Central Centrifugal Cicatricial Alopecia: An Approach to Diagnosis and Management

This document from 11 years ago discusses the diagnosis and management of Central Centrifugal Cicatricial Alopecia (CCCA), which is the most common cause of permanent hair loss in African-American women. The article emphasizes the importance of a thorough clinical history, clinical exam, and laboratory evaluations in determining the correct diagnosis. CCCA is a scarring alopecia that clinically resembles non-scarring alopecia, making it challenging to diagnose. The onset and duration of hair loss, grooming history, and gynecological history are important factors to consider. The article also provides a method for the diagnostic process and suggests that cosmetologists may be confounders in this disorder. Treatment options are limited, and the goal is to prevent progression of the disease. The authors recommend anti-inflammatory agents, stress reduction techniques, and discontinuation of damaging hair-grooming practices. Follow-up should occur every 3-4 months.