The most common type of scarring alopecia in African American women is called central centrifugal cicatricial alopecia (CCCA), which is a form of alopecia that starts in the center of the scalp and spreads outward. CCCA has also been called “hot comb alopecia” and “follicular degeneration syndrome”. CCCA has been suspected to be caused by heat, chemical processing, oils used in hairdressing or chronic tension on hair pulled into braids or weaves but there is no definite known cause.
A study performed by Dr. Angela Kyei M.D. M.P.H. and colleagues at the Cleveland Clinic in Cleveland, Ohio was performed to investigate risk factors behind the development of CCCA. Results of the study were published online April 11, 2011 in the Archives of Dermatology. Data was gathered from a total of 326 African American women who filled out questionnaires and gave information about their demographics, family and medical history, hormone related conditions and methods of hair grooming.
The researchers found that 59 percent of the women had symptoms consistent with a diagnosis of CCCA. "Diabetes mellitus type 2 was significantly higher in those with CCCA, as were bacterial scalp infections and hair styles associated with traction (e.g., from braids and weaves)," the authors reported in sciencedaily.com.
CCCA is diagnosed by a dermatologist who has special expertise in scalp or hair disorders. A scalp biopsy will determine the specific type of cicatricial alopecia the person has. The doctor will also pay special attention to the description of symptoms such as burning, itching or tenderness and blood work results. Based on all of this information, a specific treatment plan will then be decided.
The suggested treatment for CCCA is to stop using any chemical or heat treatments to the hair, allow hair to fall into natural curves or only wear in a light braid. A doctor will culture any areas that look like a scalp infection has started and decide if antibiotics are needed. Topical steroids may be used and topical minoxidil may also be suggested to stimulate hair growth in non-scarred hair follicles.