The hair loss condition, central centrifugal cicatricial alopecia or CCCA is one of the less common causes of balding that needs hair loss treatment. This medical condition, which characterizes with circular balding, mainly on the top (vertex and crown) which can be expanding and only leave a rim or hair around the scalp with total baldness in the more central areas in extreme cases (see picture).
The causes of this type of balding are now quite known. Here at US Hair Restoration a Los Angeles Hair Transplant Center we see CCCA on an occasional basis. This disease used to be called with different names such as hot comb alopecia, follicular degeneration syndrome, pseudopelade in African Americans and central elliptical pseudopelade in Caucasians. Microscopic evaluation of the hair loss areas shows evidences of inflammation in the area of disease activity, chronic and rapidly progressive skin changes with eventual complete baldness in some part of the scalp with its unique pattern.
This hair loss condition could be started with the evidences of skin inflammation (redness and itching), but this phase might be temporary and patient may not have any signs or symptoms other than hair loss with its specific pattern. Routine medical treatment of hair loss with finasteride (Propecia) or Minoxidil (Rogaine) are generally not beneficial.
Treatment of this condition could be challenging. Treatment with medications is generally not successful in prevention of the hair loss and to reverse the process. Hair transplant surgery could be an option, but it could not be done in the acute phase of the disease. Hair transplant surgeon need to consider hair restoration surgery for Central centrifugal cicatricial alopecia when the active phase is over and when the inflammation is completely subsided. I would like to do a small test hair transplant before committing to the actual hair transplant surgery to be assured of the survival of the hair grafts.
This post was extracted from Hair Restoration Blog, a hair loss question and answer web log.
Parsa Mohebi
