Central Centrifugal Cicatricial Alopecia

Central centrifugal cicatricial alopecia (CCCA) is a common form of scarring alopecia that results in progressive permanent hair loss, primarily affecting the crown or vertex of the scalp. It was previously known by various names, including "hot comb alopecia" and "follicular degeneration syndrome," and is seen in all races. The condition may be multifactorial in etiology and is not always related to hair care practices. Clinically, CCCA can be difficult to distinguish from other types of hair loss, and a biopsy is often necessary for diagnosis. Histologically, CCCA is characterized by features such as contraction of dermal collagen, broad hyalinized fibrous tracts, and perifollicular mucinous fibrosis. Treatment options are limited and include avoiding certain hair care practices, using topical corticosteroids, oral tetracyclines, and possibly hair transplantation, although scarring can affect graft survival. The study reviewed 44 patients to assess the association between hair care practices and CCCA.