Central centrifugal cicatricial alopecia: Past, present, and future

• Published in: Journal of the American Academy of Dermatology Vol. 60; no. 4; pp. 660 - 668
• Main Authors: Gathers, Raechele Cochran, MD, Lim, Henry W., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.2009; Elsevier
• Subjects: African Americans; Alopecia - epidemiology; Alopecia - etiology; Alopecia - pathology; Alopecia - therapy; Biological and medical sciences; Dermatology; Forecasting; Hair; Hair and nails disorders; Humans; Hygiene; Medical sciences; Terminology as Topic; CCCA; CCSA; central centrifugal scarring alopecia; ORS; outer root sheath; central centrifugal cicatricial alopecia; FDS; follicular degeneration syndrome; inner root sheath; IRS; Hair; Skin disease; Dermatology; Scarring alopecia
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2008.09.066

Clinical scarring alopecia in African American women has been recognized for years. The classification of this unique form of alopecia dates back to Lopresti, who first described the entity called “hot comb alopecia.” More recently, the term “central centrifugal cicatricial alopecia” has been adopted to describe a progressive vertex-centered alopecia most common in women of African descent. While this form of hair loss is widely recognized, and may even be on the rise, the causes of central centrifugal cicatricial alopecia are a constant source of debate and remain to be elucidated. This review outlines the descriptive evolution of central centrifugal cicatricial alopecia and the historical controversies ascribed to its pathoetiology; it also examines African hair structure and discusses how hair structure along with common physical and chemical implements utilized by individuals with African hair type may play a causal role in the development of central centrifugal cicatricial alopecia.