Central centrifugal cicatricial alopecia
Common clinical features of central centrifugal cicatricial alopecia include circle shaped balding, principally on the crown or the vertex of the scalp
In general, central centrifugal cicatricial alopecia is a condition that presents flesh colored, overtly non inflammatory (i.e. you can’t see any inflammation just by looking at the skin) cicatricial alopecia of the central scalp, which enlarges centrifugally as the disease progresses. This group of rare disorders completely destroys the hair follicle and replaces it with scar tissue, causing permanent hair loss. The condition is not to be confused with central centrifuging scarring alopecia, as defined by Sperling et al, and both conditions indicate different clinical conceptions.
Central centrifugal cicatricial alopecia was originally called “hot-comb alopecia”. According to a study done on 51 African American women, heat from hot combing or use of oil pomades for hair straightening was thought to be the factor responsible for this condition. Patients complained of soreness of the scalp during or immediately after the procedure. The spreading alopecia of the central part of the scalp, thought to result from the repeated use of the procedure.
Central centrifugal cicatricial alopecia is one of the most common as well as the most challenging form of alopecia seen by a clinician. It affects black women predominantly, but black men can also be affected. It remains to be ascertained whether central centrifugal cicatricial alopecia is a unique classifiable entity on its own or merely a morphological pattern shared by some distinctly different alopecias. There may be a hereditary component to the condition and for some black women, a combination of hair care practices might contribute to further aggravate the condition.