Patients with Central Centrifugal Cicatricial Alopeciawere recruited from Durban, from 2013 to 2016 and in Winston-Salem, North Carolina, from 2014 to 2017. Pic: Supplied
Professor Ncoza Dlova, Dean of UKZN’s School of Clinical Medicine and  internationally renowned dermatologist, through her global collaborative work with a  number of scientists; has identified a new gene that is a major cause of permanent  hair loss amongst women of African descent. 

They discovered the root cause of  Central Centrifugal Cicatricial Alopecia (CCCA), one of the most common causes of  scarring alopecia amongst African women.

This ground-breaking study, titled:  ‘Variant PAD13 in Central Centrifugal Cicatricial Alopecia’ was published recently in  the New England Journal of Medicine, one of the highest impact journals in medical  science.

Patients with CCCA were recruited from Durban, from 2013 to  2016 and in Winston-Salem, North Carolina, from 2014 to 2017. 

CCCA is  defined as hair loss or spot balding that starts from the central (crown) part of the  scalp and radiates outward in a circular pattern. CCCA causes destruction of the hair  follicles leading to scarring and permanent hair loss.

It is very common amongst  women of African descent. The root cause of this condition has always been elusive  and alluded to the use of damaging chemical products on the hair as well as the  application of heat brushes, hot combs or straighteners. 
It has often been confused  with female pattern hair loss or common baldness which is a completely different  entity.

This study found that the gene, peptidylarginine deiminase 3, (PAD13); which  mediates posttranslational modification of proteins essential for proper hair shaft  formation was mutated in the majority of affected patients suggesting that the  disease is genetically heterogeneous.

So what can we learn from these research findings? 

The results suggests that PADI3 mutations predispose individuals  to CCCA and this presents or is triggered by environmental factors like damaging
hair grooming practices like use of hair chemicals, traction, heat , braids and  weaves.

This implies that in affected families, the above mentioned practices should  be totally discouraged.

Commenting on this exciting finding, Dlova said:

‘This is probably the biggest  breakthrough in South African Dermatology. This discovery is a first in the world, and it followed links to my earlier publication of 2013, in which I reported for the first time a familial association in a cluster of black South African families with CCCA and have been following the 15 families for 5 years, and 7yrs later a gene has been identified.
This has huge implications on early diagnosis, prevention and possible future targeted therapy of CCCA.’