What is CCCA: CCCA stands for Central Centrifugal Cicatricial Alopecia and is a particular form of scarring alopecia hair loss that occurs almost exclusively in women of African descent. It is a common form of hair loss for Black women [1]. Hair loss from CCCA begins in the center of the top of the head and fans out, usually in an oval shape, or spreads from the central zones outward. “Centrifugal” refers to the circular pattern of hair loss. CCCA typically occurs gradually but can appear and progress rapidly in some cases.
Hair loss from CCCA can lead to permanent hair loss and cause scarring. The “cicatricial” part of its name comes from the scarring this form of alopecia causes due to the destruction of hair follicles, meaning that CCCA is a type of scarring alopecia. It can be uncomfortable with itching or burning on top of hair loss. The disease has also been called Hot Comb Alopecia and Follicular Degeneration Syndrome.
Central Centrifugal Cicatricial Alopecia (CCCA)
What causes CCCA?
CCCA is believed to be hereditary [2] but can be exacerbated by the following factors:
- Overuse of heated products on the hair, calling it “hot comb alopecia.”
- Tight braids, weaves, or extensions
- Chemical relaxers or other harsh products, such as hair dyes
- Tight or hot rollers
- Pulling from overuse of brushes or combs
Who does CCCA affect?
CCCA is known almost exclusively to affect Black women who are over the age of 30. This could be due to the more common use of tight hairstyles or harsh products used by women with Afro-textured hair. Recently, a genetic basis for the disease has been uncovered [3].
Most dermatologists can diagnose patients with CCCA based on the visual appearance of their scalp or by using a special handheld magnifying lens instrument called a dermoscopy or trichoscopy.
However, confirming the diagnosis would require a biopsy. Using trichoscopy, the dermatologist would be directed to the best spot on the head from which the biopsy should be taken.
The biopsy entails taking a small piece of skin between 2-4mm in size after numbing the area with a local anesthetic similar to what you get at the dentist. Then, the specimen is studied under the microscope by the dermatologist or dermatopathologist, who looks for specific features that help confirm the diagnosis of CCCA.
If you suspect that you have CCCA, it is best to treat it early. Be sure to see a dermatologist such as Dr. Umar, who has extensive experience in successfully treating CCCA patients of all severity. It may be CCCA if you notice a circular, central hair loss pattern, particularly if it is combined with an itching or burning sensation on the scalp. Fortunately, Dr. U has various original treatment procedures that he has developed himself to treat and improve the condition, particularly the hair loss component of CCCA, successfully.
What are the treatments for CCCA?
General treatment for CCCA includes oral, topical, or injectable steroids—these work by reducing inflammation and suppressing the immune system to prevent the destruction of healthy follicles. If the condition goes untreated until it is more advanced, anti-inflammatory medications are often used. Certain types of oral antibiotics (belonging to the tetracycline, for example, doxycycline and minocycline) can also potentially lessen inflammation and prevent further hair loss.
Other medications that have been tried include potent immunosuppressants and modulators such as hydroxychloroquine, Tacrolimus, cyclosporine, and mycophenolate. All these treatments can be combined with procedures that harness the potential of platelets or light. Unfortunately, many of these treatments show variable and inconsistent response rates.
Furthermore, since these treatments do not cure CCCA but keep it under control, they would require chronic use. Unfortunately, many of these medications cannot be used long-term and must be discontinued often because of side effects and complications. To this end, there is a need to find a treatment that can be used in the long term with fewer concerns for adverse effects of treatment toxicity.
The Dr. U Skin & Hair Clinic Difference: How Does Dr. U Treat CCCA?
Over years of experience managing hair conditions and as a world-renowned hair expert, and having used all the conventional approaches for treating CCCA, Dr. U has devised his own original natural botanical products for treating CCCA.
Instead of using steroid scalp injections, topicals, and other drugs, Dr. U has been able to help save his patients from the pain and discomfort associated with those treatments by using his self-formulated natural hair product line, Dr.UGro Gashee.
Whereas other general treatments have shown little to no improvement in CCCA symptoms, Dr. U’s self-formulated Gashee has recently been reported as the first botanical to show a positive response toward CCCA.
Dr.UGro Gashee – Natural Alternative
Gashee is a popular hair care product brand that utilizes natural ingredients to nourish the hair and scalp while effectively maximizing hair health for growth and strength.
Dr.UGro Gashee products are formulated with natural ingredients, including necessary vitamins for hair health. Some of their quality natural ingredients include a proprietary blend of green tea, cinnamon, celery, grape seed, rosemary, aloe vera, pumpkin seed, and more.
In addition to these botanical ingredients, Gashee uses hyaluronic acid, zinc, iron, and other crucial vitamins to reduce inflammation, boost growing hair health, provide moisture, and repair damaged hair with healthy growth. The botanical lotion and pomade work topically to fight various forms of alopecia and improve hair and scalp health, while the oral botanical supplements assist hair health through internal means.
In a recently published peer-reviewed medical journal, Dr.UGro Gashee’s hair products have been reported as the first botanical to impact CCCA symptoms, including hair loss, positively. In the study, several women with a history of CCCA, previously treated with pharmaceuticals and drug-based means such as topical and injectable steroids with little to no positive results, have shown positive responses when using Gashee natural hair products. This is a significant finding that warrants further study, as the role of natural products in the future of CCCA treatment can have massive potential, as natural products often come with more favorable side effect profiles better suited for long-term patient use.
View Full Gashee Publication on CCCA: First Natural Botanical to Show Positive Response Towards CCCA
What are botanicals?
The term “Botanical” refers to something derived from plants. Utilizing plants to curate natural ingredients allows for a healthier, more effective product. Botanicals are mainly known for their naturally-occurring healing and medicinal properties. Dr.UGro Gashee uses botanicals in all products, providing naturally-derived lotions, pomades, and supplements. These products, made from plants, promote holistic wellness and hair health, helping fight symptoms of CCCA safely, naturally, and effectively.
Before and After – CCCA Gashee Published Patient Results
The pictures below show the before and after results of the previously mentioned Gashee publication in the Clinical Cosmetic and Investigational Dermatology peer-reviewed medical journal. The patient was able to recover a large portion of hair loss in the areas of balding after the use of Gashee topical and oral supplements.
If you are interested in Dr. UGro Gashee products, visit our Gashee product page using the shop Gashee button link below:
CCCA Frequently Asked Questions
What is Scarring Alopecia?
- Scarring Alopecia, or cicatricial, refers to any alopecia where hair follicles are destroyed, resulting in scarring.
Is Scarring Alopecia the same thing as CCCA?
- CCCA is a form of scarring alopecia, of which there are many other types. Other types of scarring alopecia include lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA)
Is Alopecia a diagnosis?
- Yes. Alopecia can be diagnosed by your dermatologist, including the particular form of the disease you may have.
Can CCCA be cured?
- When caught and treated early enough, symptoms of CCCA can be lessened to the point where its effects may not be noticeable, but severe damage from CCCA can be irreversible.
Can I treat CCCA with hair transplantation?
- With the right experienced hair surgeon, hair transplantation is possible. Be sure to find a reliable doctor, like Dr. U, who specializes in covering scars and restoring damaged scalps.
What about platelet-based treatments?
- Some studies, including one linked here, have shown that platelet-based treatments may help combat CCCA symptoms. Be sure to speak with your dermatologist in detail and consider all your options.
Can I use Gashee or other botanicals to treat my scarring alopecia or CCCA on my own?
- If you suspect you have scarring alopecia, you must first consult your dermatologist to get a proper diagnosis and then follow their recommendation on how best to treat the condition. Unfortunately, nothing has been specifically approved for the treatment of CCCA, so your dermatologist must use their judgment to determine the best treatment for you.
- You can complete a free consultation for your hair loss with board-certified dermatologist Dr. Sanusi Umar by using this link: https://dru.com/hair-free-consultation/ or using the free consultation button below.
If you suspect you have CCCA or any other hair or skin condition and would like to consult Dr. Umar, who has had a great deal of experience in treating CCCA patients successfully, please feel free to do so using the link below:
References
- Central Centrifugal Cicatricial Alopecia (CCCA) | Hair Loss in Black Women. (2015, March 13). Skin of Color Society. https://skinofcolorsociety.org/patient-dermatology-education/central-centrifugal-cicatricial-alopecia-ccca/
- Central centrifugal cicatricial alopecia | DermNet NZ. (n.d.). Dermnetnz.org. https://dermnetnz.org/topics/central-centrifugal-cicatricial-alopecia
- Malki, L., Sarig, O., Romano, M.-T., Méchin, M.-C., Peled, A., Pavlovsky, M., Warshauer, E., Samuelov, L., Uwakwe, L., Briskin, V., Mohamad, J., Gat, A., Isakov, O., Rabinowitz, T., Shomron, N., Adir, N., Simon, M., McMichael, A., Dlova, N. C., & Betz, R. C. (2019). Variant PADI3 in Central Centrifugal Cicatricial Alopecia. New England Journal of Medicine, 380(9), 833–841. https://doi.org/10.1056/nejmoa1816614
