By Gary M. White, MD

Central Centrifugal Cicatricial Alopecia also known as Follicular Degeneration Syndrome The woman shown has severe CCCA with near total scalp involvement.

Central Centrifugal Cicatricial Alopecia (CCCA), also known as Follicular Degeneration Syndrome is the most common type of primary scarring alopecia in women of African descent.


Hair loss begins at the crown or vertex and spreads out centrifugally and symmetrically over time. Advanced cases show a smooth and shiny scalp. Erythema and inflammation are usually absent. Darker skinned women are preferentially affected.

Pediatric Cases

Rarely CCCA may affect children [PD 2017;34;133]. In one review of 6 adolescents, the age range was 14-19 years, 4/6 were female and tender papules, pruritus and scaling were common in addition to the alopecia.


No good proven therapy yet exists.

In one study [JAAD April 2014], those women with a history of braiding or weaving their hair and use of chemicals to process the hair (relaxed or permed) had more severe disease. Thus, the admonition for the patient and any children is:

If there are symptoms such as itching and/or burning ala seborrheic dermatitis, use of medicated shampoo and a topical steroid may be prescribed.

Therapies that are being tried at various centers include:


Homepage | FAQs | Use of Images | Contact Dr. White

It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.