Understanding scarring alopecia: Centrifugal cicatricial alopecia

Scarring (Cicatricial) alopecias refer to a group of conditions in which hair loss is permanent, centrifugal cicatricial alopecia is one of those. Battling hair loss often brings a host of other symptoms too, notably a loss of confidence. Dr. Khoza treats a number of patients with various forms of scarring alopecia (permanent hair loss), one of which is centrifugal cicatricial alopecia.


Scarring alopecia


What is centrifugal cicatricial alopecia?

Centrifugal cicatricial alopecia is a form of scarring alopecia that can affect people of all races and genders but is often more prevalent among African women. It is a form of scarring hair loss, meaning the hair that is lost won’t regrow. For that reason, it’s important to seek a diagnosis and undergo treatment early. While the condition cannot be reversed, it can be controlled and prevented from spreading.

What are the symptoms of centrifugal cicatricial alopecia?

Like most forms of scarring alopecia, many people have no symptoms at all and only become aware of the problem once they see their hair thinning. Others may experience a burning or itching sensation which can be irritating and sometimes painful.

The loss of hair is experienced starting at the top of the head (CENTRAL) or crown. It first starts breaking and falling out until it progressively thins. The progression is slow, with progressive thinning in a circular and outward (CENTRIFUGAL) fashion. The hair loss is permanent.

What causes centrifugal cicatricial alopecia?

At this stage, the cause of centrifugal cicatricial alopecia is still unknown. Literature from South Africa and from other countries suggest a genetic link. The genetic predisposition and combination of certain hair care practices is the most probable cause. Traditional hair care practices in which traction and or relaxers may weaken and break the hair, eventually cause it to fall out. Dr. Khoza recommends avoiding any hairstyles that place tension on the hair, like weaves, even if you don’t have scarring alopecia.

Centrifugal cicatricial alopecia is also associated with hot combs, chemical treatments like relaxers, oils, and excessive heat.

How is centrifugal cicatricial alopecia diagnosed?

Dr. Khoza will perform a scalp biopsy. This involves taking a small sample of the scalp from an affected area. The sample will be used to rule out any other scalp disorders. Dr. Khoza will look at the cells to see if there are any changes (histopathology) to healthy cells. Inflammatory cells around the base of the hair follicle (infundibulum) and scarring are typical symptoms of scarring alopecia, like centrifugal; cicatricial alopecia.

How is scarring alopecia treated?

Centrifugal cicatricial alopecia, like all forms of permanent hair loss, cannot be cured. Once scarring has occurred, the hair is unable to regrow. Treatment will halt or prevent it from progressing.

We treat centrifugal cicatricial alopecia with anti-inflammatories to bring the symptoms under control. Anti-inflammatory treatment can take the following shape:

  • Oral anti-inflammatories, intra-lesional scalp injections, topical anti-inflammatories, and antibiotics may help to ease the symptoms as the inflammation that affects the hair follicle reduces. A minoxidil solution may also encourage follicles to recover and allow hair to regrow.
  • A medicated shampoo may also be prescribed.
  • You may wish to try hair transplants. This is only available once the inflammation levels have subsided and the condition is under control. There is not a high success level, but should you wish to look at that option, it certainly exists and you can discuss that with Dr. Khoza at your appointment.

Everyone is different, what works for one patient may not work for another. Dr. Khoza will treat the condition from various angles in order to find the best results for you.

Living with scarring alopecia in your daily life

  • At home, we recommend very gentle grooming techniques. Avoid using too many products on the hair and give the follicles a chance to recover from the inflammation.
  • Avoid tension on the hair at all costs, opt for wigs instead of weaves.
  • Relish the natural beauty of your hair. If you do want to treat yourself to a hairstyle, be sure to visit a qualified professional and tell your stylist about your condition so that precautions can be taken to safeguard against further inflammation.

What to expect at your appointment

Dr. Khoza takes the time to welcome you. In order to get the best results from your appointment, be ready for a detailed look into the history of your symptoms, your medical history, and any conditions, including non-scarring and scarring alopecia, which may run in your family.

Dr. Khoza will want to know when you first started experiencing symptoms and what you have done to treat it at home. You will also be asked about the hairstyles you commonly wear. Write down the names of the products you use and bring that list with you to your appointment.

Once an accurate diagnosis is made, your treatment plan will commence. Your treatment plan is designed to give you the best results for your hair. For some, the results are fast and lasting. For others, it is a slow process with mixed results.

In order to prevent further hair loss, it is important to seek treatment as soon as possible. Dr. Khoza understands the complex emotions and the fear associated with hair loss. Book your appointment and get the condition under control. Give us a call today!