Topical anti-inflammatory drugs, such as cortisone, may be given to reduce inflammation. Dr. Henry says intralesional steroid injections can also be effective. “They allow anti-inflammatory drugs to penetrate deeper and are the standard treatment for active traction alopecia.”
Both doctors suggest lower doses of minoxidil, depending on the severity of the case. Minoxidil “helps thicken any remaining hair,” says Dr. Renzi. “This is because the hair left behind is often very fine and brittle,” Dr. Henry added, adding that this is an option for those who have difficulty sticking to topical formulations.
Dr. Henry also offers platelet-rich plasma (PRP). “Although evidence is limited to case reports and small series of scarring/traction alopecia, PRP has shown promise in slowing disease progression and reducing inflammation,” she says.
Central centrifugal cicatricial alopecia
Hair loss on the crown that spreads outward is known as central centrifugal cicatricial alopecia (CCCA). The exact cause of CCCA is unknown. Certain hair care habits and hairstyles (such as high puffs and tight ponytails) are said to cause scarring on the crown of the head, leading to hair loss, but it appears that the way you style your hair isn’t the only cause of this condition.
Dr. Lester says more research is being done to determine exactly why CCCA occurs. “Some people can get this even if they always wear low-tension hair and have never used chemicals,” she says. “So it’s not just about hairstyling.”
Cicatricial comes from the Latin word for scar, and as noted by multiple dermatologists on our expert panel, CCCA is the most common form of cicatricial hair loss in black women. Inflammatory cells, such as lymphocytes, can lead to the destruction of hair follicles, Dr. Renzi explains.
Treatment method: Proper diagnosis precedes treatment. In his practice, Dr. Renzi performs biopsies to properly diagnose this condition, which is often mistaken for other forms of hair loss. A pathologist can use a microscope to see inflammatory cells. In CCCA, “the hair follicles are replaced with scar tissue,” she says. “So, if you look at this below, [dermatoscope] The hair follicles are no longer visible. Scar tissue is visible. ”
Areas scarred in this way usually do not regrow, Dr. Renzi added. However, she points out that some people have hair that is “stunted,” and dermatologists can encourage hair growth by controlling inflammation and adding other treatment options.
For this reason, early and accurate diagnosis of CCCA is critical, Dr. Renzi said, adding that CCCA tends to be treated more aggressively than other forms of hair loss. “We found that if you don’t treat it aggressively enough, it tends to progress more quickly,” she says. “So I use things like oral antibiotics, not because it’s an infection, but because antibiotics have anti-inflammatory properties.”
Dr. Renzi uses some of the same treatments to treat CCCA as he uses traction alopecia. For example, topical corticosteroids combined with minoxidil. They may also choose steroid injections to increase penetration into the scalp, or nutritional supplements to help grow and thicken any remaining hair.
Source: Allure – www.allure.com
