Treatment for central centrifugal cicatricial alopecia-Delphi consensus recommendations.

Background: There is no established standard of care for treating central centrifugal cicatricial alopecia (CCCA), and treatment approaches vary widely.

Objective: To develop consensus statements regarding the use of various pharmacological therapies in treating adults with CCCA.

Methods: We invited 27 dermatologists with expertise in hair and scalp disorders to participate in a 3-round modified Delphi study between January and March 2023. Statements met strong consensus if 75% of respondents agreed or disagreed. Statements met moderate consensus if 55% or more but less than 75% agreed or disagreed.

Results: In round 1, 5 of 33 (15.2%) statements met strong consensus, followed by 9 of 28 (32.1%) in round 2. After the final round 3 meeting, strong consensus was reached for 20 of 70 (28.6%) overall statements. Two statements achieved moderate consensus.

Limitations: This study included only English-speaking, US-based dermatologists and did not consider nonpharmacological therapies.

Conclusion: Despite varying opinions among dermatologists, consensus was reached for several statements to help clinicians manage CCCA. We also highlight areas that lack expert consensus with the goal of advancing research and therapeutic options for CCCA.