A Case of Rapid Progression of Central Centrifugal Cicatricial Alopecia After COVID-19 Infection

A 33-year-old Black female with a history of central centrifugal cicatricial alopecia (CCCA), a primary form of scarring alopecia, experienced an acute exacerbation of hair loss 2 weeks after a mild COVID-19 infection. Despite being fully vaccinated, the patient developed a new, large patch of alopecia on the crown extending toward the frontal scalp, associated with scalp pain and tenderness. The patient had a 4-year history of CCCA and had previously achieved near-complete regrowth of hair with various treatments. After the COVID-19 infection, she was re-started on oral doxycycline, intralesional Kenalog, clobetasol solution, and minoxidil solution. After 2 months of topical treatment and 3 rounds of intralesional triamcinolone acetonide injections, the patient noted an improvement in her scalp symptoms and moderate hair regrowth. This case suggests that COVID-19 may contribute to exacerbation of CCCA, and early treatment is important in halting scarring and establishing hair regrowth in areas of the scalp that are not permanently scarred.