Central Centrifugal Cicatricial Alopecia (CCCA) is a kind of alopecia that affects the scalp and may lead to permanent hair loss. This kind of scarring hair loss occurs in black women more often than any other type. On the other hand, it may occur in men and people of any ethnicity or hair color (though this happens very seldom). The population most likely to be affected is middle-aged women.


Central Centrifugal Cicatricial Alopecia begins with hair falling and thinning at the top of the scalp. Over time, the region of thinning hair grows and evolves to more severe, irreversible hair loss. Some patients may experience in the area of hair loss:

  • Itching
  • Redness
  • Acne-like bumps or pimples
  • Burning
  • Tenderness
  • Scaling


Early diagnosis of Central Centrifugal Cicatricial Alopecia is critical because medical intervention may halt future development, often resulting in significant, irreversible hair loss. The clinical characteristics, scalp biopsy, and exclusion of other hair loss conditions are used to diagnose.

A scalp biopsy should be collected from the active periphery of an alopecia patch rather than the scarred center. Histopathology indicates lymphocytic inflammatory infiltration (inflammatory cells) and fibrosis (scarring) surrounding the infundibulum (base of the hair follicle).


The primary objective of treating Central Centrifugal Cicatricial Alopecia is to alleviate symptoms, stop additional hair loss, and promote hair regeneration in non-irreversibly damaged regions. Mild CCCA is frequently treated with a topical steroid medicine used at home by the patient, sometimes in conjunction with local corticosteroid injections in the scalp given by the physician at 4- to 8-week intervals. In the case of more severe CCCA, these therapies will be combined with oral drugs that reduce inflammation by weakening the immune system (immunosuppressants).

Furthermore, women suffering from Central Centrifugal Cicatricial Alopecia should reconsider their hair care routine. While there is no conclusive evidence linking hair styling to CCCA, preventing possibly damaging chemicals (relaxers are best used by a professional) and hairstyles (tight braids, weaves), as well as limiting the use of heated styling tools (hooded hair dryers, flat irons) will help to prevent further damage. Patients are also recommended to wash their hair at least once every 1 to 2 weeks to help reduce scalp irritation.

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