Hair Loss: Balding at the Centre of the Head

Central centrifugal cicatricial alopecia is a kind of alopecia that involves hair loss at the center (crown) of the head that spreads outwards.

It mostly affects middle-aged black women.

.We unpack all things Central centrifugal cicatricial alopecia (CCCA) :-

*Pssst, check out our flagship feature on How to Treat Balding & Thinning Edges. 

1.Early signs of CCCA

The early signs of CCCA are: –

• Hair loss/ bald patch at the top / crown of the head;
• A bald patch starts small and then spreads outwards;
• Balding spreads out in a circular pattern;
• Scalp appears shiny and smooth where the hair loss occurs;
• Some women experience an itchy / burning scalp in this area, while others do not.

2. Do poor hair practices cause CCCA?

Certain hair care practices have previously been attributed to CCCA and these are: –

• Relaxers;
• The use of hot combs;
• Tight extensions and weaves.

Scientific studies have not found a link between these hair practices and CCCA. In some cases, women who had never used relaxers got CCCA, whole some who had used relaxers never got CCCA.

In a nutshell, these poor hair practices have not been found to cause this type of alopecia.

However, as part of overall good hair practices, as well as to limit / minimise the risk of Traction Alopecia, it is better not to engage in these poor hair practices.

3. What really causes CCCA?

What causes CCCA is not known, however it is believed that there are several factors that contribute to it.

One suggested cause is genetics – a gene mutation of the enzyme that modifies protein essential for the hair shaft. Other suggested causes of CCCA are fungal infections, bacterial infections, and autoimmune diseases.

4. What does CCCA look like?

CCCA is characterised by a bald patch at the center of your head, that spreads outwards. Over time, the scalp becomes bare, shiny and smooth.

In some rare instances, one will not experience once central patch at the top of their head, but may experience several scattered patches of hair loss all over their scalp.

5. Why is the bald spot shiny and smooth?

CCCA is a condition that destroys hair follicles.

After the hair follicles have been destroyed, then scar tissue forms over the destroyed hair follicles. This gives the scalp that shiny and smooth appearance.

6. Can your hair grow back?

Yes, your hair can grow back, as long as your hair follicles are not damaged. Hair follicles are the tiny openings from which your hair grows, and once they have been damaged, scar tissue develops over it – causing permanent damage.

Therefore, once hair follicles have been damaged, then there are no viable follicles for hair growth and your hair cannot grow back on this spot.

7. Can CCCA be reversed?

Yes, you may be able to reverse this condition and experience some hair growth if you catch the problem early on.

Your hair will be able to regrow, as long as scar tissue has not formed over the hair follicles.

8. How to stop CCCA spreading

It is important to visit a dermatologist at the first sign of hair loss / bald patching so that you can get medical interventional early.

Getting treatment early allows you to prevent further hair loss and permanent damage to your hair follicles. This will stop the bald patch from spreading further.

9. CCCA Treatment

CCCA treatment is mainly focused on: –

• Stopping / slowing CCCA and;
• Preventing any further hair loss.

Once diagnosed, CCCA is treated through: –

🌺Topical steroids and ointments;

🌺 Oral prescribed tablets; and

🌺 Hair transplantation.

10. How to manage CCCA

Once you have been diagnosed with CCCA / or you notice a circular bald patch at the crown that seems to be spreading, you should: –

🌺 Immediately consult a dermatologist for early intervention.
Also to minimise further damage, you should: –

🌺 Reduce the use of heat styling tools (hot combs, hooded hair dryers, blow dryers & flat irons);

🌺 Wear natural hairstyles;

🌺 Stop use of relaxers on your hair to minimise damage / breakage;

🌺 Avoid tight hairstyles that put a strain on your crown (braids, weaves, cornrows)

🌺 Limit use of products that will irritate your scalp and rather use organic hair products;

🌺 Daily 5 mins massages using scalp stimulating oils;

🌺 Get any inflammation in the body under control with a healthy diet;

🌺 Frequently and properly cleanse your scalp to decrease inflammation of the scalp; and

🌺 Avoid / treat a dry, itchy scalp.

Is your hair dry and lifeless due to heat. Read up on What to Do with Heat Damaged Hair. 

11. Conclusion

CCCA can be distressing, however when caught early, it can be managed with the right treatment and hair practices.

Also, prevention is better than cure, and while its cause is mainly genetics, It is important to practice good hair practices that need heat treatment or provide friction.

More importantly, maintaining a healthy diet and regular hair regime where you constantly check on the status of your hair.

Are you struggling with CCCA? Do you know anyone who may benefit from learning about this condition? Share in the comments, as well as send this article to loved ones to spread awareness on this condition that mainly affects black women.

Are you struggling with CCCA? Do you know anyone who may benefit from learning about this condition? Share in the comments, as well as send this article to loved ones to spread awareness on this condition that mainly affects black women. 

And until the next time beautiful ladies, happy naturaling!