Speaker shares pearls for hair loss treatment in women with skin of color
MIAMI BEACH, Fla. — Women with skin of color experience higher prevalence in central centrifugal cicatricial alopecia, leading to a need for clinical guidance, according to a speaker here.
“When we look at some of the treatment strategies with hair loss in women of color, basically it’s almost the same,” Valerie D. Callender, MD, professor of dermatology at Howard University College of Medicine in Washington, D.C., and medical director of Callender Dermatology & Cosmetic Center in Glenn Dale, Maryland, said during her presentation at South Beach Symposium. “There are just a few nuances or pearls that clinicians need to be aware of.”
Women with skin of color experience higher prevalence in central centrifugal cicatricial alopecia, leading to a need for clinical guidance.
Central centrifugal cicatricial alopecia (CCCA) is one of the most common causes of hair loss among women with skin of color, particularly in women of African descent, according to Callender.
CCCA will clinically present as hair loss at the crown or vertex of the scalp, expanding symmetrically and centrifugally. Patients will also experience follicular pustules, scaling and may describe symptoms such as tenderness, burning and tingling.
Although CCCA is associated with hair grooming practices, it is traced to genetic causes, specifically a PADI3 gene mutation.
It is also important for practitioners to know that patients with CCCA are at a higher risk for comorbidities such as prediabetes, diabetes, breast cancer, uterine leiomyomas and hyperlipidemia.
Current treatment of CCCA is aimed at resolving the inflammatory process and preventing the progression of the disease. Treatments include anti-dandruff or seborrheic shampoos, topical and intralesional corticosteroids, topical calcineurin inhibitors and topical or oral minoxidil.
Callender specifically recommends oral doxycycline, treating patients with “100 mg twice a day.”
Although CCCA is prevalent in women with skin of color, Callender emphasizes that clinicians should not assume a CCCA diagnoses. Women with skin of color also suffer from androgenetic alopecia, traction alopecia and frontal fibrosing alopecia. Therefore, it is important that diagnostic procedures, such as a dermoscopy, be performed to confirm a diagnosis and avoid ineffective treatment.
“Always remember just because they’re skin of color patients and they’re Black patients, doesn’t mean they only have CCCA,” she said. “Female pattern hair loss is the most common type of hair loss in all women regardless of their race.”