What are the treatment options for central centrifugal cicatricial alopecia?

Central centrifugal cicatricial alopecia is a scarring hair-loss condition that often begins near the crown and can expand outward. Active inflammation can damage follicles, while established scar tissue cannot produce a normal hair shaft. Treatment therefore focuses on slowing ongoing loss and reducing symptoms such as tenderness, itch, burning, or scalp bumps. [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/) delivers anti-inflammatory medicine into selected areas. An oral antibiotic may be chosen for its anti-inflammatory effect as well as its activity against particular bacteria; it is not appropriate for everyone.

Arrange a dermatology assessment if the crown is widening, the scalp is sore or itchy, or smooth areas are developing. The clinician may examine the scalp closely and discuss whether a biopsy is needed to confirm the diagnosis. Use gentle hair care, avoid tight styles and repeated heat or chemical irritation, and tell the clinician about medicines, pregnancy plans, allergies, and previous treatments. Do not start leftover antibiotics or steroid products without guidance. [Oral Antibiotics For Acne](/treatments/medical-dermatology/oral-antibiotics-for-acne/) is an example of a medicine category that must be prescribed for the right indication.

Book prompt review for rapidly expanding hair loss, increasing scalp pain, pus-filled bumps, marked redness, or new areas of smooth scarring. Seek urgent care for facial swelling, breathing difficulty, severe medication reaction, or a high fever. Earlier assessment can help distinguish active inflammation from inactive, established scarring.

Do you see signs that the condition is active? Would a scalp biopsy clarify the diagnosis? Which areas would injections target, and what side effects should I watch for? If an oral antibiotic is considered, how long might treatment last and what monitoring is needed?