central centrifugal scarring alopecia (CCSA)

[kimmy]

Hi,

I had a biopsy a few months ago and the Dr. said I had lichenplamaris (?similar). My symptoms were itching at my crown (for over a year) and significant hair breakage (primarily around the crown area), no baldness and healthy looking scalp. The biopsy showed mild scarring. I initially started clobetasol and biotin with no change after month. He wanted to try some injections into my scalp but I've been out of the area for a few months. I'm currently in a different state and this dermatologist looked at the biopsy (I had faxed) and it also noted CCSA. She opts for this diagnosis as the itching has mostly stopped. She thinks the clobetasol just took a few months to work. I had started using an OTC itch reliever also but she believes its the clobetasol. Regardless, I've had no lengthening of those short hairs around the crown area and have worn a wig. I stopped chemical relaxers for several months with no change, I then switched to braids with no change (not tight). I've never been a fan of heat on my hair and have done so only four or five times (i.e. hot comb, flat iron...very rarely and well after symptoms started). So, I just recently had a relaxer put in for manageability but still wear a wig.

When I get back to my state should I do the injections? I'm thinking of braids if I can find someone to do the "short" areas. What do you think? Thank you.

P.S. I did have some breakage all over but the extreme shortness was at the top. A protein pack did signifiantly help with the breakage, but still no growth on top.

[Dr. William Rassman]

Hi,

I had a biopsy a few months ago and the Dr. said I had lichenplamaris (?similar). My symptoms were itching at my crown (for over a year) and significant hair breakage (primarily around the crown area), no baldness and healthy looking scalp. The biopsy showed mild scarring. I initially started clobetasol and biotin with no change after month. He wanted to try some injections into my scalp but I've been out of the area for a few months. I'm currently in a different state and this dermatologist looked at the biopsy (I had faxed) and it also noted CCSA. She opts for this diagnosis as the itching has mostly stopped. She thinks the clobetasol just took a few months to work. I had started using an OTC itch reliever also but she believes its the clobetasol. Regardless, I've had no lengthening of those short hairs around the crown area and have worn a wig. I stopped chemical relaxers for several months with no change, I then switched to braids with no change (not tight). I've never been a fan of heat on my hair and have done so only four or five times (i.e. hot comb, flat iron...very rarely and well after symptoms started). So, I just recently had a relaxer put in for manageability but still wear a wig.

When I get back to my state should I do the injections? I'm thinking of braids if I can find someone to do the "short" areas. What do you think? Thank you.

P.S. I did have some breakage all over but the extreme shortness was at the top. A protein pack did signifiantly help with the breakage, but still no growth on top.

Your diagnosis is best treated by a good Dermatologists. As I am a hair transplant surgeon, I am reluctant to give an opinion on the medical treatments and the recommendations of dermatologists. Scaring Alopecia (a general name for this type of diagnosis) frequently does cause hair loss and the treatment are often aggressive steroid use to control the active phase of the disease.

With regards to the use of braids, this is something I do not like because no matter what you try to do, braids do pull on the hair and this is a cause of alopecia.