From the Research
Central centrifugal cicatricial alopecia (CCCA) treatment should prioritize stopping inflammation and preventing further hair loss, with first-line treatment including potent topical steroids like clobetasol 0.05% foam or solution applied twice daily to affected areas for 2-4 weeks, then tapered to maintenance use, as supported by recent studies 1, 2. The goal of treatment is to halt progression rather than reverse existing damage, as regrowth in scarred areas is typically not possible. Key treatment options include:
- Potent topical steroids like clobetasol 0.05% foam or solution applied twice daily to affected areas for 2-4 weeks, then tapered to maintenance use
- Intralesional steroid injections (triamcinolone 5-10 mg/ml) administered every 4-6 weeks for more extensive disease
- Oral antibiotics such as doxycycline 100 mg twice daily or minocycline 100 mg daily for 2-3 months to reduce inflammation
- Oral immunosuppressants like hydroxychloroquine 200-400 mg daily for severe or progressive cases
- Hair care modifications, including avoiding chemical treatments, heat styling, tight hairstyles, and hair extensions, and using gentle, sulfate-free shampoos and moisturizing conditioners Regular follow-up every 3-6 months is recommended to monitor response and adjust treatment as needed, with consideration of emerging therapies like platelet-rich plasma, botanical formulas, and cosmetic procedures for refractory cases 1. It is essential to note that while hair transplantation can be a safe and well-tolerated procedure for end-stage CCCA, as shown in a study from 2014 3, it is not a primary treatment option and should be considered on a case-by-case basis. Overall, a comprehensive treatment approach that addresses the multifactorial etiology of CCCA and prioritizes patient education on hair care modifications is crucial for managing this condition and improving quality of life 4, 5.