Cutis Verticis Gyrata
Q: Dr. Eppley, I was recently diagnosed with a very mild case of Cutis Verticis Gyrata . I’m concerned with the size getting larger.I saw a dermatologist who diagnosed it and prescribed topical Ammonium Lactate 12% cream and 500mg of Vitamin C daily and said if it worsens there’s some laser type treatments that were possible but he was very confident it wasn’t going to worsen. I used to frequently get alopecia areola prior to going bald and would receive steroid injections which could be the cause?? I’m very open to having surgery/injections with someone who has done this in the past.
A: Thank you for your inquiry in regards to cutis verticis gyrata (CVG) and sending your pictures. From this information I can make the following statements:
1) No one knows or understands why CVG occurs.
2) Its natural course is completely unpredictable, it may stay the same or get worse over time. No one can predict what it will do in the future.
3) There are no proven treatment methods for CVG, either to treat it or prevent it from getting worse.
4) Topical treatments such as Ammonium Lactate or Vitamin C has no documented efficacy in the medical literature.
5) There are no laser treatments for it. This is a problem that emanates deep in the scalp tissues not on its surface at the skin level.
5) The only logical treatment for it is fat injections mixed with PRP. Since this is a condition of fibrosis, adding new tissue with stem cells and fibroblast activating factors makes the most biologic sense.
6) It is easier to treat CVG early when the fibrosis is less severe then when it is advanced when the tissues are as hard as concrete. (which is what occurs in its more advanced stages)
Dr. Barry Eppley