Treatment-Refractory Central Centrifugal Cicatricial Alopecia Responsive to a Novel Botanical Treatment

Abstract

Purpose Central centrifugal cicatricial alopecia (CCCA) is the most common cause of scarring alopecia in women of African descent. However, current treatments for CCCA, such as immunosuppressants and immunomodulatory pharmaceutical agents, have suboptimal efficacy and undesirable side effects. This case series reports the therapeutic effect of a new botanical formulation (Dr. UGro Gashee) in four patients with histologically supported diagnoses of CCCA. The formulations contain at least three phytoactive ingredients that affect multiple targets in the cascade of pathophysiologic events contributing to CCCA. Possible mechanisms of action include anti-inflammatory effects, inhibiting proinflammatory cytokines, and the net antifibrotic effect of inhibiting transforming growth factor-beta while upregulating AMP-activated protein kinase and peroxisome proliferator-associated receptor-gamma activity. Patients and Methods Four African American women with treatment-refractory CCCA were treated with a new topical botanical formula (cosmeceutical) alone or in combination with its oral formulation (nutraceutical) for 8 weeks to 1 year. The cosmeceutical and nutraceutical treatments contain similar phytoactive ingredient profiles. Treatment outcomes were collected using documented patient reports and images and by direct observation. Results In all patients, scalp pruritus cessation occurred within 2 weeks of treatment, and significant hair regrowth was observed within 2 months. All patients reported a high satisfaction level without adverse effects. Conclusion Patients with treatment-refractory CCCA responded to the novel botanical treatment reported in this study. Further evaluations in a controlled trial with more patients are warranted.

Unveiling a Shared Precursor Condition for Acne Keloidalis Nuchae and Primary Cicatricial Alopecias

“…4 Overall, our findings suggest that apart from therapies directed locally at AKN lesions, an emphasis on early diagnosis and expanded treatment approaches directed at inflammatory scalp-wide diseases (eg, steroids, tetracyclines, or biologics) are necessary for all patients. Therapeutic targets include PPAR-γ, 58 AMP-activated protein kinase, 59 JAK/ STAT, [49][50][51][52][53][54][55] TGF-β, 60,61 and mast cell stabilizers 29 However, secondary therapeutic measures that recognize peculiarities of specific diseases may be required, such as the use of antibiotics for FD, 62 DHT blockers in FFA, 20,21 and the avoidance of chemical and heat injuries in CCCA and shaving micro-traumas in AKN.…”