The first sign of CCCA is often noticeable hair loss in the center, or crown, of your scalp. If you have this type of hair loss, you want to treat it early. Starting treatment early can prevent CCCA from spreading outward and causing more permanent hair loss.
Early in the disease, the scalp may appear normal or exhibit hair breakage or decreased hair density in an area measuring only a few centimeters in diameter. However, it may be difficult to obtain an accurate duration of symptoms due to the insidious onset and slow progression of CCCA in many patients.
Often there are no symptoms. Some people may experience burning, tingling, itching, soreness, or tenderness of the scalp. Hair breakage may be an early sign before CCCA patches develop. CCCA typically begins as a slight patch of hair thinning on the midline of the crown (top) of the scalp.
CCCA can also result from too much tension on hair follicles from braids, weaves or extensions. But some research suggests that CCCA might be hereditary. Chronic cutaneous lupus erythematosus (CCLE): CCLE describes skin problems caused by lupus erythematosus, an autoimmune disease.
What is the age of onset of CCCA? The onset of CCCA is very slow, typically developing over the course of years. Patients usually present with thinning and balding of the scalp in their second to fourth decade of life.
One good indicator of scarring alopecia is a ragged edge around the patch, but since irritated patches don't always form, a small biopsy is usually performed to detect inflammatory cells around your hair follicles that may indicate scarring alopecia.
Indeed, CCCA itch is often accompanied by burning, tenderness and/or pricking sensations1,2 that appear to correspond to sensations accompanying cowhage-induced itch. Cowhage spicules elicit itch by stimulating protease-activated receptor (PAR)-2 in the skin.
So dead hair follicles can look like a smooth, bald patch of skin or like a scar. A trichologist may be able to get a better view of your follicles by using a microscope or other trichological tools.
Topical Minoxidil solution or foam
Applying 2% or 5% minoxidil solution/foam to the affected areas on the scalp twice daily may stimulate hair growth. Continue treatment until you are happy with the growth and, as long as the traction has been stopped, the minoxidil can be discontinued.
Oral doxycycline (or other tetracycline antibiotics) up to 200 mg per d is appropriate (alone or in combination) up to 6 mo in the treatment of adults with active CCCA. Oral antibiotics are appropriate (alone or in combination) for treatment of adults with active CCCA. CCCA, Central centrifugal cicatricial alopecia.
Testing for vitamin D deficiency should be considered in patients with alopecia due to its high prevalence. While supplementation is controversial, we recommend giving cholecalciferol 50,000 IU once weekly for 12 weeks followed by 2,000 IU daily.
Scalp feels scaly, bumpy, or crusty
Before you see noticeable hair loss, CCCA may cause some changes to your scalp. You may feel tiny bumps. Some women say their scalp feels scaly or crusty. Dermatologists think that inflammation in your scalp causes these signs.
These results support previous findings showing hair regrowth with topical metformin in central centrifugal cicatricial alopecia. Metformin's potential to reduce fibrosis and inflammation may explain its therapeutic effects in central centrifugal cicatricial alopecia and other fibrotic hair loss disorders.
[9] CCCA, at its end stages, is irreversible, as the follicular epithelium has been replaced by connective tissues. [12] Additionally, pustules and crusting may be found in patients with superimposed folliculitis decalvans.
A hair loss medication may be the solution to your dying hair follicles. There are several types of options available. First, there is minoxidil, a type of topical treatment you can purchase over the counter. This one works by stimulating blood flow to the scalp, which can help revive dying follicles.
Follow your dermatologist's recommendations for hair care and hairstyles. Shampoo once a week. Protect your scalp from the sun. Ask your dermatologist about ways to hide noticeable hair loss.
A deep conditioning treatment can ease your dryness and reduce symptoms if you suffer from an itchy scalp or dandruff. Deep conditioning treatments can also restore your hair's natural pH balance.
This form of hair loss looks like scarred skin surface where your hair used to be. The surface of the skin will look less or more pigmented, shiny, and smooth. And of course completely bald.
To find out if you have CCCA, your dermatologist will: Examine your hair and scalp closely. Ask how long you've noticed the hair loss and whether you have any symptoms like itching or tenderness on your scalp. Ask about your health, medical conditions, and medications.
Folliculitis signs and symptoms include: Clusters of small bumps or pimples around hair follicles. Pus-filled blisters that break open and crust over. Itchy, burning skin.
This type of hair loss often looks like a receding hairline that runs along the front and sides of your head. Frontal fibrosing alopecia (FFA) tends to start slowly, often causing a thin band of balding skin that runs along the front and sides of the hairline. FFA can also cause hair loss elsewhere on the body.