What Is the First Treatment for Central Centrifugal Cicatricial Alopecia?

Central centrifugal cicatricial alopecia, or CCCA, is a scarring form of hair loss that often begins near the centre of the scalp and can spread outward. Inflammation can injure follicles; once a follicle is replaced by scar tissue, it may not grow hair in the same way. Treatment therefore focuses on reducing active inflammation and limiting further loss.

A clinician places small amounts of steroid medicine into selected scalp areas. The plan depends on scalp findings, tenderness, scaling, progression, and any other health factors. Oral anti-inflammatory or antibiotic medicines may be considered when the examination suggests they could help.

Book a dermatology assessment if hair loss is spreading, the scalp feels sore or itchy, or you notice scale or pustules. Use gentle hair care, avoid tight hairstyles and repeated chemical or heat treatments, and tell the clinician about recent changes in products or grooming practices.

Do not inject or apply prescription steroid medicine without guidance. Ask how often review is needed and whether treatment is targeting active inflammation. Further information is available about [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/).

Arrange prompt review for rapidly increasing hair loss, marked scalp pain, pus-filled bumps, crusting, bleeding, or areas that become shiny and smooth. These changes can signal active inflammation, infection, or another cause of hair loss that needs a different approach.

Ask whether the scalp shows active inflammation or established scarring, where injections would be placed, what side effects to watch for, and how progress will be assessed. Discuss whether oral treatment is appropriate and which hair practices should be paused.