a variant form of androgenetic female patterned hair loss specific to black women (with a minute percentage occurring in others). 23

Other symptoms of CCCA can include: 23

  • Desquamation of inner root sheath early in the disease
  • Hair loss beginning with a circular/oval patch at the central midline scalp and spreading outward (with decreasing thinning) that slowly worsensHyperpigmentation around the hair follicle
  • Itchiness
  • Tender scalp

Treatments for Central Centrifugal Cicatricial Alopecia

There is no treatment standard for CCCA, but a variety of treatments have shown some effectiveness: 23, 182

  • Corticosteroid-containing shampoo
  • Intralesional steroid shots (triamcinolone acetonide, 2.5-5 mg/ml)
  • Oral antibiotic (tetracycline, 500 mg twice a day)
  • Systemic hydroxychloroquine
  • Topical high-potency steroids
  • Topical nonsteroidal cream (tacrolimus, 0.1% potency applied twice a day)
Disclaimer: This website is not intended to replace professional consultation, diagnosis, or treatment by a licensed physician. If you require any medical related advice, contact your physician promptly. Information presented on this website is exclusively of a general reference nature. Do not disregard medical advice or delay treatment as a result of accessing information at this site.