What is the Link Between CCCA and Uterine Fibroids?

While you may have heard that Central Centrifugal Cicatricial Alopecia (CCCA)—a type of permanent, scarring hair loss that usually starts at the center of the scalp—is linked to uterine fibroids (noncancerous growths in the uterus), the current medical evidence shows a possible connection but not a proven cause-and-effect relationship. Some research suggests that people with CCCA might have a higher chance of also having uterine fibroids, but other studies have found no increased risk at all ^[1][2]. Because both conditions are very common in Black women, experts are still working to understand if they truly share an underlying biological cause or if they simply happen to occur often in the same population.

Bottom Line Summary

• CCCA does not cause fibroids, and having CCCA does not mean you automatically have them.
• Research on the link is mixed and inconclusive.
• You do not need a pelvic ultrasound solely because you have CCCA.
• You should seek medical evaluation if you develop abnormal bleeding, severe pelvic pain, or signs of anemia.

Understanding the Research on CCCA and Fibroids

The medical community has been investigating whether CCCA and uterine fibroids are linked because researchers hypothesized they might both be “fibroproliferative” conditions—meaning they involve a process of inflammation and excess tissue scarring ^[3][4]. However, this is just a theory. Direct genetic or molecular evidence linking the two conditions is currently weak, and they do not share a proven biological cause ^[5].

When looking at the numbers, the research is mixed:

• Some studies suggest a connection: A 2025 review that combined data from multiple studies estimated that about 28% of people with CCCA also had uterine fibroids ^[1]. The review found that, on average, the odds of having fibroids were higher in people with CCCA than those without it ^[1]. However, this 28% is a pooled average from specific study groups, not a prediction of your personal risk, and the results varied widely between the individual studies ^[1].
• Other studies show no connection: In contrast, a large study comparing 427 Black women with biopsy-confirmed CCCA (diagnosed by a tissue sample) against 1,281 women without the condition found that the CCCA group was not more likely to have fibroids ^[2]. Another smaller study also found no meaningful mathematical difference in fibroid rates ^[6].

It is important to note that uterine fibroids are very common overall, especially among Black women, with estimates suggesting up to 80% may develop them by age 50 ^[7][8]. Because fibroids are already so prevalent, it makes it challenging for researchers to determine if having CCCA actually increases your risk, or if the two conditions just frequently happen to co-occur in the same demographic ^[9][10].

What This Means for Your Health

The most important takeaway is that having a CCCA diagnosis does not mean you automatically have or will develop uterine fibroids ^[1][11].

Because a direct link is not fully established, medical guidelines do not recommend that you get a routine pelvic ultrasound or other imaging just because you have CCCA ^[1][11]. In fact, many uterine fibroids do not cause any symptoms and require no treatment or further investigation ^[11]. If fibroids are found, whether they need treatment depends on your symptoms, their size and location, and your pregnancy or fertility goals.

Symptoms to Watch For

While you don’t need automatic testing, you should be aware of your body and monitor for symptoms that might indicate uterine fibroids or other reproductive health conditions. If you experience any of the following, report them to your primary care doctor or gynecologist:

• Abnormal bleeding: This includes menstrual periods that are unusually heavy, prolonged, irregular, or occur between cycles ^[7].
• Postmenopausal bleeding: Any vaginal bleeding after you have gone through menopause always requires prompt medical evaluation ^[7].
• Pelvic pain or pressure: A feeling of fullness, bulkiness, or dull pain in your lower abdomen or pelvis ^[7].
• Bathroom changes: Needing to urinate frequently or experiencing unexplained constipation ^[7].

If your doctor suspects you might have fibroids based on your symptoms and a physical examination, an ultrasound is commonly the first step used to see what is going on ^[12]. They may also recommend a blood test (complete blood count) to check for anemia or a pregnancy test if relevant.

When to Seek Urgent Care

Heavy bleeding and severe pain can sometimes become medical emergencies. Seek urgent or emergency medical care if you experience:

• Bleeding that soaks through one or more pads or tampons every hour for two or more hours consecutively.
• Signs of severe blood loss, such as feeling dizzy, lightheaded, unusually weak, short of breath, or fainting.
• Severe, sudden, or rapidly worsening pelvic pain.
• Bleeding or pain when there is a possibility you could be pregnant.

Keep a record of your bleeding days, the number of pads or tampons used, pain levels, and any dizziness to share with your clinician. This information is highly valuable for determining the best next steps for your care.