South African Professor Ncoza Dlova discovers the source of permanent hair loss

Professor Ncoza Dlova has made what is being described as the biggest breakthrough in hair loss among African women. The study, titled “Variant PAD13 in Central Centrifugal Cicatricial Alopecia” and published recently in the New England Journal of Medicine, details how Dlova, together with US scientists, discovered the core source of Central Centrifugal Cicatricial Alopecia (CCCA).

CCCA is one of the most common causes of scarring alopecia among African women. It 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. It causes the destruction of the hair follicles, leading to scarring and permanent hair loss. It is not the same as female-pattern hair loss or common baldness.

The gene Peptidylarginine Deiminase 3 (PAD13), which helps mature proteins for proper hair shaft growth, was mutated in most of the affected patients the scientist studied. This suggested that the disease is genetically heterogeneous.

The research suggests that PAD13 mutations predispose individuals to CCCA, which then presents or is triggered by environmental factors, like damaging hair grooming practices, including the use of chemicals, traction, heat, braids and weaves.

“CCCA is very common among 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,” the University of KwaZulu-Natal said in a statement.

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Dlova is quoted by The Independent newspaper as saying that the discovery 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. I have been following the 15 families for five years, and seven years later a gene has been identified. This has huge implications for early diagnosis, prevention and possible future targeted therapy of CCCA,” she said.

“None of this would have been possible without the families and our patients showing the will to participate in our research endeavours. I am also grateful to my local and international colleagues for working with me and this is indeed testimony to the power of diversity in research,” said Dlova.

According to the International Society of Hair Restoration Surgery, women represent 14.2% of all hair restoration patients worldwide. Further studies are still needed to explore other facets such as the justification of genotyping in asymptomatic women.