Central centrifugal cicatricial alopecia (CCCA) is a scarring hair loss disorder that primarily affects women of African descent. This condition can lead to permanent hair loss if not treated. While the exact cause of CCCA is not fully known, some research has shown that metabolic disorders, such as type 2 diabetes, may contribute to the inflammation and scarring seen in CCCA. This emphasizes the importance of exploring treatments that can address both CCCA and type 2 diabetes.
What are GLP-1 receptor agonists, and how do they work?
Glucagon-like peptide-1 receptor agonists (GLP-1As) are commonly used to treat type 2 diabetes. They facilitate weight loss by increasing insulin secretion, which in turn decreases blood glucose levels.
Study overview
In this retrospective study, the authors reviewed medical records of adult patients with CCCA seen at the University of Pennsylvania between 2019 and 2023 who were also using a GLP1A. A total of 81 patients met the inclusion criteria for this study, all of whom were Black females. Patients were classified as responders based on improvement in scalp inflammation, scalp symptoms, or hair regrowth at follow-up visits. The study examined the duration of GLP1A use, metabolic markers such as hemoglobin A1C, and concurrent use of standard CCCA therapies.
Key findings
Of the 81 adults included in this study, 47 (58.0%) were responders, and 34 (42.0%) were nonresponders. There were no meaningful differences between responders and nonresponders in demographics (e.g., age, smoking history), baseline metabolic profiles (e.g., hemoglobin A1c at initial visit), or use of standard CCCA treatments (e.g., topical or intralesional corticosteroids, topical or oral minoxidil, or antibiotics). However, responders used GLP1As for a longer time than nonresponders (3.04 ± 2.61 years vs 2.42 ± 2.80 years). Responders also showed greater improvement in blood glucose control, with a decrease in hemoglobin A1C between initial and follow up visits (−0.5 ± 0.74), compared to a slight increase among nonresponders (0.1 ± 0.2).
Implications and limitations
The findings of this study suggest that longer GLP1A use and lower hemoglobin A1c were associated with better clinical outcomes in CCCA when combined with standard therapies. Medications that improve blood glucose control, such as GLP1As, may play a role in managing inflammation and scarring associated with CCCA. However, this study was limited by its retrospective design, small sample size, and missing data. Larger prospective studies are needed to better understand whether GLP1As can directly influence the progression of CCCA disease.
References
Desir N, Encarnacion IN, Schell N, Anusionwu I, Ogunleye TA, Taylor SC. GLP-1 agonists may modulate treatment efficacy in central centrifugal cicatricial alopecia. J Am Acad Dermatol. 2025;93(3):771-773. doi:10.1016/j.jaad.2025.04.058
Summarized by: Nancy Anabaraonye, BA – Harvard Medical School
Reviewed by: Dr. Kathie Huang, MD, FAAD