Publish 2 September 2021
Gettin’ Your Hair Did
In more youthful days, as a woman of color, you wore every popular hairstyle. Gossiping passed the hours at the hairdresser or in your girlfriend’s kitchen while getting your hair washed, pressed and curled. Before flatirons were mainstream, you touched up those wild roots by heating your own hot comb on the stove.
Then you discovered perms allow you to eliminate the hot comb altogether. Oh, and those weaves? Girl, necks would snap when you strutted into the room. After much hair breakage from overheated hot combs, you are now known for your fashionable collection of wigs.
Heating up petroleum-based hair products with a hot comb can cause severe hair burns and permanent scalp damage.  It is difficult for your hair follicles to recuperate from this. Hot Comb Alopecia, known formally as central centrifugal cicatricial alopecia (CCCA), affects more women than men worldwide.
What is Hot Comb Alopecia?
Hot Comb Alopecia is the progressive degeneration of hair follicles. It usually begins at the crown region of the scalp. The gradual degeneration of the follicle’s external root sheath ultimately causes a follicle scar.  Hot combs are not the only cause of CCCA. Using harsh chemicals is a precursor to this form of alopecia.
Dermatological Views on CCCA
Fortunately, CCCA can be reversible if caught early. So consult a dermatologist immediately and avoid using heating tools for the best outcome.
Why Your Hair Is Falling Out
Researchers of dermatology identify many factors leading to CCCA. This includes heating tools, dyes, chemicals, braiding hair tight, and drugs. Genetics can also be a CCCA trigger. [2,3]
This disorder commonly affects African American women due to the shape of their hair-follicles. The term central centrifugal cicatricial alopecia, adopted by the North-American Hair Research Society, describes the pattern of damage. 
Do You Have Hot Comb Alopecia?
CCCA is similar to female and male pattern alopecia. This is why it has the informal name Hot Comb Alopecia.
Initially, CCCA begins at the crown and then spreads gradually in a centrifugal direction. Hair loss is in patches due to follicular degeneration which is your alarm to seek professional dermatology care.  It is more difficult and expensive to recuperate from late diagnosis. Symptoms can include:
- Scalp Inflammation
- Itchy Scalp
- Burning Sensation
- Hair Loss
Get professional treatment as soon as possible for best results.
Getting Your Hair Back
Astounding advances in dermatology make it easier to treat CCCA now than was possible in previous years.
- Professionals reduce inflammation with anti-inflammatory medicines. Consult a dermatologist who can prescribe creams to relieve the pain and soothe the scalp. Anti-inflammatory medications include hydroxychloroquine, cyclosporine, tetracycline, and potent tropical steroids. 
- Making lifestyle changes is essential. Avoid heating tools, tight braiding, and shampoos with high chemical percentages.
- Follicular Unit Extraction is the most popular method of hair transplantation with promising results. The three-step process involves collecting hair follicles from another part of the body, creating recipient sites in the scalp. Then installing the hair similar to planting seeds. [6,7]
Cosmetology Guidelines for CCCA
These cosmetology guidelines can help prevent CCCA:
- Organic shampoos
- Healthy diet
- Stress-free life
- Soft brushing
- Avoid tight braiding
Save Your Hair
Your scalp is part of the integumentary system, which includes your skin, hair, and nails. It is important to maintain a barrier against infection. So you should not disregard scalp inflammation.
If CCCA runs in your family, strictly follow cosmetology guidelines to ensure a CCCA-free life. Carelessness can lead to baldness. Check for symptoms periodically and consult a dermatologist immediately with concerns.
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Co-author Zarsha Noureen is a writer specializing in beauty, health, and wellness.
- LoPresti P, Papa CM, Kligman AM. Hot Comb Alopecia. Arch Dermatol [Internet]. 1968 Sep 1;98(3):234–8.
- Herskovitz I, Miteva M. Central centrifugal cicatricial alopecia: challenges and solutions. Clin Cosmet Investig Dermatol. 2016 Aug 17;9:175–81. doi:0.2147/CCID.S100816. PMID: 27574457; PMCID: PMC4993262.
- Dlova NC, Forder M. Central centrifugal cicatricial alopecia: possible familial aetiology in two African families from South Africa. Int J Dermatol. 2012 Nov 1;51(s1):17–20.
- Gathers RC, Lim HW. Central centrifugal cicatricial alopecia: Past, present, and future. J Am Acad Dermatol. 2009;60(4):660–8.
- Alopecia. drugs.com/cg/alopecia.html Retrieved 2 Sep 2021
- CCCA – A Common Cause of Hair Loss. eternaldermatology.com/ccca-alopecia-hair-loss-treatment Retrieved 2 Sep 2021
- Dua A, Dua K. Follicular unit extraction hair transplant. J Cutan Aesthet Surg. 2010;3(2):76-81. doi:10.4103/0974-2077.69015
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