Agape Hair + Wellness

Burning, Itching And/Or Tender Scalp? Beware Of This Condition: Central Centrifugal Cicatricial Alopecia (CCCA)

The battle won against hair loss begins once we have the right information. Knowledge is POWER! At Agape Body and Soul we desire to empower you to seek care early, without hesitation or shame and ask the right questions. You deserve thorough answers with solutions that apply the principles of holistic healthcare (incorporating the mind, body, and soul) to live your best life.


WHAT IS IT? Central Centrifugal Cicatricial Alopecia (also known as CCCA) 

Central = referring to the central (crown) part of the scalp

Centrifugal = a round or circular pattern

Cicatricial = scarring of tissues

Alopecia hair loss

The most common type of scarring alopecia seen in Black women is Central Centrifugal Cicatricial Alopecia (CCCA). While conservative estimates place the prevalence of CCCA at anywhere from 2.7% to 5.7%, it is likely that the numbers affected are much higher because people with CCCA often remain untreated and suffer in silence with this devastating disease. Wigs and weaves are often used to cover up the effects of this disease but they actually do more damage.

 CCCA is progressive, destructive and, if left untreated, the hair loss may be permanent. Early recognition and treatment are critical.



***CCCA may FEEL like scalp tenderness, burning, and itching usually in the crown area.

***CCCA may LOOK like redness of the scalp, thinning, dry, brittle hair with breakage, and baldness (in the later stages) usually in the crown area.


Although no single cause for CCCA has been identified; most researchers believe that there are multiple factors that contribute to this problem. Our understanding of CCCA has developed as scientific knowledge has evolved; this is illustrated by the timeline below:

Interestingly enough, there is no single causative factor for CCCA. The disease was first identified in medical literature as “hot comb alopecia” in 1968. At this time, it was thought that the grease applied to hair, when heated with a hot comb, drips down the root to the scalp causing repetitive burns to the follicles resulting in hair loss.

Almost 25 years later, after it had become clear that CCCA occurs in the absence of hot comb use; the term “follicular degeneration syndrome” was proposed.  Research suggested that degeneration of the hair follicle was caused by chemicals and certain hairstyles.

In 2001 the North American Hair Research Society designated the term “central centrifugal cicatricial alopecia” to describe this disorder within a broader category of other hair loss syndromes in which hair follicle scarring is caused by inflammation from blood cells called lymphocytes.

In 2014 a South African research study documented that CCCA occurs in hereditary patterns, and suggested that there may be a dominant, CCCA inducing gene mutation, that is passed down from parent to child. A study in 2019 confirmed the South African findings by identifying a specific gene mutation (PDAI3) in a group of patients with CCCA. This gene is significant because it is responsible for a protein that is required for healthy hair shaft development.

Scientific research has also identified risk factors for having CCCA. Risk factors are conditions that occur significantly more frequently in people with CCCA than the general population.

Risk Factors for CCCA:

  • A medical history that includes autoimmune diseases, diabetes, thyroid disorders, recent pregnancy or menopause
  • A family history of similar hair loss in both male and female relatives
  • Styling and grooming history that includes repeated use of chemicals, high heat, and high-tension styles, sometimes these are used to cover up the hair loss.



Experiencing symptoms of CCCA? DO NOT WAIT!

Get help from our certificated trichologist (hair loss specialist)

Book your evaluation today.



Stay tuned:  In our next blog we will discuss what options are available if you think you, or someone close to you may have CCCA.




    1. Gathers RC, Lim HW. Central centrifugal cicatricial alopecia: past, present, and future. J Am Acad Dermatol. 2009 Apr;60(4):660-8. doi: 10.1016/j.jaad.2008.09.066. PMID: 19293013.
    2. Herskovitz I, Miteva M. Central centrifugal cicatricial alopecia: challenges and solutions. Clin Cosmet Investig Dermatol. 2016;9:175-181. Published 2016 Aug 17.
    3. Malki, Liron,, (2019). Variant PADI3 in Central Centrifugal Cicatricial Alopecia. New England Journal of Medicine. 380. 10.1056/NEJMoa1816614.
    4. Ncoza C. Dlova,, Journal of Investigative Dermatology Symposium Proceedings (2017) 18, Central Centrifugal Cicatricial Alopecia: New Insights and a Call for Action
    5. Ncoza C. Dlova, Francois H. Jordaan, Ofer Sarig, Eli Sprecher, Autosomal dominant inheritance of central centrifugal cicatricial alopecia in black South Africans, Journal of the American Academy of Dermatology, Volume 70, Issue 4, 2014, Pages 679-682.e1, The American Hair Research Society  

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About Author
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Alisa Gooding

Alisa is the founder, co-owner and operator of Agape Hair Restoration and Wellness Center whose products division formulates and produces natural and organic hair and skin care solutions.