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Conditions

Hair restoration · Hair-loss diagnosis and restoration

Central centrifugal cicatricial alopecia

Recognise scarring hair loss that starts at the crown and expands outwards.

Editorial publication · Medical review pending.

Understand

Central centrifugal cicatricial alopecia is an inflammatory disease that destroys follicles, usually from the centre of the scalp, and replaces them with scar tissue.

Possible symptoms

Density falls at the crown and spreads; itch, burning, pain, tenderness or breakage may precede a smooth shiny area.

Causes and associated factors

The cause is complex and incompletely understood; genetic susceptibility and inflammation contribute, while some hair practices may worsen damage.

Diagnosis

A dermatologist assesses the pattern, symptoms, hair practices and dermoscopic appearance; biopsy often confirms the diagnosis.

Tests

Dermoscopy helps select an active area for biopsy; other tests depend on suspected associated diseases or causes.

Course of the condition

Without treatment, the scarred area can expand and loss from destroyed follicles becomes permanent.

Care options

Early treatment aims to stop inflammation and preserve remaining hair, with hair care that reduces traction, heat and irritants; any transplant requires prolonged stability.

When to consult

Seek early assessment if the crown thins, burns, itches or becomes tender, especially when loss is progressing.

Urgent help

Rapidly increasing pain, pustules, swelling, pus or fever needs prompt medical advice.

Questions for your doctor

  • What is causing my hair loss?
  • Are the follicles still active or already scarred?
  • Which medical treatments should be tried or stabilised before a transplant?
  • Can my donor area support a realistic and lasting result?
  • Which scalp signs need prompt medical care?

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A procedure linked to a condition does not establish an indication for your individual situation.

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