Hair Loss: 5 Signs You Need to Pay Attention to!

Friday, May 30, 2019

I am not a medical professional, so please consult your doctor if you are experiencing any type of hair loss. Please see here:  Disclaimer. 

You may click on a hair loss topic to jump right to it or scroll down to read on!

What is CCCA?

Sign #1: Hair Thinning

Sign #2: Bald Patches

Sign #3: Itchy, Burning Scalp

Sign #4: Scalp Tingling

Sign #5: Scalp Tenderness

What is CCCA?

Example of CCCA Picture Credit: Indian Dermatology Online Journal See Here

One of the leading causes of hair loss for African American women is Central Centrifugal Cicatricial Alopecia (CCCA) according to board-certified dermatologist, Dr. Yolanda Lenzy [1].

CCCA  also known as  “hot comb alopecia”,  or CCSA (central centrifugal scarring alopecia), is a progressive disorder where the hair loss affects the crown or the top of the head, and expands outward from the center over time [2].

During the disorder’s end stages, the inflamed hair follicles are replaced with scar tissue which will no longer produce hair ever again. 

While the symptoms of CCCA have been investigated, there has been no definitive explanation of its causes.

However, tight braiding, and weaving techniques have been discussed as aggravating factors along with genes possibly, playing a role [3].

The one thing researchers do agree with is early treatment. The key is to catch the hair loss early since CCCA can disfigure and scar your scalp leaving permanent baldness [4].

Here are 5 early signs to look for before losing your hair to CCCA . 

1. Hair thinning 

Often we don’t even think about visiting the dermatologist for signs of hair thinning, but we should.

Wider scalp parts where the skin is more visible, thinner twists,  braids, or less poofy buns can be early signs. 

With the natural hair DIY movement, we often think that we will diagnose and treat our own scalp ailments with some essential oils, or some growth serum we have seen mixed up on YouTube.

While those remedies may be appealing, a more serious condition could be brewing involving the inflammation of our hair follicles.

Dr. Lenzy, explains that many black women experience this type of alopecia, yet it goes undiagnosed since many don’t know that they should visit a dermatologist for hair and scalp issues [5]. 

Visiting early catches the scalp damage sooner, possibly allowing you to prevent bald patches from forming with topical treatments, or oral antibiotics to decrease the inflammation.

Additionally, a prescription of minoxidil may encourage the regrowth of hair [6].

In the Black Women’s Health Study at Boston University, at the time of Dr. Lenzy’s reporting in 2016, There were 5,594 women who had completed the health survey. 

47.6% of these women reported hair loss on the crown of their head [7] and 81.4% hadn’t visited the dermatologist when they experienced hair loss symptoms.

If you are experiencing any type of hair loss, consult with a dermatologist as soon as you can with experience working with afro textured hair [8]. 

2. Small Bald patch(es) on your scalp 

Bald patches on your scalp are an immediate sign that you should run (not walk) to the dermatologist. These patches create thinner twists, or braids.

With CCCA, the bald patches, which may start out small become larger over time leading to a more visible part on your scalp. 

Make it a priority to use a mirror to monitor every part of your scalp and especially look at the back of your head and the top area. 

Along with monitoring your own hair, ask your hairdresser or braider if they notice that your hair is thinning. Since they have frequent contact with your hair, they will notice anything out of the ordinary. 

3. Itchy, Burning Scalp

An itchy and burning scalp is a symptom of CCCA caused by inflammation [9].

Whether it is tight braids, used in a style or as a part of weave installation, these processes can fuel CCCA leaving your scalp red, feeling itchy and like it’s on fire.

About a decade ago, I went to get braids installed and the braider had installed them way too tight. My head was hurting and my scalp was itching so much I had to take them out.

During the visit, I did mention if she could braid loosely. However, it wasn’t enough. I had to take the braids out after a day.

I literally paid for one day of braiding. While I was angry, I wasn’t going to lose my follicles for one hair style. No amount of money is worth that.

Either go to a braider who knows how to braid with the right amount of tension, or teach yourself to braid and flat twist.

An inflamed scalp can also be connected to not only tight braids, but bacteria from product buildup, or a toxic hair care ingredient.

Maintaining a clean scalp will go a long way in keeping your scalp healthy. Working with a dermatologist can also help you get to the bottom of the problem before your hair falls out.

All skin even on your scalp is sensitive. Care for your scalp, the way you care for your face. Remember, it’s all skin and needs to be monitored for inflammation. 

4. Scalp Tingling

Scalp tingling is another early symptom of CCCA, which is caused by inflammation. According to Dr. Lenzy, many women ignore it since it seems unimportant.

With your hair, it's better to think everything is something. I would rather have a doctor tell me an tingle on my scalp was nothing rather than lose my hair because I ignored it.

5. Scalp Tenderness

If you touch your scalp and it hurts, looks red, or feels soft and tender, that’s not normal and could be an early sign of CCCA.

Usually, there is this pain on the skin’s surface where it is super sensitive. Red skin= inflammation. 

There is a myth in the afro-haired community called being “tender-headed.”

I call it a myth because according to Dr. Raechele Gathers, senior physician at the Multi-Cultural Dermatology Center of Henry Ford Hospital in Detroit, any type of “pain = damage”[11]. 

If a hair stylist, or anyone, is hurriedly or harshly combing or brushing your hair,  your scalp will feel the pinch. This is what is called pain not being "tender-headed".

The pain has nothing to do with having a tender scalp.

People who don’t say anything when their hair is combed harshly, have learned to keep their mouth shut from a young age because we were trained to do so;It doesn’t mean the pulling hurt less.

We just knew that we would be called “tender-headed.”

Don’t call anyone that.  It implies they are weak in some way and that you can’t take pain. Hair styling should not be painful.

It’s best to go to the dermatologist at the earliest sign of any of these five symptoms since they can prescribe treatments that may slow the progression of this disease.

However, not all treatments will work at regrowing hair [12], that is why prevention has to come first.

Find out if any one in your family has had CCCA since there may be a genetic component of the disease. Monitor your scalp every week and pay attention to itchy or burning sensations.  Take it seriously. 

So let's recap. Check your scalp for the following symptoms:

1. Hair Thinning

2. Small, Bald Patches

3. Itchy, Burning Scalp

4. Scalp Tingling

5. Scalp Tenderness

Our hair is important, and so is our scalp which can often become neglected or clogged with product buildup.

A rule of thumb should be if you wouldn’t put it on your face, you shouldn't put it on your scalp; Your scalp is just an extension of your face!