Genetic susceptibility is also a critical pathomechanism affecting hair loss conditions even in rare cases of central centrifugal cicatricial alopecia (hot comb alopecia, PADI3 gene mutation), which is a scarring hair loss, common in middle-aged African-American females displaying inflammation at the edges of balding lesions [29]. Here, PADI3 is linked to central centrifugal cicatricial alopecia.