Is central centrifugal cicatricial alopecia safe in skin of colour?

CCCA is a scarring form of hair loss that often begins near the centre of the scalp and may spread outward. Inflammation around follicles can injure them, and a scarred follicle may no longer produce hair. Skin of colour is not a reason to avoid evaluation or treatment. However, darker skin can develop visible colour changes after inflammation or irritation, so scalp redness may be less obvious than symptoms such as itch, tenderness, burning, scaling, or increased hair breakage. The diagnosis may require a close scalp examination and sometimes a small biopsy.

Arrange a dermatology appointment if thinning is widening, the scalp feels sore or itchy, or you notice smooth areas with fewer visible follicles. Until you are assessed, reduce tight braids, extensions, chemical straightening, and heat that causes scalp discomfort. Use gentle cleansing and avoid scratching or picking. Keep notes about when symptoms began and bring a list of hair products and styling practices. Treatment may aim to calm inflammation and protect remaining follicles; the plan depends on examination findings.

Seek a prompt review for rapidly expanding hair loss, increasing scalp pain, pus, crusting, marked swelling, or tender bumps. Urgent help is needed if swelling spreads to the face, you develop fever, or you have eye symptoms. A new smooth or shiny patch should not be dismissed as a styling issue, because scarring hair loss can progress with few early visible changes.

Ask whether the pattern suggests scarring hair loss, whether a biopsy is useful, how activity will be monitored, and which treatments suit your scalp. Discuss safe styling, colour-change risk, ways to manage itch or pain, and what changes should trigger an earlier appointment.