Central Centrifugal Cicatricial Alopecia <<anyone ever diagnosed with this? and resolved it? Some hairstyling processes, such as chemical relaxers and repeated use of heated styling tools, can actually cause a type of reversible and preventable hair loss condition called central centrifugal cicatricial alopecia. Two forms of “traumatic” hair loss can occur because of improper styling and grooming practices, and African-American women are culturally predisposed to both conditions. Traction alopecia is caused by styling and wearing hair pulled so tight that hair follicles are damaged. Central centrifugal cicatricial alopecia (CCCA), the subject of this article, results from the use of either constant heated styling close to the scalp or irritating chemical processes, or both; hair loss typically occurs at the crown area of the head and can go unnoticed until patients report pain in their scalp. Although the exact cause of this type of hair loss is “idiopathic,” meaning “from no proven or known cause,” doctors make this determination by taking a careful patient history and physical examination in combination with the patient’s cultural perceptions to determine this diagnosis and an appropriate course of action. You can prevent hair loss such as CCCA by learning simple hair loss prevention methods. Signs and symptoms of CCCA Is your scalp dry, flaky and sensitive after getting your hair relaxed? Does your scalp get sore? Are you noticing any thinning on the top of your head? Do you use heated styling tools every day? How did I lose my hair? One form of this type of alopecia occurs from a process at the salon, such as the application of a relaxer that was overprocessed and may eventually cause the hairs to just break off midshaft, explains Diahna Husbands, hair replacement specialist and owner of Diahna Lynn Hair Studios in the Washington, D.C., metropolitan area. Dr. Valerie Callender, M.D., board-certified dermatologist, specialist in African-American skin and hair disorders, and director of the Callender Skin & Laser Center, also in the Washington, D.C., metropolitan area, adds that the inflammatory condition and permanent scarring of the skin can damage hair follicles to the point of killing them, thereby causing hair loss. Sometimes called hot comb alopecia or follicular degeneration syndrome, CCCA is caused by multiple factors and has a large cultural predisposition factor involving unique hair care and styling practices that result in this type of hair loss. Many times the condition remains unknown because most women cannot see the very top and back of their head, called the crown, and it will go unnoticed until they feel pain and soreness or they notice the hair loss or someone else, such as a friend or hair stylist, alerts them to a problem. Some women may mistakenly think it is female-pattern baldness and not seek medical intervention, but if they practice a lot of chemical or heated styling, they need to be on the alert for this condition. Callender explains that if caught early, it can be reversed. “We can scalp biopsy and look at the follicles to determine the severity of the condition,” she adds. Will my hair grow back? As Dr. Callender explains, your hair will grow back if you have diagnosed the problem early enough, “but you have to immediately stop what you are doing that is causing the condition!” Along with changing styling habits and forgoing all heated styling tools and chemical processes, whether at home or in a salon, the most common course of action is oral and topical antibiotics followed by cortisone injections and/or topical cortisone cream to reduce the inflammation that is damaging the follicles, notes Callender. “After that, we may prescribe Rogaine to stimulate quicker regrowth at 2 percent, generally, or 5 percent depending on the amount and severity of the hair follicle trauma. And the great thing about Rogaine for this type of alopecia is that once follicles regain their health and start growing, it will no longer be necessary. It’s one time we can prescribe Rogaine for temporary results that last.” The bottom line Therapeutic options for these patients range from changing current hair styling practices or products to the use of specific medical treatments to, in severe cases where hair loss is permanent, undergoing hair replacement surgery, says Callender. If you notice any signs of oversensitivity, such as itchiness, redness or flaking directly after a treatment at the salon, definitely call your stylist immediately, advises Husbands. “She may be able to neutralize or reverse the process. And she (and you) should make a note of what did not work for your hair, so she can try a different formula the next time. Otherwise, you may need to find a more skilled stylist.” Finally, if you experience burns, scalp sensitivity or hair thinning of any kind, make an appointment with your dermatologist.