Type 2 Diabetes Management May Be Linked to Alopecia Severity

Black woman looking at her scalp, skin of color
Shot of a young african woman examining her scalp and hair in front of the mirror
Does a clinical link exist between diabetes mellitus type 2 and prediabetes and the severity of central centrifugal cicatricial alopecia (CCCA) in Black patients?

There may be a link between poor diabetes mellitus (DM) type 2 management and central centrifugal cicatricial alopecia (CCCA) severity in Black patients, according to findings from a retrospective study published in the Journal of the American Academy of Dermatology.

Using electronic medical records, investigators identified all patients with CCCA who were seen at a specialty alopecia clinic from 2016 through 2022. They included patients with a documented hemoglobin A1C (HbA1C) level and clinical scalp pictures taken within 3 months of the HbA1C measurement. Using the CCCA photographic severity scale, scalp pictures were graded for severity and then compared to determine an association with type 2 DM or prediabetes.

There were 20 patients with CCCA and type 2 DM or prediabetes included in the analysis. Patients were matched with a control group of 15 patients with CCCA matched for age, race, and sex who had clinical scalp photos and no diagnosis of type 2 DM or prediabetes. The mean age in both groups was about 50 years. There were no statistically significant differences between the groups regarding average BMI, family history of type 2 DM, or smoking status.

Among patients with type 2 DM or prediabetes, the average HbA1C was 6.93% compared with 5.23% in the control group, and “notably” 7 patients in the diabetic group were on medication to control glucose levels for an average of 5.5 (range, 1-21) years. The average CCCA severity in the diabetic group was 3.16 compared with 2.57 in the control group (P =.043).

The study was limited by its retrospective design and small sample size.

Study authors noted that shared mechanisms in both diseases “may suggest CCCA as a marker of metabolic dysfunction.”


Ali S, Collins M, Taylor SC, Kelley K, Stratton E, Senna M. Type 2 diabetes mellitus and central centrifugal cicatricial alopecia severity. J Am Acad Dermatol. Published online August 22, 2022. doi:10.1016/j.jaad.2022.08.031