Don't Ignore the Pain: Spotting CCCA (Central Centrifugal Cicatricial Alopecia) Early

January 03, 2026

Does your scalp hurt at your crown? Have you noticed hair loss at the crown? If your answer is yes then I think this article is excellent for you. So, there's this thing called Central Centrifugal Cicatricial Alopecia; let's call it CCCA. CCCA is one of the many types of alopecia (hair loss) and is mostly found in black women.

You know you have CCCA if you have:

• A burning sensation

• Itchiness

• Hair thinning

• Weak hair strands

• Hair loss

All these on the crown. One thing about CCCA is that it goes undetected most times until it becomes very late. That stinging pain you felt when your braider worked on the hair at your crown, which you ignored, might just be CCCA, even if you aren't seeing any hair loss yet.

One thing a lot of people of African descent think is that pain while making hair is normal, and this shouldn't be. Frankly, I don't believe beauty is pain. If that hair stings like they're using needles to prick your scalp, take it off. If not, you're literally surrendering your hair to be feasted on by any kind of alopecia.

What are the causes of CCCA?

• Tight hairstyles will definitely top my list. I repeat, beauty is not pain. Hairstyles that put a lot of tension on the scalp call for alopecia because they cause tension, inflammation, and put pressure on the hair follicles.

• Four-part hairstyles or just any hairstyle that requires parting, putting tension on the crown of the head.

• Packing your hair into a high puff. Now, we know that high puffs are really pretty and honestly, they're very easy to just do and go your way, but they put tension on the crown.

• Using heat on your hair. This includes stand dryers, anything that focuses heat on your scalp.

• Chemical treatments on the hair, including relaxers and dyes when used excessively and unprofessionally, can lead to alopecia.

Avoiding these will go a long way, especially if you're already seeing early signs of CCCA. It is the kind of alopecia that sneaks up on you; you'll feel like you were fine just yesterday, and today, the hair on your crown looks like a clipper was used on it. It happens very slowly over time, and its location is at the crown of the head, so it's not as noticeable as some other kinds of alopecia, say, traction alopecia, for example.

If you notice that the hair at your crown is almost significantly shorter than the rest of your hair, even if you haven't noticed any other symptom, it is a sign of CCCA and is not normal. A burning or itchy sensation at your crown is not normal. If you ignore it, one day you'll just wake up and see that you have a bald spot on your crown, and it just keeps spreading because CCCA spreads out to other parts of the head. If you don't take care of it in the early stages, it can lead to permanent hair loss, which, at this point, will need a hair transplant.

If you have noticed some or all of these symptoms, stop all tension on your hair and tight hairstyles and start paying attention to moisturizing your hair, especially at your crown. Stop any form of heat application to your hair and, very importantly, see a qualified dermatologist. Before you say it's not that deep, yes, it is that deep if you don't want to go bald. A qualified dermatologist will give so much more information on the remedies to this before it goes haywire.

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