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CENTRAL CENTRIFUGAL CICATRICIAL ALOPECIA (CCCA) is a type of scarring alopecia typically seen in middle-aged women of African descent with a history of exposure to certain hair care practices (such as tight braids, hot combs).
Another common type of hair loss among Black women is hot comb alopecia or central centrifugal cicatricial alopecia, which begins at the central portion of the scalp and progresses rapidly.
Her presentation reviewed treatment for key conditions including seborrheic dermatitis, alopecia, central centrifugal cicatricial alopecia, hair transplants and acne keloidalis, as well as advances in laser hair removal for pseudofolliculitis barbae.
CENTRAL CENTRIFUGAL cicatricial alopecia (CCCA) is characterized by hair loss with rapid, progressive, and permanent hair follicle destruction, Jouni Uitto, MD, PhD, wrote in an accompanying editorial.
In primary cicatricial alopecia, the hair follicle is the target of inflammatory destruction, with little effect of the disease process on other components of the dermis.2 Examples of primary alopecia include discoid lupus erythematosus, lichen planopilaris, central centrifugal cicatricial alopecia, pseudopelade of Brocq, folliculitis decalvans, and acne keloidalis.3,4 In secondary cicatricial alopecia, the hair follicle is an "innocent bystander" and is destroyed indirectly.
The following scarring and nonscarring alopecias should be considered in the differential diagnosis: dissecting cellulitis of the scalp, central centrifugal cicatricial alopecia (CCCA), acne keloidalis nuchae, erosive pustular dermatosis, lichen planopilaris (LPP), inflammatory tinea capitis, and secondary syphilis.
a: With central centrifugal cicatricial alopecia (CCC alopecia), the hair loss begins at the top of the scalp and progressively covers a larger area, commonly resulting in scalp itching and tenderness.
A few entities in scarring alopecia are lichen planopilaris, central centrifugal cicatricial alopecia, pseudopelade, discoid lupus erythematosus and traction alopecia.
If there is polytrichia or compounding of follicles, it may be tempting to fit the punch tool over what are also sometimes called "doll's hairs." But those structures are nonspecific, end-stage features of many different cicatricial alopecias, including lichen planopilaris, central centrifugal cicatricial alopecia, and even lupus.
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