The hair loss condition, central centrifugal cicatricial alopecia or CCCA is one of the less common causes of balding that needs hair loss treatment. This medical condition, which characterizes with circular balding, mainly on the top (vertex and crown) which can be expanding and only leave a rim or hair around the scalp with total baldness in the more central areas in extreme cases (see picture).

The causes of this type of balding are now quite known. Here at US Hair Restoration a Los Angeles Hair Transplant Center we see CCCA on an occasional basis. This disease used to be called with different names such as hot comb alopecia, follicular degeneration syndrome, pseudopelade in African Americans and central elliptical pseudopelade in Caucasians. Microscopic evaluation of the hair loss areas shows evidences of inflammation in the area of disease activity, chronic and rapidly progressive skin changes with eventual complete baldness in some part of the scalp with its unique pattern.

This hair loss condition could be started with the evidences of skin inflammation (redness and itching), but this phase might be temporary and patient may not have any signs or symptoms other than hair loss with its specific pattern. Routine medical treatment of hair loss with finasteride (Propecia) or Minoxidil (Rogaine) are generally not beneficial.

Treatment of this condition could be challenging. Treatment with medications is generally not successful in prevention of the hair loss and to reverse the process. Hair transplant surgery could be an option, but it could not be done in the acute phase of the disease. Hair transplant surgeon need to consider hair restoration surgery for Central centrifugal cicatricial alopecia when the active phase is over and when the inflammation is completely subsided. I would like to do a small test hair transplant before committing to the actual hair transplant surgery to be assured of the survival of the hair grafts.

This post was extracted from Hair Restoration Blog, a hair loss question and answer web log.

Patient question and answers on FUE – follicular unit extraction from Hair Restoration Blog:

After Hair Transplant Care

After hair transplant care is something that patients who undergo a hair transplant procedure need to know and follow closely.

Here is the post-op instruction of the patients at US Hair Restoration. Different hair restoration clinics may have different post-op care and instructions due to their different surgical methods.

Patients who had a hair transplant surgery using a strip technique usually leave our hair transplant center with a bandage around their head. The bandage is used only to support the newly closed donor wound on the back of scalp. Patients are given prescription for pain and anti-inflammatory medications for first few days after surgery. The first night after hair transplant surgery, patient needs to be cautious not to rub or scratch the transplanted area. It is recommend that all patients take it easy for the first days and avoid heavy physical exercises.

All patients need to come back for physician evaluation and hair wash the day after surgery. During this first visit, the bandage is removed and donor wound and the transplanted hair is assessed. The donor and recipient areas need to be washed very carefully while teaching the patient how to wash it at home during day two to four after hair transplantation. Hair wash after hair transplant surgery needs to be done twice a day with a special method to minimize the probability of dislodging the grafts. Patients ask if they can skip washing hair within the first few days to avoid damaging the grafts. The answer is “No”. Hair wash is a key step in hair transplant care that guaranties the normal growth of the transplanted hair follicular grafts.

There are some restrictions in patient’s physical activities after hair transplants. Some clinics recommend very strict rules for physical activities. It is preferred that patient keeps his normal daily activities with some minor limitations. The activities that add to the tension of the wound edges at donor area should be avoided for the first four weeks after surgery. Those activities are: extreme bending of neck and heavy weight lifting.

Patients need to go back to hair transplant clinic at day ten after hair transplant surgery to remove the staples (for patients who had strip surgery and donor is closed with metal staples) and to reevaluate the donor and recipient area. For the patients who have their donor closed with absorbable sutures, it is recommended to be seen in ten days to assess the healthiness of recipient and donor area, which includes patient’s who had FUE (follicular unit extraction) hair transplant, eyebrow hair transplant, hair transplant repair or body hair transplants. All follow up visits are included in the initial cost of hair transplant surgery and patients won’t be charged for any follow up visits.

Patient should avoid direct sun exposure to the recipient area for about six months after follicular unit transplant surgery. Extreme and direct sun exposure may harm the growing grafts. Sun contact may also cause skin changing the skin color.

And finally the last follow up appointment for their after hair transplant care is between months ten to eleven after their hair transplant surgery, when transplanted hair grows to its final thickness and length. At last session Dr. Parsa Mohebi evaluates the transplanted hair grafts and assesses the finial size and condition of donor scar. This visit is a good time for patients who want to consider a repeat surgery to increase the density of hair or cover the areas that has not been completely covered with first hair transplant surgery due to the limited scalp laxity or extended balding area. All patients who are planning for a repeat surgery do not have to wait that long and a repeat surgery could be done any time after month 5 after the initial hair transplant procedure.

At US Hair Restoration, a LA hair transplant surgery center, patients can also be seen as needed in addition to the above mentioned visits.

After Hair Transplant Care

By: Dr. Parsa Mohebi

After hair transplant care is something that patients who undergo a hair transplant procedure need to know and follow closely.

Different hair restoration clinics may have different post-op care and instructions due to their different surgical methods.

Eveyone who had a hair transplant surgery using a strip technique usually leave our hair transplant center with a bandage around their head. The bandage is used only to support the newly closed donor wound on the back of scalp. Patients are given prescription for pain and anti-inflammatory medications for first few days after surgery. The first night after hair transplant surgery, patient needs to be cautious not to rub or scratch the transplanted area. It is recommend that all patients take it easy for the first days and avoid heavy physical exercises.

All patients need to come back for physician evaluation and hair wash the day after surgery. During this first visit, the bandage is removed and donor wound and the transplanted hair is assessed. The donor and recipient areas need to be washed very carefully while teaching the patient how to wash it at home during day two to four after hair transplantation. Hair wash after hair transplant surgery needs to be done twice a day with a special method to minimize the probability of dislodging the grafts. Patients ask if they can skip washing hair within the first few days to avoid damaging the grafts. The answer is “No”. Hair wash is a key step in hair transplant care that guaranties the normal growth of the transplanted hair follicular grafts. Check Before and After Hair Transplant Photo Gallery of US Hair Restoration.

There are some restrictions in patient’s physical activities after hair transplants. Some clinics recommend very strict rules for physical activities. It is preferred that patient keeps his normal daily activities with some minor limitations. The activities that add to the tension of the wound edges at donor area should be avoided for the first four weeks after surgery. Those activities are: extreme bending of neck and heavy weight lifting.

Patients need to go back to hair transplant clinic at day ten after hair transplant surgery to remove the staples (for patients who had strip surgery and donor is closed with metal staples) and to reevaluate the donor and recipient area. For the patients who have their donor closed with absorbable sutures, it is recommended to be seen in ten days to assess the healthiness of recipient and donor area, which includes patient’s who had FUE (follicular unit extraction) hair transplant, eyebrow hair transplant, hair transplant repair or body hair transplants. All follow up visits are included in the initial cost of hair transplant surgery and patients won’t be charged for any follow up visits.

Patient should avoid direct sun exposure to the recipient area for about six months after follicular unit transplant surgery. Extreme and direct sun exposure may harm the growing grafts. Sun contact may also cause skin changing the skin color.

And finally the last follow up appointment for their after hair transplant care is between months ten to eleven after their hair transplant surgery, when transplanted hair grows to its final thickness and length. At last session Dr. Parsa Mohebi evaluates the transplanted hair grafts and assesses the finial size and condition of donor scar. This visit is a good time for patients who want to consider a repeat surgery to increase the density of hair or cover the areas that has not been completely covered with first hair transplant surgery due to the limited scalp laxity or extended balding area. All patients who are planning for a repeat surgery do not have to wait that long and a repeat surgery could be done any time after month 5 after the initial hair transplant procedure.

At US Hair Restoration, a LA hair transplant surgery center, patients can also be seen as needed in addition to the above mentioned visits.