From the Research
The most effective treatment for Central Centrifugal Cicatricial Alopecia (CCCA) is a combination of high-potency topical corticosteroids, such as clobetasol 0.05% foam or solution, and hair care modifications, including avoiding chemical relaxers, excessive heat styling, tight hairstyles, and hair weaves, as supported by the most recent study 1. The goal of treatment is to prevent progression of the disease, as once scar formation occurs, it is irreversible.
- First-line therapy typically involves high-potency topical steroids like clobetasol 0.05% foam or solution applied twice daily to affected areas for 2-4 weeks, then tapered to once daily for 2-4 weeks, followed by maintenance therapy 2-3 times weekly.
- For more severe or resistant cases, intralesional triamcinolone acetonide (5-10 mg/ml) injections every 4-6 weeks can be effective, as shown in a study 2.
- Topical minoxidil 5% solution applied twice daily helps promote hair regrowth in areas that aren't completely scarred.
- For cases with inflammation, oral antibiotics such as doxycycline 100mg twice daily or minocycline 100mg twice daily for 2-3 months can reduce inflammation.
- Hair transplantation is also a safe and well-tolerated procedure to improve hair loss in African American women with end-stage CCCA who histologically display a lack of inflammation on scalp biopsy, as reported in a study 2. Regular follow-up every 3-6 months is recommended to monitor response and adjust treatment as needed, taking into account the multifactorial etiology of CCCA, including variants in gene expression, hair grooming practices, and associations with other systemic conditions 3.