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Beyond the Hot Comb: Updates in Epidemiology, Pathogenesis, and Treatment of Central Centrifugal Cicatricial Alopecia from 2011 to 2021

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Abstract

Central centrifugal cicatricial alopecia (CCCA) is a form of scarring alopecia that predominantly affects middle-aged women of African descent. Recent data suggest a multifactorial etiology of CCCA that is influenced by environmental and genetic factors. Emerging evidence regarding the genetic basis of the condition may elucidate new therapies. While topical and intralesional steroids and tetracycline antibiotics are the mainstay of treatment, refractory cases may be considered for hair transplantation. Emerging therapies using platelet-rich plasma, botanical formulas, and cosmetic procedures have shown promising results for the future management of CCA. As recent notable advances in CCCA have been achieved, this review provides an update on the epidemiology, pathophysiology, and management of CCCA.

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Author notes

  1. Elisabeth A. George and Caneisaya Matthews contributed equally.

Authors and Affiliations

  1. Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA

    Elisabeth A. George

  2. Florida State University College of Medicine, Tallahassee, FL, 32304, USA

    Caneisaya Matthews

  3. The Children’s Mercy Hospital and Clinics, Kansas City, MO, 64108, USA

    Fritzlaine C. Roche

  4. Division of Dermatology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA

    Fritzlaine C. Roche & Susan C. Taylor

  5. Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA

    Susan C. Taylor

  6. Department of Dermatology, Perelman Center for Advanced Medicine, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Susan C. Taylor

Authors
  1. Elisabeth A. George
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  2. Caneisaya Matthews
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  3. Fritzlaine C. Roche
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  4. Susan C. Taylor
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Correspondence to Susan C. Taylor.

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Dr. Fritzlaine Roche contributed to the manuscript in leading the initiation of the research project, searching for relevant references, and reviewing and editing the manuscript. Caneisaya Matthews and Dr. Elisabeth George both worked diligently in preparing the first draft of the manuscript. After review and editing by Dr. Roche and Dr. Susan Taylor, Caneisaya Matthews and Dr. George revised the draft and produced the final paper.

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George, E.A., Matthews, C., Roche, F.C. et al. Beyond the Hot Comb: Updates in Epidemiology, Pathogenesis, and Treatment of Central Centrifugal Cicatricial Alopecia from 2011 to 2021. Am J Clin Dermatol 24, 81–88 (2023). https://doi.org/10.1007/s40257-022-00740-w

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