Hair Loss Associated with Age Becoming More Common

A Rare Form of Hair Loss Becomes More Common

By: Kari Williams, PhD

Dr. Kari Williams, Trichologist

Hair loss is typically associated with aging, but an increasing number of people are losing hair and they are not in their “golden years.”  Unfortunately I have seen many young women in there 20’s and early 30’s who are suffering from severe hair loss, especially in the crown of the head. Many women who have hair loss are not initially aware of it, particularly women who wear weaves on a consistent basis. It’s not until it becomes apparent to family and friends, excessive hair is seen in the shower or sink after a shampoo, or they finally take a good look in the mirror and actually touch their hair after two years of back to back weave styling (yes, many women don’t look at or touch their own hair in between weaves) that they realize something is seriously wrong. What’s even worse is that many women wait until most of the hair is gone before consulting with someone about it.

Many women have tried various ineffective home remedies before seeking help.  The problem is there are several reasons for hair loss including a number of systemic causes and the use of medications. Therefore, we cannot assume that a topical application of an over-the-counter product that claims hair regrowth is the solution.


There is a rare form of alopecia that is now becoming more common. Central Centrifugal Cicatricial Alopecia (CCCA) is a form of scarring alopecia that occurs almost exclusively in African American women. This pattern of hair loss resembles the diffuse pattern linked to androgenic alopecia. The difference is with CCCA there is a complete obliteration of the hair follicles, a change in scalp texture and scar tissue that forms in the scalp, resulting in permanent hair loss.  Symptoms of burning, itching and pain may accompany this form of hair loss that is typically located in the center of the scalp.  The area involved is smooth and shiny and the remaining hairs in the area of the scarring are dry and brittle.

The cause of CCCA is poorly understood but it involves inflammation of the hair follicle where the stem cells and sebaceous glands (oil glands) are located. Once this is destroyed there is no possibility of regeneration of hair cells.  Although the exact cause of this alopecia is not known, certain factors have been implicated in the development of CCCA. These include, thermal straightening (using blow dryers and hot combs), traction or excessive tension on the hair, chemical straightening (relaxers) and infection. There is no conclusive evidence that determine these factors as causes, but we must discontinue certain hair care practices when we notice that it is affecting our hair and scalp.

Currently, there is no consistently successful treatment for CCCA. A dermatologist who can perform a scalp biopsy must confirm this diagnosis for your hair loss. Some treatments that have been used are topical anti-inflammatory agents, oral antibiotics, topical minoxidil treatments, intralesional steroids (injections) and hair transplant surgery. Again I caution, before trying one of these treatments consult with your physician or dermatologist to determine what may be most effective.

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2 thoughts on “Hair Loss Associated with Age Becoming More Common

  1. BlueCornMoon

    I know 2 women with CCCA. Both relaxed for years. One I’ve known for over 20 yrs. I told her years ago she should stop because her already thin hair was getting thinner,looking raggedy & her forehead hairline was receding but she didn’t listen. She wore a lot of wigs but still got perms & even braids. Her hair kept getting thinner & her scalp shiny. Last year she was diagnosed with CCCA by a derm. She’s getting treatments for the rest of her hair but is permanently bald at crown & forehead so she has a lot of cute wigs. The other woman works at my school & is permanently bald the same way but decided to loc her remaining hair & Is also seeing a derm . The locs are doing vey well & she says it’s the best thing she could’ve done. She, too, had had relaxers & braids for years. It’s a shame how so many black women will perm the hair right out of their scalps. I did the BC in 2009 after years of curly perms & will ever have another.

  2. Karen Mundia

    Av gone natural too, never to look back, my scalp have been scarred by wreck less expensive stylists who pay no attention to safe application of relaxers, I want an Afro, am African


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