What is CCCA Alopecia
CCC Alopecia stands for Central Centrifugal Cicatricial Alopecia (CCCA). CCCA is the most common form of scarring alopecia and it the most consulted from of hair loss amongst women of African descent. CCCA usually starts to occur or at least show its symptoms in women between the ages of 20- 30. CCCA is a form of inflammation hair loss and if left untreated it could lead to permanent hair loss.
CCC Alopecia although very common is it not as well researched in comparison to other forms of hair loss such as Alopecia Areata or Androgenetic Alopecia so expects find it very difficult to suggest medical treatment to combat this form of hair loss, instead treatment is directed at preventing and suppressing inflammation and slowing down the scarring process.
Two separate studies, one in South Africa Cape town found that out of 874 adults 2.7% of the women had CCCA and the second study conducted in the US found that out of 529 women 5.6% of the women had CCCA. The huge difference in numbers suggested that CCCA may be due to genetic and environmental factors.
Some evidence suggests that CCCA may be linked to genetics as a study conducted on 326 African American women found a significant coloration between type 2 diabetes and CCCA so women with CCCA are more at risk of having type 2 diabetes however prevalence is low.
The cause of CCCA doesn’t really have a clear answer as more clinical studies still need to know the genetic correlation of CCCA.
History of CCC Alopecia
The history of CCC Alopecia can be dated back to when African American women used hot combs to straighten their hair. In 1968, 51 African American Women were experiencing hair thinning from the centre of their scalp which would then proceed towards the front.
It was concluded at the time that when heat was applied to the petroleum coated hair shaft, this caused sever inflammation to the scalp which may have led the to follicle destruction.
However, since hot combing became less of a common practice amongst the black community, the subject was not revisited again until 1992. This is was when it was then termed as follicular degeneration syndrome. In 1993 another study was conducted on 8 women who had the same pattern hair loss and this collaborated with the findings of the studies done previously in 1992, fast forward to 2001 it was then given the name CCC Alopecia as the hair loss was due to external injury to the hair shaft.
What are the symptoms and causes?
Many studies have suggested that CCC Alopecia is mainly caused by environmental factors such as drugs, shampoos, cosmetics, prolonged chemical treatments such as relaxers and aggressive haircare practices, these can all be a trigger or even aggravate CCCA and some studies have even shown a positive correlation between bacterial infection and CCCA
When dealing with any type of hair loss it is very important to identify and seek treatment as early as possible to avoid permanent hair loss. The most common symptoms to really look out for in CCCA are; itching, burning, tenderness and pain and hair thinning in the centre region of the scalp. These symptoms will then be followed by the appearance of a round bald patch the centre of the scalp which will then starts to progress toward the front of the head, and in more advanced stages the scalp will appear clean and shiny and with no hair follicles. This is why It is highly recommended that when you start to see the early signs of CCC Alopecia to get a scalp biopsy to give you a proper diagnoses and form of treatment.
How can it be diagnosed and treated?
CCCA can be difficult to diagnose and distinguish from Androgenetic alopecia especially in early stages as they can both show the same type of pattern hair loss.
CCCA is a form of scarring alopecia and the amount of hair loss cannot be regained so treatment is always aimed at preserving the available hair and avoiding further progression of hair loss. There are no randomised, controlled or published data on treatment for CCCA. CCCA alopecia is therefore treated on and individual bases by the results from the degree of inflammation from the histopathology or the patient’s symptoms.
Most studies have concurred that the management of CCCA should start with hair practices such as hair styling and use of chemicals.
When it comes to medical treatment the first point of call is the use of steroids. These steroids are applied both topically as well as injected.
The injections are usually done once a month over a course of six months with the addition of the topical steroids applied at least three times per week until the hair loss and is stabilised.
The most common topical steroid used in the treatment of CCCA is minoxidil 2% of 5%. This tends to help slow down or stop the progression of the disease. The final stage will be will be surgical hair transplant, this is done once the inflammation has been controlled for at least a year.
What to do if you think you have CCCA
The fist point of call is to make sure you are looking out for the early symptoms and seek a diagnosis as early as possible. CCCA is mainly caused by inflammation so it would be a good idea to suppress the inflammation as much as possible to reduce the progress of the hair loss. This can be done using medical treatments as well as natural treatments as well. As studies are not very clear on whether CCCA is linked to genetics, it is important to also look at how to control inflammation through diet as well. Avoid any foods or drinks that main cause any type of inflammation in the body.
The easiest place to start will be with your hair practices, avoid any harsh or abrasive chemicals on the scalp, do more loser hair styles to avoid an aggravation on the scalp that may cause inflammation which may eventually trigger CCCA.