Central Centrifugal Cicatricial Alopecia (CCCA)

CCCA

Overview

Central centrifugal cicatricial alopecia (CCCA) is a form of scarring hair loss that begins at the crown or vertex of the scalp and spreads outward in a centrifugal pattern. It is the most common cause of scarring alopecia in women of African descent. The condition destroys hair follicles and replaces them with scar tissue, resulting in permanent hair loss if not treated early.

Key Symptoms

  • Progressive hair thinning and loss starting at the crown of the scalp
  • Gradual centrifugal (outward) spread of hair loss
  • Scalp may appear shiny or smooth in affected areas
  • Tenderness, itching, or burning sensation on the scalp
  • Loss of follicular ostia (follicle openings) visible on close examination
  • Breakage of remaining hairs at the margins of affected area

Affected Areas

Crown of the scalp, Vertex, Central scalp expanding outward

Care Instructions

  1. See a dermatologist early — treatment is most effective before extensive scarring occurs.
  2. Avoid or minimize chemical relaxers, tight hairstyles, and excessive heat styling.
  3. Anti-inflammatory treatments including topical or intralesional corticosteroids can slow progression.
  4. Oral antibiotics with anti-inflammatory properties (such as doxycycline) may be prescribed.
  5. Topical minoxidil may help maintain existing hair in unaffected areas.
  6. A scalp biopsy may be recommended to confirm the diagnosis.

Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified dermatologist for diagnosis and treatment.

Prevalence: Most common scarring alopecia in women of African descent; estimated prevalence of 2-5%