Can steroid injections treat central centrifugal cicatricial alopecia?

Central centrifugal cicatricial alopecia, also called CCCA, is a scarring form of hair loss that often begins near the centre of the scalp and can spread outward. Inflammation can damage follicles; once a follicle is replaced by scar tissue, it cannot produce a normal hair shaft.

An intralesional steroid may be placed into selected areas when inflammation is active. The goal is to reduce symptoms such as tenderness, burning, itch, or scalp sensitivity and to limit further inflammatory damage. A quiet, shiny scarred area may not benefit in the same way as an active edge.

Arrange a dermatology appointment for progressive central thinning, scalp discomfort, or broken hairs. The clinician may inspect the scalp closely and may recommend a biopsy when the diagnosis or activity is uncertain. Mention braiding, extensions, heat, chemical relaxers, and any tenderness because these details can affect the plan.

Use low-tension styles, reduce chemical and heat irritation, and avoid scratching the scalp. Ask how injections fit with other anti-inflammatory care and how activity will be monitored. Local pain, skin colour change, or thinning at an injection site are possible concerns to discuss beforehand.

Seek prompt review if hair loss is spreading, the scalp is increasingly tender or burning, pustules or crusting develop, or the scalp becomes noticeably shiny. These changes can indicate ongoing inflammation or another scalp problem requiring a revised assessment.

Is the CCCA active or mainly scarred? Do I need a biopsy? Which scalp areas would you inject, and how will we judge whether inflammation is settling?