Central Hair Loss in African American Women: Incidence and Potential Risk Factors

In a study of 529 African American women, researchers found a 5.6% incidence of extensive central scalp hair loss, also known as central centrifugal cicatricial alopecia (CCCA). The study did not find significant associations between hair loss and the use of hair relaxers, hot combs, or other hair care practices, nor with bacterial infections, reactions to hair care products, seborrheic dermatitis, eczema, thyroid disease, autoimmune or hormonal disorders. However, there was a significant association between hair loss and a history of tinea capitis, as well as a strong correlation between the severity of hair loss in subjects and that of their mothers, suggesting a hereditary component. The pattern of hair loss observed was similar to that seen in Caucasian women with female pattern hair loss (FPHL), but less extensive. The study also noted a high incidence of clinical signs of hyperandrogenism in participants, indicating a potential area for further investigation. The study concluded that genetics and other factors may play a role in CCCA, and that further research is needed to fully understand causality and treatment options. The study was limited by the lack of scalp biopsy correlation and the inability to determine the safety or risk of specific hair care practices.