Hair loss types: Central centrifugal cicatricial alopecia signs and symptoms
Where does central centrifugal cicatricial alopecia (CCCA) develop on the body?
This type of hair loss often affects middle-aged Black women and usually begins in the center (or crown) of the scalp. The first sign that most people see is noticeable hair loss on the top of the head.
What are the signs and symptoms of CCCA?
One sign that everyone with CCCA eventually develops is noticeable hair loss on the top of the head. Some people also develop symptoms like intense itch or pain on their scalp. Others say they never feel any discomfort. The following explains what may happen before — and after — you see noticeable hair loss.
When you have hair breakage, part of the hair breaks off. This makes some hairs shorter than others, and you may see a lot more hairs on your brush. Hair breakage, especially in the center of the scalp, may be the first sign of CCCA.
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.
Noticeable hair loss: Center of the scalp
CCCA gets its name from the way it causes hair loss. The first sign is usually noticeable hair loss in the center of the scalp. This is why you see the word “central” in the name. Instead of developing one patch in the center of the scalp, a few people with CCCA develop scattered patches of hair loss on their scalp. This is rare.
Scalp itches, burns, or feels painful
You may not develop these symptoms. However, some people who have CCCA develop one or more of the following symptoms on their scalp:
- Pins-and-needles sensation
The intensity of these symptoms varies from person to person. For some people, symptoms can become so intense that they interfere with everyday life. Treatment for CCCA can ease the pain and other symptoms.
Hair loss spreads outward
The hair loss tends to spread outward in a circular pattern, as shown here. This is why it’s so important to see a dermatologist at the first sign of hair loss. If you have CCCA, treatment can prevent further hair loss.
Scalp appears shiny and smooth
CCCA is a disease that destroys hair follicles (the openings from which hair grows). Scar tissue then grows over the destroyed hair follicles. The scarring often gives the scalp a shiny and smooth appearance.
The emotional effects of CCCA
The hair loss and symptoms like pain and intense itch can take a toll on your emotions. Women have confided in their dermatologists that CCCA makes them feel embarrassed, depressed, frustrated, or discouraged.
Research supports the claim that CCCA can affect your outlook on life. When researchers at Northwestern University surveyed Black women living with CCCA, the researchers found that 82% of women said their hair loss made them feel embarrassed, frustrated, or self-conscious.
In other studies, women said that having CCCA lowers their self-esteem. Some women said that they start to feel anxious around people.
Many women blame themselves for developing CCCA, as it was previously thought that various hairstyling practices cause CCCA. However, research suggests that how you style your hair may not play a role.
To find out what may play a role in causing CCCA, go to Central centrifugal cicatricial alopecia: Causes.
Images 1,2,3,5: Getty Images
Images 4,6,7: Journal of the American Academy of Dermatology
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Paula Ludmann, MS
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
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