Published on April 22, 2022. Last Updated on April 28, 2022.
In a recent study titled: Treatment-Refractory Central Centrifugal Cicatricial Alopecia Responsive to a Novel Botanical Treatment published by Dove Medical Press in its peer-reviewed journal Clinical, Cosmetic and Investigational Dermatology, four women who had failed multiple drug-based treatments responded to a new natural, plant-based formulation – Dr. UGro Gashee (Manhattan Beach, CA). The report mentions that all the participants in the case series who used Gashee in its topical or oral form showed notable hair improvements in hair fullness and the cessation of hair symptoms.
What is CCCA? Who Does Central Centrifugal Cicatricial Alopecia Affect?
Central centrifugal cicatricial alopecia (CCCA) is a common cause of hair loss called scarring alopecia, affecting approximately 15% of black women over the age of 30 [1-2]. CCCA is known as a persistent condition that causes inflammation, pain, itchiness, scarring, and an expanding area of permanent hair loss which begins at the top of the head .
CCCA-related hair loss can be aggressive. If caught and treated in its early stages, some hair loss may be recovered, but for the most part, CCCA progresses quickly to result in permanent scarring and permanent damage to the hair follicles. This scarring at the hair follicles is what leads to the irreversible hair loss that is seen during the later stages of CCCA.
The Issue Behind Central Centrifugal Cicatricial Alopecia – Scarring Alopecia Related Hair Loss Treatments
Current CCCA Treatments – Scarring Alopecia, Scarring Hair Loss
CCCA has been a source of frustration and struggle for many patients and doctors alike. This condition is very stubborn to treat and therefore has posed itself as a difficult challenge in the fight against hair loss. CCCA is often resistant to the many medications doctors use in treating it, such as pharmaceuticals and steroid injections into the scalp.
Current treatments for CCCA include:
- Topical steroids
- Steroid injections
- Oral & topical minoxidil
- Calcineurin inhibitors
- Topical metformin
These treatments are often discontinued due to unwanted side effects and poor compliance from patients frustrated by lack of progress. There are also many other factors, such as the unpleasantness of scalp injections, and other frequent complications [3-8]. Due to these reasons, many CCCA patients lose a significant portion of their hair – resulting in near-total baldness and scarring, often leading to a lifelong need for wigs and headwear to hide their condition.
A Breakthrough for CCCA Hair Loss – The Role of Natural Products
The results studied within this publication signal a significant development in the role of natural products for CCCA. As the report is now public, this topic warrants further study, as natural botanical products are more agreeable for long-term use due to a more potentially favorable side effect profile. Most hair loss patients, including those affected with CCCA, have coincident hair health issues which must be addressed. The study within this report highlights the potential of well-researched natural hair products in supporting hair health and hair growth in this form of CCCA scarring alopecia.
“As more and more consumers favor a more holistic approach to wellness, natural products will soon be the way of the future,”
-Dr. Sanusi Umar, MD, formulator of Gashee & Co-Author of Paper
“The ingredients in Gashee are sourced from around the globe using a proprietary compounding process that I personally developed to optimally preserve and deliver the beneficial molecules of the plants to the hair. Even the packaging took into account our respect for nature,” said Dr. Umar.
Improving Hair Health in CCCA: Improving Patients’ Quality of Life
It has been a significant and empowering breakthrough that patients have now been able to improve their quality of life by improving their hair health – even in tough hair loss conditions such as CCCA – through the use of GASHEE natural Products. “After years of witnessing the devastating effects of CCCA and its frustrating effect on my patients,” Dr. Umar mentioned that he “cannot be happier” to witness the result of the work reported in the paper. “I cannot wait to study further the role of this botanical on CCCA and other scarring alopecia,” said Dr. Umar.
“As with all conditions related to alopecia or hair loss, improving the patient’s quality of life by minimizing their symptoms is our first priority as dermatologists. Next, we want to halt the progress of hair loss as much as possible, and finally, aim for a state where the patient will no longer need any treatments – a state where they can flourish comfortably on their own,” says Dr. Umar.
Ways to Help Prevent CCCA: Early Preventive Measures
While the findings from the report show a major breakthrough in CCCA studies, it is essential to know that early preventive measures can significantly help reduce the likelihood of CCCA.
While the cause of CCCA is unknown and perhaps multi-factored, such as genetic factors that may come into play, there are clear aggravators or precipitators of CCCA that must be minimized. For example, hair habits and hair grooming practices such as the use of tight braids, weaves, heavy or tight dreadlocks, and harsh chemicals, should all be avoided to reduce the likelihood and onset of CCCA.
And sometimes, it is best to listen to the body. “The rule of thumb [here] is: if it hurts or itches, stop it,” says Dr. Umar.
VIDEO: GASHEE Reported as First Natural Product with Positive Response Towards CCCA
CCCA – Frequently Asked Questions (FAQ)
What were the results of the Gashee – CCCA Study?
The study states that all patients’ scalp pruritus had stopped within two weeks of treatment, and significant hair regrowth was observed within two months, including a cessation of hair loss and hair thinning, as well as a noticeable, significant growth in hair volume and thickness.
Can you recover hair loss from CCCA?
CCCA is a persistent and progressive condition, meaning that it will continue to spread over time around the top of the head. Particularly if left untreated, CCCA will result in permanent scarring of the hair follicles, leading to permanent or irreversible hair loss.
Are the conditions of CCCA reversible?
If CCCA is treated effectively during its early onset, it may still be possible to recover some lost hair and thinning areas on the scalp.
However, once scarring at the follicular level occurs, it will be too late for the hair to grow back and any regrowth of hair in the affected area is very unlikely.
What causes CCCA?
Many factors may contribute to the development of CCCA, such as:
- History of autoimmune disease
- Various hairstyling practices such as the use of excessive heat and tension (tight braids, tight weaves, tight dreadlocks), and tension chemical relaxers on the scalp
Although there are factors listed such as genetics and history of autoimmune disease that may be beyond patient control, it is recommended to discontinue the CCCA-related hairstyling practices mentioned to minimize the likelihood of CCCA formation or progress.
About Dr. Sanusi Umar, MD, FAAD
Dr. Umar is a board-certified dermatologist, a fellow of the American Academy of Dermatology, and a world-renowned hair expert with several related worldwide patents in hair transplantation. He is an associate faculty at the Department of Medicine, Dermatology Division, University of California, Los Angeles, Harbor-UCLA Medical Center, Torrance, where he leads the Scalp Disorders Specialty Clinic and private practice at Dr. U Hair and Skin Clinic in Manhattan Beach, California.
- Bin Saif GA, McMichael A, Kwatra SG, et al. Central centrifugal cicatricial alopecia severity is associated with cowhage-induced itch. Br J Dermatol. 2013;168(2):253–256. doi:10.1111/bjd.12043
- Aguh C, McMichael A. Central centrifugal cicatricial alopecia. JAMA Dermatol. 2020;156(9):1036. doi:10.1001/jamadermatol.2020.1859
- Araoye EF, Thomas JAL, Aguh CU. Hair regrowth in 2 patients with recalcitrant central centrifugal cicatricial alopecia after use of topical metformin. JAAD Case Rep. 2020;6(2):106–108. doi:10.1016/j.jdcr.2019.12.008
- Olsen EA, Whiting D, Bergfeld W, Olsen EA, Whiting D, Bergfeld W, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007;57(5):767–774. doi:10.1016/j.jaad.2007.04.012
- Gathers RC, Lim HW. Central centrifugal cicatricial alopecia: past, present, and future. J Am Acad Dermatol. 2009;60(4):660–668. doi:10.1016/j.jaad.2008.09.066
- Callender VD, Kazemi A, Young CM, et al. Safety and efficacy of clobetasol propionate 0.05% emollient foam for the treatment of central centrifugal cicatricial alopecia. J Drugs Dermatol. 2020;19(7):719–724. doi:10.36849/JDD.2020.5201
- Okereke UR, Simmons A, Callender VD. Current and emerging treatment strategies for hair loss in women of color. Int J Womens Dermatol. 2019;5(1):37–45. doi:10.1016/j.ijwd.2018.10.021
- Herskovitz I, Miteva M. Central centrifugal cicatricial alopecia: challenges and solutions. Clin Cosmet Investig Dermatol. 2016;9:175–181. doi:10.2147/CCID.S100816
- 2022. [online] Available at: <https://www.aocd.org/page/CCCA> [Accessed 22 April 2022].