CENTRAL CENTRIFUGAL CICATRICIAL ALOPECIA

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.

Clinical

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.

Treatment

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:

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