Cutis Verticis Gyrata and need HT doc

[ANTWIS79]

I thought i would start this thread bc I think this condition is still new to many who have it and also hair transplant docs who might encounter it with their patients. I am 32 year old male who has had thinning class 3 currently (i think) I have been using Propecia and Rogaine for the last 10 years and have definitely slowed my loss greatly!! Over the last 12 years or so i have noticed the ridges or folds on the top of my scalp . After some internet research i found the non-life threatening condition is called CVG or Cutis Verticis Gyrata. Link to Medscape: Medscape Access . These ridges have been more prominent as I have gotten older. The hair inside the ridges is relatively thicker compared to the hairs around them.

My first Visit was to Dr Feller. He immediately looked at me and to my surprise told me I looked fine and did not need a HT. I was very gracious for his honesty and that he did not just want my money. I was however discouraged after trying to explain my condition. He cut me off before I had a chance to explain CVG from what I remembered. I would like to revisit a consolation to a HT Doc who will take me seriously. My hair loss has continued and I keep my cut short but the CVG shows. I would like to keep my hair longer but need a stronger hairline. If there are any HT Docs on this site who might be interested in this condition, I would like to hear your thoughts and opinions. I would also like others with this condition to share their stories. Also if you have had a HT with CVG, please send me your pics. I would like to hear from a HT doc and their thought on what might be needed for at this point i am ready to move forward with whatever options i might have within my budget. And Dr Feller, if you read this, i still say you rock,, but i want some more hair........... To anyone with CVG,,,,lol, you are not alone........

Edited May 18, 2011 by ANTWIS79
Spelling

[Spanker]

We actually have a very similar scalp.

 

You said, "The hair inside the ridges is relatively thicker compared to the hairs around them."

 

The ridges (I would call) are the high parts and the furrows (again...I would call) are the low part. Do you mean that the ridges have thinner hair than the furrows?

 

Are you wanting hair transplanted in this area or just the hair line?

[ANTWIS79]

I think the hair deep inside the ridges( the furrows) only appears to be thicker since the hair continues to grow inside of them. I think the balding around the area is typical of my familys. I have used anabolic steroids in the past I have found that there seems to be some correlation to anabolic misuse and CVG. I am looking in a HT but need a doc who has a treatment plan that will work for CVG. When I grow hair longer it hides nicely. Have you used anabolics in the past or any type of hormone treaments? Have you consulted with any HT docs?

Edited May 16, 2011 by ANTWIS79

[Spanker]

Only online and they seem to think that it will grow fine, my only concern is a lack of blood flow. That said, I have seen 70 year old men with it that still have hair on the ridges (high parts) so that gives me hope...but my question is why in the heck does hair continue to grow in the furrows? Is there more blood flow? Since you are on medication is your hair lasting longer than most in your family?

I think you only lose hair there if you are genetically disposed to it, but I think it goes quicker in the higher parts for some reason.....

[ANTWIS79]

My hair has definitely hung around longer than that of my older two brothers and father. Propecia was a big big help. I agree, with the hairs on (high parts) does get thinner quicker. I am consulting with another HT Doc this week. I know if I let hair grow it will cover most of CVG but its hard on MY eyes most of the time. The hairs grow in all sorts of directions. Please send me your pics as i am curious of scalp. Are you thinking of getting HT

[Spanker]

Sent, yes I am prolly getting one soon, saving up a little more because of the newest estimate I got, I want to pay cash for everything.

 

You do not appear to have a realy pattern of loss established yet.

 

What are your thoughts about why the loss is faster on the ridges. They should be genetically the same, so there hass to be another reasom....more dht? less blood flow?

 

Ths is a rare condition, but not so rare that is basically no info on it. There are a lot of people that have it. I see them in public, when I was in the Army I saw a few guys with it. It is not a one in a billion thing....wish I knew more about it.

[ANTWIS79]

Not sure about the blood flow. Again my feeling is the hair in the furrows only looks thicker because the hairs follicles are squeezed together.More of an optical illusion. If there was a way to stretch it out, I feel all the hair would look even and consistent . I have read some posts on stress causing it, to over abundant growth hormone levels due to pituitary gland, to wearing a cap too tightly. I have read we are 1 in 100,000. Like you said. I see more and more people with it

 

 

Here is the info I usually find

 

 

Cutis verticis gyrata (CVG) is a superficial medical condition usually associated with thickening of the scalp.

The condition was first described by Alibert in 1837

Sufferers show visible folds, ridges or creases on the surface of the top of the scalp. The number of folds can vary from 2 to roughly 10 and are typically soft and spongy. These folds cannot be corrected with pressure. The condition typically affects the central and rear regions of the scalp, but can sometimes can involve the entire scalp.

Hair loss can occur over time, where the scalp thickens, though hair within any furrows remains normal.

Thus far, due to the (apparent) rarity of the condition, limited research exists and causes are as yet undetermined. What is known, is that the condition is not exclusively congenital.

Classifications

 

CVG is classified according to the presence, or lack of, underlying cause. Many studies seem to show that CVG occurs in individuals in a secondary form to other ailments. However, the condition can also be present on its own.

The classifications are:

*Primary*Primary essential*Primary non essential*Secondary Primary CVG is where the cause of the condition in unknown.Primary essential CVG has no other associated abnormalities. This occurs mainly in men, with a male:female ratio of 5 or 6:1, and develops during or soon after puberty. Because of the slow progression of the condition, which usually occurs without symptom, it often passes unnoticed in the early stage

Primary non essential CVG can be associated with neuropsychiatric disorders including cerebral palsy, epilepsy, seizures and ophthalmologic abnormalities, most commonly cataracts.

Secondary CVG occurs as a consequence of a number of diseases that produce changes in scalp structure. (These conditions include: Acromegaly (excessive growth hormone, due to pituitary gland tumour),Melanocytic naevi (moles), Birthmarks (including Connective tissue naevi, fibromas and naevus lipomatosus), Inflammatory processes (e.g., eczema, psoriasis, Darier disease, folliculitis, impetigo, atopic dermatitis, acne

[Sociallyakward]

Well i just found out about this from spanker like an hour ago, thus began my research...Cant tell you how much it sucks to seemingly be losing your hair at a young age because of CVG. Then you cant shave your head because of the very same reason. I seem to have it but have never taken steroids even tho i do weight lift quite a bit. hmmm. Some celebrities that seem to have it are Biz markie and Terry cruz. But biz still has his hair. But hopefully you guys will keep posting your experiences for people to see.

[Spanker]

I honestly feel that in most cases hair loss is not due to CVG, but due to Male Pattern Baldness. I really don't think the loss is from the CVG, unless the CVG is extremely severe.

[time123]

Let me clear this up.

 

I feel that where hair loss occurs at the top of the ridges, but is normal within the furrows - then Cutis Verticis Gyrata IS THE CAUSE of the hair loss.

 

I suffer from CVG and have started losing hair only where the scalp thickens.

 

In terms of family history, there's not one person in my family suffering from MPB or hair loss of any sort.

 

I do weight train - however, I've never taken steroids, and whilst there is one study that had a patent who turned up with CVG having used steroids - the steroid use I feel was not the cause of the condition - and the study could not conclude for sure that this was the case either - they just speculated.

 

I have tried creatin - but don't think that would have caused this.

 

I think the build up of collagen or whatever it is that causes the underneath of the scalp to thicken and bulge somewhat is detrimental to hair growth and can cause hair loss to occur.

 

I think that generally the top of the scalp at the back where most people start balding first is probably a weak area, and any sign of CVG in that area willl result in hair loss.

 

The condition is a PITA, and I wish some doc somewhere could work out a fix to what seems like a simple condition.

 

Perhaps some sort of liposuction to remove the excess fibreous tissue in the first instance. Where are the scalp experts?!

Edited June 22, 2011 by time123

[Spanker]

I have to disagree, for 2 reasons, the first reason is that I have seen much older guys with CVG that I have seen with very short hair that have no signs of balding. There is a case study that you could google, he is in his seventies, with pretty severe, black man. Never really knew he had CVG until he cut his hair.

 

The second reason is that I had a ht doctor talk to another ht doctor who had done a transplant on a cvg and he said that it was quite successful. While I do believe that the hair falls out a little quicker, maybe much quicker, in the higher are of the ridges, but I can feel confident that it is not the actual cause of hair loss except in very severe cases. I only have hair loss in my CVG areas where many people lose hair, but it does seem like it falling out first. This is just my observations, and I think this is true for me and many others, but it may not be for you. I am in a 5 person email group of people with CVG. You can send me a messege with your email and I will add you to the list. Most of us are doing research with doctors, consults, etc.

[Traction]

Hey there, I suffer from CVG too. The dermatologists I've been too, have been clueless about it...and printed off information for me to read...which was the same info I found!

 

Has there been any progress into treatments of it? As its causing alot of stress.

[Traction]

Also, Spanker I can't send you a pm? I want to give you my email so I can keep in touch with any developments.

[Traction]

I've found this article,

 

Treating Cutis Verticis Gyrata Using Skin Expansion Method

 

 

Abstract

 

The objective of this study was to evaluate the feasibility and clinical effect of repairing scalp defect after the excision of cutis verticis gyrata using expanded scalp skin flaps. For this purpose, 8 patients with cutis verticis gyrata were subjected to scalp skin expander implantation under the skin. After saline injection and scalp expansion for 2–3 months, the cutis verticis gyrata was excised and the expanded scalp flaps were applied to recover the skin defect. As a result, the flaps and hair grew well without contractures and significant scarring, suggesting that this method is useful for surgical correction of cutis verticis gyrata."

 

SpringerLink - Cell Biochemistry and Biophysics, Online First

[TakingThePlunge]

Traction,

 

Welcome! As a new member, you won't be able to send PM's until your account is verified. It may take a couple of days. If you are unable to send PM's at that time, feel free to email me and I'll check into it for you.

 

service@hairtransplantnetwork.com

 

Best of luck!

[Spanker]

That seems like quite a severe treatment and may be appropriate if the CVG was bad enough. The degree of CVG varies greatly from very minor to disfiguring, so it would really depend on where you are in the spectum of things to know if this would me worth looking further into.

[Cam Simmons MD ABHRS]

First let me say that I do not have a lot of experience with CVG.

 

After seeing a CVG patient in consultation and seeing email photos of another a couple of years ago, I realized that I had done a hair transplant a couple of years ago on someone with very mild CVG. He had 2 sagittal slight indentations that could be felt at the time of his hair transplant but not really seen. I wondered at the time if he had a couple of childhood scars he didn't remember. I since saw him in follow-up and his hair transplant grew well. I believe that his hair loss was caused by male pattern baldness. He had a classic Norwood 5 pattern and the indentations were most easily felt where his hair was thickest in the band across the midscalp. His CVG likely had not progressed.

 

For patients who see thinning in an area affected by CVG, it is possible that hair is being spread apart more in the ridges and not spread apart in the furroughs. Also the way the skin thickens, the hair direction will tend to fan out from side to side on the tops of the ridges and will criss-cross in the bottom of the furroughs. That will also make the hair look thicker in the furroughs and thinner in the ridges.

 

I could not find much about treatment for CVG. There was a report about subcision to reduce the depth of the furroughs, which is basically undermining under the furrough with a needle through multiple entry points. In the accompanying photos there was some evening out of the skin but it wasn't perfect. There were other reports of scalp reductions and flap rotations to remove more pronounced ridges and furroughs.

 

My patient had barely noticeable CVG and his hair transplant grew quite well. I don't know about the effect or more pronounced CVG on hair transplantation. If I find some colleagues with experience with CVG I will ask them to reply.

[Spanker]

I spoke with Dr. Ron Shapiro about this and he stated that he asked about it in an email group with other doctors one of them had done a proceedure with a patient with moderate CVG and it grew fine.

 

MPBsucks is going to be a great case to follow for this reason as well as we will have documented proof of grafts taking well (hopefully).

 

Also, I too have seen the pictures of the subcision treatment and I was less than impressed.

 

I am actually fairly suprised that more docs do not have experience in this as I see this condition pretty often, being somoone who notices it quite easily because I have it. I work in a pretty small hospital and myself (moderate form much like MPBSUCKS)and 2 African American physicians also have a mild form. I also saw a visitor (causcasion male) with it just yesterday.

[Traction]

A dermatologist told me I'm in the unforunate position that the CVG is not severe. But it still causes distress, in that I am unable to shave my head.

 

I do not have any hairloss in the crown. I was considering strip, but I don't want to mess with my scalp and the bumps. I do have migranes, but neurologist has said this is not related...only a physical was done and no scans.

 

So I'm considering FUE to fill in the front and sides, if there isnt a viable option to reduce the cvg, to the point where I can shave my head.

[NEWHAIRPLEASE]

Antwis79

Your hair does not actually look bad at all, In fact, from straight on I will bet it looks pretty good..has your loss progressed since you last saw Dr Feller? Your right, Dr Feller does rock. Maybe at the time , in his professional opinion, he didn't think you had this..maybe you should go see him now. If not, certainly make an appointment with another recommended doctor on this site as you certainly seem like you are headed in the right direction..anyway, good luck and keep us updated!

[gunnersbee]

hi, i have just found this forum. i too have recently found out i have cvg. i have diagnosed it myself as 6 doctors have looked at it and told me they didnt know what it is! i was aware of the ridges about 10 years ago and they have got worse over time. it didnt bother me too much until i started losing my hair. i am now dreading my scalp becomming visable and im am looking for answers. i have a few questions that i hope someone can answer!

i see this thread is a couple of years old so wondered if anyone had anything up to date to report

 

i would like to know

do the ridges continue to grow as you get older?

 

can anything be done about them?

 

and will a ht work?

[hairshopeing]

The 2 guy on here with cvg I know of are mpbsucks and spanker!! Both nice informative guys who I am shore would spread some light on this topic for you!! Both have had ht done!! Search there names and give them a shout!!

[gunnersbee]

Thanks for the reply hairshoping

[Spanker]

The only thing that can really be done is excision. Do you have any photos? I believe an ht will work. I didn't have much work on a cvg area. Everything I read says it gets worse but mine has been the same pretty much since I was 18. I may have gotten a few little extra bumps, I'm not sure. I would consider finasteride to keep what you have.