In short
- The commonest patterns: traction alopecia, CCCA (central centrifugal cicatricial alopecia), androgenetic thinning.
- CCCA is often mistaken for breakage — it is scarring hair loss and needs early diagnosis.
- Protective styles must alternate with rest phases to avoid traction damage.
- Trichologists trained in textured hair are now available across London — Brixton, Peckham, Hackney, Wood Green.
Textured hair (Type 4a–4c) has specific biology, specific styling pressures, and specific hair loss patterns. Historically under-researched, textured hair loss now has a growing London specialist community — this guide points you to the right diagnostic pathway.
The three commonest patterns
Traction alopecia — tight braids, weaves, wigs and locs pulling repeatedly on the same follicles. Recedes at temples and nape first. Fully reversible if caught within 12–18 months; permanent after that.
Central centrifugal cicatricial alopecia (CCCA) — an inflammatory scarring alopecia beginning at the crown and radiating outward. Affects ~10% of Black women. Early diagnosis is critical; late diagnosis means permanent loss.
Androgenetic thinning — the same female-pattern thinning as other populations, though onset can be later.
Getting the right specialist
Not every trichologist has clinical experience with Type 4 hair. Ask directly: how many textured hair patients do you see monthly? What is your CCCA protocol? Look for members of the Institute of Trichologists or the Trichology Society with specific textured hair CPD.
Protective styling — the honest rules
- No braid or weave should ever hurt — pain means damage.
- Alternate protective styles with 2-week rest phases.
- Wash and moisturise the scalp beneath braids weekly.
- Avoid grease that occludes the scalp — use water-based moisturisers.
- Photograph your hairline every 6 weeks to catch traction early.
Textured hair loss is not inevitable — but it needs specialists who see it every week.
Frequently asked
Common questions
Is CCCA reversible?+
The inflammation can be halted with early treatment (topical steroids, tacrolimus, doxycycline). Follicles already scarred do not regrow — early diagnosis is everything.
Do finasteride and minoxidil work for Type 4 hair?+
Yes — the biology of androgenetic alopecia is the same. Formulation choice (foam vs solution) may differ for styling reasons.
Where can I find textured-hair-trained trichologists in London?+
Clinics in Brixton, Peckham, Hackney, Wood Green and Streatham increasingly employ specialists. Our directory filters by textured hair experience.
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