Hair loss types: Central centrifugal cicatricial alopecia self-care

If your dermatologist prescribes medication, get the medication and immediately start treatment

Waiting allows the hair loss to worsen.

If you have central centrifugal cicatricial alopecia (CCCA), dermatologists recommend following these self-care tips. They can help you get the best results from your treatment.

1. Fill your prescriptions and follow your treatment plan. CCCA can cause permanent hair loss. Delaying treatment gives CCCA time to spread outward and cause more permanent hair loss.

2. Talk with your dermatologist before trying a quick fix or home remedy for hair loss. You’ll find plenty of home remedies and products that claim you’ll regrow your hair. Some sites even promise to refund your money if you don’t regrow your hair.
   
   Dermatologists tell their patients to be wary of these products and home remedies, which can sound so appealing. If there really was a quick fix or home remedy for CCCA, your dermatologist would share it with you.
   
   Even knowing this, promises of “all-natural,” “alopecia hair growth oil,” and “money-back guarantee” can sound tempting. Some patients want to try one of these quick fixes before seeing a dermatologist or starting a treatment plan.
   
   When you delay seeing a dermatologist and following your treatment plan, CCCA can cause more permanent hair loss.
   
   If you still feel that a hair loss product, alopecia diet, or home remedy could help? Talk with your dermatologist before you try it.

3. If you are concerned about possible side effects from the medication, talk with your dermatologist. Dermatologists have plenty of experience treating people with the medications that they prescribe to stop further hair loss. They also understand that some patients may have concerns about taking medication to treat hair loss.

4. Follow your dermatologist’s recommendations for hair care and hairstyles. When you start treatment for CCCA, your dermatologist may recommend gentle hair care. That’s because you’re taking medication to reduce the inflammation in your scalp. Gentle hair care can further help to reduce this inflammation. Gentle hair care means that you want to:

   • Avoid wearing your hair in a style that can pull on your scalp like tight braids, a weave, or hair extensions.
   • Avoid irritating your scalp with dry heat from hooded dryers, blow dryers, and hot combs.
   • Avoid putting irritating chemicals like those found in relaxers on your scalp.
   • Brush your hair gently, never pulling on your hair.
   If any of this advice seems like it won’t work for you, tell your dermatologist. These doctors understand that changing your hairstyle isn’t always an option.

5. Shampoo once a week. Following this advice can help reduce symptoms like itch and pain as well as treat a scalp condition called seborrheic dermatitis. Many people who have hair loss also have seborrheic dermatitis.
   
   If your dermatologist recommends a certain shampoo, be sure to use it.

6. Protect your scalp from the sun. Some medications prescribed for CCCA can make your scalp more sensitive to the sun. If your scalp sunburns, you’re causing inflammation, which you want to avoid.
   
   A wide-brimmed hat or wig can give you the protection you need. Apply sunscreen to the bare areas of your scalp not covered by a hat or wig.
   
   You want to apply sunscreen before going outdoors and use a sunscreen that offers broad-spectrum protection, water resistance, and an SPF 30 or higher. A tinted sunscreen can match your skin tone and avoid a white residue.

7. Ask your dermatologist about ways to hide noticeable hair loss. If you want to hide signs of hair loss, tell your dermatologist. A dermatologist can explain how to camouflage hair loss in a way that gives you a natural look.
   
   You may be able to apply a powder to your scalp that hides the hair loss. With the right technique, this can look completely natural. Your dermatologist can also give you tips for wearing a hair piece or wig.

8. Consider joining a support group. Is hair loss making you feel sad or less capable? If hair loss is taking an emotional toll, talking about it with others who are experiencing hair loss can help.
   
   The Cicatricial Alopecia Research Foundation offers support groups for people who have a scarring type of hair loss like CCCA. To find out more about these support groups, go to CARF: Support and meetings.

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Reference
Ogunleye TA, Quinn CR, et al. “Alopecia.” In: Taylor and Kelly’s Dermatology for Skin of Color. (second edition). McGraw Hill, USA, 2016:254-5.

Written by:
Paula Ludmann, MS

Reviewed by:
Crystal Aguh, MD, FAAD
Erin McKinley Ducharme, MD, FAAD
Shani Francis, MD, MBA, FAAD
Carrie L. Kovarik, MD, FAAD
Shari Lipner, MD, PhD, FAAD
Benjamin Stoff, MD, FAAD

Last updated: 3/14/22

All content solely developed by the American Academy of Dermatology

The American Academy of Dermatology gratefully acknowledges support from the following companies: