Risk Factors and Comorbidities Associated With Central Centrifugal Cicatricial Alopecia

September 2023 in “ International journal of women’s dermatology ”

Maxwell Green, Aileen Feschuk, Manuel Valdebran

TLDR Certain hairstyles, diabetes, scalp infections, and vitamin D deficiency may increase the risk of hair loss in Black women; more research is needed for better treatment.

The document reviews 15 studies on Central Centrifugal Cicatricial Alopecia (CCCA), a common form of hair loss primarily affecting Black women aged 30-55. Risk factors for CCCA include type 2 diabetes mellitus, bacterial scalp infection, traction hairstyles, previous pregnancies, use of chemical hair relaxers, and certain hair grooming practices. Comorbidities associated with CCCA include type 2 diabetes mellitus, uterine fibroids, hyperlipidemia, and vitamin D insufficiency/deficiency. However, the results are mixed, with some studies finding no increased risk of comorbidities or no significant difference in rates of depression or anxiety in women with CCCA compared to controls. The document concludes that more research is needed, and that current treatment focuses on anti-inflammatory medications, with potential future use of antifibrotic agents.

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Research cited in this study

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research Increased Risk of Vitamin D Deficiency and Insufficiency in Black Patients With Central Centrifugal Cicatricial Alopecia

3 citations , February 2022 in “Journal of the American Academy of Dermatology”

Black patients with a specific type of hair loss have a much higher chance of lacking enough vitamin D.

research Association of Breast and Colorectal Cancer in Patients With Central Centrifugal Cicatricial Alopecia: A Retrospective, Cross-Sectional Pilot Study

9 citations , October 2020 in “Journal of the American Academy of Dermatology”

Patients with central centrifugal cicatricial alopecia may have a higher risk of breast and colorectal cancer.

research Association of Type 2 Diabetes With Central-Scalp Hair Loss in a Large Cohort Study of African American Women

16 citations , June 2019 in “International Journal of Women's Dermatology”

Type 2 diabetes may increase the risk of severe hair loss in African American women.

research Variant PADI3 in Central Centrifugal Cicatricial Alopecia

95 citations , February 2019 in “The New England Journal of Medicine”

Mutations in the PADI3 gene are linked to a higher risk of scarring hair loss in women of African descent.

research Fibroproliferative Genes Are Preferentially Expressed in Central Centrifugal Cicatricial Alopecia

25 citations , June 2018 in “Journal of The American Academy of Dermatology”

Genes linked to fibrosis are more active in people with central centrifugal cicatricial alopecia.

research Vitamin D Status in Scarring and Nonscarring Alopecia

13 citations , April 2018 in “Journal of The American Academy of Dermatology”

People with certain types of hair loss, especially lichen planopilaris and telogen effluvium, as well as African Americans, Asians, and men, are more likely to have severe vitamin D deficiency.

research PPAR-γ Agonists and Their Role in Primary Cicatricial Alopecia

38 citations , January 2017 in “PPAR Research”

PPAR-γ helps control skin oil glands and inflammation, and its disruption can cause hair loss diseases.

research Factors Affecting the Severity of Central Centrifugal Cicatricial Alopecia

29 citations , January 2016 in “International Journal of Dermatology”

Longer hair loss leads to more severe CCCA; early treatment and avoiding damaging hairstyles help regrowth.

research Medical and Environmental Risk Factors for the Development of Central Centrifugal Cicatricial Alopecia

88 citations , April 2011 in “Archives of Dermatology”

Type 2 diabetes, bacterial scalp infections, and tight hairstyles like braids and weaves are linked to a higher risk of a scarring hair loss condition in African American women.

research Central Centrifugal Cicatricial Alopecia

72 citations , July 2008 in “Dermatologic Therapy”

CCCA is a scarring hair loss condition mainly in African descent women, possibly caused by genetics and hairstyling, treated with gentle hair care and medications.

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community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

nkrata in Research 830 upvotes 1 year ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community I am a dermatologist with a clinical interest in alopecia. AMA

in Will treatment work for me? 3 years ago

In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

community Finasteride doesn't work for me in 2 years and my bloodtest result just came in.

in Progress Pictures 88 upvotes 2 years ago

A user has been treating hair loss with finasteride for two years without success and is experiencing an itchy scalp with seborrhea. Despite low DHT levels, they are still losing hair, suggesting that DHT might not be the main cause of their hair loss, and they are considering other treatments or causes.

community scarring alopecia awareness in this community

in Chat 33 upvotes 3 years ago

Lichen Planopilaris (LPP), a form of permanent hair loss, which can be mistaken for seborrheic dermatitis and is characterized by scalp itching, burning, redness, and dandruff. Treatment options discussed include steroidal creams, finasteride, minoxidil, and RU58841.

community Wanted to say that Derma rolling and Pumpkin seed oil helped my crown out.

in Treatment 4 upvotes 6 years ago

Derma rolling, pumpkin seed oil, and daily massages helped regrow weak hairs on the crown. Nizoral shampoo and yoga also contributed to reducing scalp pain and stress.

community lost my hair in a single year of treatment at 20 years old

in Finasteride/Dutasteride 87 upvotes 1 year ago

A 20-year-old lost significant hair after one year of treatment, using minoxidil, finasteride, and later dutasteride. They are considering adding RU58841 but are advised to return to finasteride and minoxidil for a year before deciding.

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research Clinical Factors and Hair Care Practices Influencing Outcomes in Central Centrifugal Cicatricial Alopecia

May 2023 in “Archives of dermatological research”

Some factors like thyroid disease, diabetes treatment, hair dryers, natural hairstyles, and scalp conditions can affect the treatment results for a hair loss condition called CCCA.

research Factors Affecting the Severity of Central Centrifugal Cicatricial Alopecia

29 citations , January 2016 in “International Journal of Dermatology”

Longer hair loss leads to more severe CCCA; early treatment and avoiding damaging hairstyles help regrowth.

research Central Centrifugal Cicatricial Alopecia: A Survey of Treatment Practices Among Dermatology Residents and Attending Physicians

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There is no standard treatment for CCCA, and practices vary widely.

research Medical and Environmental Risk Factors for the Development of Central Centrifugal Cicatricial Alopecia

88 citations , April 2011 in “Archives of Dermatology”

Type 2 diabetes, bacterial scalp infections, and tight hairstyles like braids and weaves are linked to a higher risk of a scarring hair loss condition in African American women.

research Prevalence and Etiology of Central Centrifugal Cicatricial Alopecia

19 citations , August 2011 in “Archives of Dermatology”

CCCA is a common scarring hair loss in African descent women, possibly linked to genetics, hair care practices, and health issues like diabetes.