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Could ‘Gentle Wounding’ Treat Central Centrifugal Cicatricial Alopecia?

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There are currently a number of research projects investigating potential solutions for hair loss conditions which currently have no viable options.

One of these is Central Centrifugal Cicatricial Alopecia (CCCA), also known as Follicular Degeneration Syndrome (FDS) and Hot Comb Alopecia.

It causes a patch of hair loss which, as it progresses, radiates outwards from this initial area, and predominantly affects women of African origin.

Whilst it is not a particularly well-known condition, its effects are widespread among women of colour, though not necessarily officially diagnosed.

Current CCCA treatments

As CCCA is understood to involve inflammation in the upper part of the hair follicle, permanent hair loss can occur because this is where the stem cells and sebaceous glands are located. Once those are destroyed, irreversible baldness occurs due to the destruction of the follicle.

Surgical hair restoration is possible for some CCCA patients, however results from the small number of hair transplants carried out in such situations have so far provided disappointing results, according to researchers at the highly respected John Hopkins University in America.

Current treatments tend to focus on alleviating the inflammation associatd with CCCA and preventing hair loss from spreading, through the use of corticosteroid therapy and anti-inflammatory antibiotics.

Although in some cases CCCA hair loss treatment can be possible, it has no officially authorised MHRA-licensed or FDA-approved remedy.

As such, clinical trials are currently investigating potential measures, the latest of which involves ‘gentle wounding’ of the scalp in order to stimulate hair regrowth by generating new hair follicles.

Gentle wounding and hair follicle regeneration

The John Hopkins research team is currently recruiting 20 volunteers with CCCA to take part in a novel interventional trial into hair follicle regeneration in patients using fractionated CO2 laser therapy. All patients – male and female – will be aged 18 to 80 years.

Their work springboards off previous mice trial findings showing how new, fully-functional hair follicles were formed after wounding.

Participants with a professional diagnosis of Central Centrifugal Cicatricial Alopecia will be treated at John Hopkins’ dermatology clinics.

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They will be administered fractionated CO2 laser therapy – not to be confused with Fraxel laser resurfacing treatment – to induce gentle wounding of the affected area, and retinoid acid in one affected area. It is hoped that this approach will produce new hair follicles capable of normal healthy hair growth.

Fractionated CO2 laser therapy is a common dermatological tool, used to heat, vaporise and remove the skin’s superficial layers, creating a ‘thermal zone’. The cells surrounding this zone get to work on healing the wound, producing cell regeneration which, when retinoids are added, can help to promote ‘extra Wnt signalling‘ – which is crucial for skin and hair development.

Sham devices and treatments will also be given in another affected area of their scalps in order to establish a control with which to compare results.

Treatment will be on-going with results being monitored and primary outcomes measured within one year of each patient’s start date. This will be carried out using in vivo confocal microscopy to count the number of new hair follicles present.

The study is estimated to have a completion date of 31st December 2025. For anyone worried about hair loss, thinning or an unusual drop in their hair volume in the meantime, a consultation with a specialist is widely advised in order to receive a prompt diagnosis, information and – where appropriate – personalised hair loss treatment recommendations.


The Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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