When people see thinning hair, suddenly everybody has an opinion. “Cut it all off!” “You should try this!” “You need to go get those shots!” Sis, it's YOUR hair, YOUR scalp, and YOUR journey. Somebody else can't make the whole decision for you based on a picture. 😭
In this part of my Central Centrifugal Cicatricial Alopecia (CCCA) journey, I'm sharing some of the steps I went through, including doing a big chop, trying steroid injections, and meeting with a dermatologist. I'm also explaining something that took me time to understand: cutting your hair, treating inflammation in the scalp, and caring for the hair shaft are three different things.
There is room for personal experience, science, and hope in the same conversation. I want you to understand what these options actually do, so you don't think a big chop must “reset” a scarred follicle—or assume somebody else's injection experience predicts your own outcome.
Watch my CCCA journey: The Big Chop, Steroid Shots & Dermatologist Visit
Watch my full conversation below, including what I experienced and what I learned while working through CCCA. The information in this article adds background and research to the video, rather than claiming my personal choices are a treatment plan for everybody.
Watch “CCCA Hair Loss: I Did the Big Chop, Tried Steroid Shots…” on YouTube.
Before anything else: what actually is CCCA?
CCCA stands for Central Centrifugal Cicatricial Alopecia. “Central” refers to the center of the scalp, often the crown. “Centrifugal” describes the pattern of spreading outward. “Cicatricial” refers to scarring, while alopecia simply means hair loss.
What makes this different from ordinary hair breakage? CCCA involves a process in the skin around hair follicles. When inflammation causes follicles to be permanently replaced by scar tissue, those follicles may no longer produce hair. That is why the timing and location of changes matter. The American Academy of Dermatology explains that some people notice breakage or thinning at the crown before more obvious bare areas become visible.
I also want you to know that some people experience burning, itching or tenderness, while others may not notice those symptoms. An absence of itching does not prove that a scalp is free of disease activity. And not every thin crown is CCCA—different conditions can cause overlapping appearances.
My big chop: what cutting my hair changed—and what it didn't
Let's talk about the scissors. A big chop can feel emotional and freeing at the same time. For some people, starting with shorter hair makes it easier to manage their routine, eliminate damaged ends and stop fighting with uneven lengths. For others, keeping more length and trimming gradually feels right. I understand both.
But a big chop is a haircut. It removes or shortens the visible hair shaft. It does not physically remove the inflammatory process beneath the skin that causes CCCA, and it cannot make a destroyed follicle grow hair simply because its older hair was cut off.
That means you can do a dramatic big chop and still have a thinning area at the crown. The cut doesn't mean you failed if your scalp doesn't immediately look different. It means we have to separate changes in length from changes in follicle health.
For me, telling this part of my story matters because the visual transformation can make people expect an instant biological transformation, too. Those are not the same thing. Your mental relationship with your hair may change after a big chop even while the health of your scalp requires its own attention.
Does the big chop make your hair grow faster?
No. Hair growth originates at the follicle beneath the skin, not at the ends that were cut. Removing split or fragile ends can help prevent some tangling and breakage, which may make it easier to retain the new length you grow. That isn't the same as speeding up the follicle's rate of growth.
What were those steroid shots actually meant to do?
When people hear “steroid shots,” they may immediately think of something used to build muscle. That isn't what we're talking about. Dermatologists sometimes use intralesional corticosteroid injections—medication injected directly into affected scalp skin—to help control inflammation in conditions such as CCCA.
The treatment goal is generally to limit active inflammation and protect follicles that remain functional. It is not a guarantee that follicles already replaced by scar tissue can be revived. Treatment plans vary according to disease activity, tolerance and individual circumstances.
In my video, I discuss trying steroid injections as part of my own experience. I don't want anybody to hear that and conclude that if something did or didn't happen for me, the exact same thing must happen to them. Personal experiences matter, but they aren't controlled studies.
The AAD discusses corticosteroid treatment as one option for CCCA, alongside other approaches. Decisions about injection dose, frequency and suitability belong in an individualized medical conversation.
Are steroid injections painful or risky?
People report different levels of injection discomfort. Potential adverse effects include temporary soreness, pigment changes and localized skin thinning or atrophy; their likelihood depends on technique, dose and individual factors. This is another reason not to copy another person's medication experience from a video.
My big chop, my photos, and why a visual comparison isn't a diagnosis
Before-and-after pictures can tell a powerful story. You know I use photos because I want to document what is going on with my own hair. But they can also be misleading if the camera angle, lighting, hair condition or styling isn't comparable.
With a short style, the scalp may become more visible and help you observe your hairline or crown. With a longer style, the shape and direction of the hair can hide or exaggerate patches. Neither tells the whole story of what is happening beneath the skin.
When you're documenting your hair, use comparable lighting and angles. Record the dates, the symptoms and your overall routine. If your scalp changes over time, those details can help you explain what you've noticed instead of relying on one picture taken on a good hair day.
Why I had to separate medical treatment from my hair-care regimen
You know I formulate hair and skincare products, so naturally I pay attention to ingredients, cleansing, moisture and scalp comfort. But just because I own Sydney Nicole Products doesn't mean I'm going to confuse what a conditioner does with what a medical anti-inflammatory treatment is designed to do.
A shampoo cleanses. Conditioner makes strands easier to manage and may reduce friction. A cosmetic scalp mist can feel refreshing for people who tolerate its formula. Low-tension styling reduces avoidable mechanical stress. Those are meaningful functions in a hair-care routine—but none of those things proves that a destroyed follicle has been restored.
That's how I want people to think about building a regimen: understand the problem and let each step do its appropriate job.
What I focus on with my own hair
- Cleanse consistently: regularly shampoo the scalp instead of allowing buildup to accumulate beneath styles.
- Condition and detangle gently: support the strands without pulling through knots.
- Deep condition weekly: I often use Rosemary & Peppermint Herbal Deep Conditioner and prefer a plastic cap with a towel rather than direct heat.
- Protect vulnerable sections: I choose low-tension mini braids, twists and comfortable crochet styles rather than styles that pull.
- Use cosmetic scalp products only as tolerated: if something causes irritation, I pay attention rather than assuming burning means it's working.
- Check changes over time: compare my crown pictures, not somebody else's timeline.
The point of this list isn't to prescribe somebody else's care. It's to show how a routine can be organized without pretending that every product does the same thing.
When the big chop and steroid shots get talked about like they're competing options
“Big chop or steroid shots?” makes a good conversation starter, but biologically these are not interchangeable procedures. Sometimes a person may choose shorter hair for styling reasons while also receiving treatment aimed at inflammation; sometimes their situation may call for different decisions.
Cutting damaged ends does not substitute for addressing an inflammatory scalp disorder. Likewise, scalp medication doesn't automatically protect the longer hair shafts from rough detangling, friction or tension. Each part of a hair-care plan has its own purpose.
What I wish people knew before giving advice to someone with CCCA
First, please stop telling someone that their crown is thinning because they didn't use the right oil. Second, cutting the hair off isn't an instant cure. Third, not everybody wants to share every medical detail or scalp photo—and they shouldn't have to.
People with CCCA can have different degrees of inflammation and scarring, different histories, different styling habits and different responses to treatments. I can share my experience because I want other women to feel seen and ask informed questions. But my story isn't the blueprint for every person's treatment choices.
And there are other reasons for thinning that may happen at the same time, including traction, breakage and different non-scarring forms of loss. That's one reason an individualized evaluation matters when the diagnosis isn't clear.
Questions worth writing down during a CCCA journey
- Where did I first notice a difference—in the crown, temples, edges or throughout?
- Is the change mostly shorter, broken strands, a wider part, or complete hairs shedding?
- Have I noticed itching, pain, burning or tenderness? If not, is the density still changing?
- How long have I noticed the current pattern?
- What hair-care routines, styles or treatments have I tried, and what was the response?
- Am I keeping consistent progress photographs?
- What am I hoping to improve—scalp comfort, preserving density, length retention, or all three?
My cosmetic hair-care products and their place in the story
For anyone who wants to learn about the products I use in my routine, I'll link two options below. Both are for cosmetic hair and scalp care; neither is a replacement for medical management of active CCCA.
Frequently asked questions about big chops, steroid shots and CCCA
Will shaving my head make CCCA go away?
No. A haircut changes the hair shaft above the scalp; it does not resolve inflammation or scar tissue in affected follicles.
Do steroid injections make every person regrow hair?
No. They may be used to control inflammation in appropriate cases, but responses vary, and established scarred follicles may not regrow. Preserving remaining hair can itself be an important goal.
Are steroid injections the only treatment for CCCA?
No. Treatment may involve topical or other medications based on the individual's clinical assessment and treatment plan.
Can I deep condition after a big chop?
You can still care for hair strands at any length with products that your scalp tolerates. Conditioning makes the hair easier to manage but doesn't treat follicular scarring.
Does regrowth in a photo mean scarring was reversed?
Not necessarily. A picture may show a change in coverage or new hair from follicles that remain functional; it cannot establish what happened to a scarred follicle.
My final thought: make room for hope and accurate information
I'm sharing this because I don't want women feeling that they have to pick one person's story as the only possible outcome. You deserve to understand what you're seeing, have room to make your own decisions, and protect the hair and scalp you have today.
And please don't beat yourself up because one thing you tried didn't change everything. My own journey has involved learning, adjusting, documenting and growing in my understanding of CCCA. That's what I'm bringing to the conversation.
And remember, Rome wasn't built overnight. Slow and steady wins the race. It's time to take your crown back® 💜
Continue learning from Black Hair Alchemy
- My 10-Year CCCA Crown Journey
- What Nobody Tells You About Protective Styles
- Hair Breakage or Hair Loss?
- CCCA Hair Loss After 40
Research and references
- American Academy of Dermatology: CCCA diagnosis and treatment
- American Academy of Dermatology: CCCA symptoms
- American Academy of Dermatology: Possible causes of CCCA
- Herskovitz & Miteva (2016): CCCA challenges and solutions
Let's talk in the comments: Watch the full Big Chop and Steroid Shots video and tell me which part of the journey made you think differently about your own crown. 💜
Educational information and personal experience only. This article is not individual medical advice. Corticosteroid injections and other medical treatments should only be used under appropriate professional supervision. Cosmetic products cannot reverse established follicular scarring.
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