What began as bumps on the back of his head gradually evolved into severe inflammation, painful nodules, drainage, and extensive scalp changes. Simple activities became difficult. Confidence faded. Social interactions became something to avoid rather than enjoy.

The condition affected far more than his scalp.

It affected how he moved through life.

Compounding those challenges was the emotional aftermath of a serious car accident years earlier. By the time John met Dr. U, he was carrying both physical and emotional burdens that had accumulated over decades.

When the Condition Takes Over Daily Life

John’s case was unusually complex.

During his evaluation, Dr. U identified multiple advanced scalp disorders occurring at the same time, including acne keloidalis nuchae (AKN), folliculitis decalvans (FD), and cutis verticis gyrata (CVG).

Years of inflammation had created painful lesions, recurring drainage, and significant changes to the scalp.

Previous treatments, including antibiotics, topical medications, and visits with multiple specialists, had failed to provide lasting improvement.

The discomfort affected his sleep.

The appearance of the lesions affected his confidence.

The emotional weight affected nearly every part of his life.

Finding Someone Who Saw the Whole Picture

For many years, John searched for answers.

He was often told he had infections, ingrown hairs, or scalp keloids. Treatments came and went. The symptoms remained.

By the time he arrived at Dr. U’s clinic, he was looking for more than another temporary solution.

He wanted understanding.

He wanted a plan.

Dr. U’s evaluation extended beyond the visible scalp disease. Laboratory testing revealed that John was also at increased risk for developing type 2 diabetes.

Instead of rushing directly into surgery, the focus shifted to improving his overall health first.

Through careful planning, medical management, and support from the Hair Peace Foundation, John finally had access to a comprehensive treatment strategy designed around his specific needs.

The Work That Happened Before Surgery

The next chapter required patience.

After beginning semaglutide therapy and making significant lifestyle changes, John committed himself to improving his health.

He adjusted his diet.

He increased physical activity.

He remained focused on the goal ahead.

Month after month, the progress continued.

By the time he returned for reassessment, John had lost approximately 72 pounds and met the surgical readiness criteria established by the clinical team.

The achievement represented more than a number on a scale.

It demonstrated determination, discipline, and a commitment to creating the best possible conditions for treatment.

The Day Everything Changed

When surgery day arrived, John’s sister was by his side.

There was relief.

There were nerves.

And there was hope.

For the first time in years, John felt he was moving toward a solution grounded in careful evaluation and evidence-guided care.

Dr. U performed surgery to remove the chronic inflammatory scalp lesion while addressing the underlying disease process responsible for years of symptoms. To support healing, nanofat enriched with regenerative cells from John’s own tissue was applied during the procedure.

The operation was completed successfully.

But perhaps the most important outcome was what came afterward.

A renewed sense of possibility.

A Future Bigger Than the Condition

After surgery, John began looking forward again.

The condition that had shaped so many years of his life no longer occupied the center of every thought.

Instead, he focused on the future.

On reconnecting with people.

On rebuilding confidence.

On returning to the outgoing personality his family knew so well.

His story is not simply about surgery.

It is about perseverance.

It is about refusing to stop searching for answers.

And it is about discovering that healing often begins when someone finally sees the whole person, not just the condition.

For medical details of this case, visit dru.com.

Watch John’s Story

Watch John’s journey and see how determination, family support, and personalized care helped him reclaim hope for the future.

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Take the Next Step

If you are living with folliculitis decalvans, acne keloidalis nuchae, or another chronic scalp condition, early evaluation can make a meaningful difference. Learn more about John’s story on dru.com and consult a qualified physician for personalized guidance.

At The Bumpinator and The BaldCast, every patient is a hero.

Disclaimer: This story reflects one patient’s personal experience and treatment by Dr. Sanusi Umar. Individual results vary. Always consult a qualified physician for personalized advice.

The post John’s Road Back first appeared on Bumpinator.

The post John’s Road Back appeared first on Bumpinator.

Primary Form

The primary form of bulldog scalp syndrome, or CVG, affects the vertex and occipital regions on the scalp, with folds running symmetrically in an anterior-posterior direction.

The two types are:

•  Primary Essential CVG: This form is prevalent among young adults, especially postpubertal men. The cause is attributed to genetics and endocrine factors.
•  Primary Non-essential CVG: Unlike the primary essential, the non-essential CVG is often associated with various abnormalities such as schizophrenia, epilepsy, retardation, ophthalmologic and cranial abnormalities.

Secondary Form

The secondary form of bulldog scalp syndrome, or CVG, is associated with inflammatory and underlying scalp diseases. These may include cutis laxa, syphilis, amyloidosis, intracranial aneurysms, and acromegaly. 

What Causes Cutis Verticis Gyrata (CVG)?

Little research on the disorder shows that the cause is still undetermined. Understanding the etiology of CVG shows that it is not an individual disease entry. It is a manifestation of diverse causes:

Hormonal: The post-puberty onset of CVG and the male dominance suggest that various hormones can cause the disorder.

Imbalances of the growth hormone (GH) in some cases may lead to acromegaly or other endocrine disorders, which affect the overall physical growth of the body.

Genetics:

Genetics is often linked to the primary non-essential CVG, where the form is associated with neurodevelopmental disorders like epilepsy and retardation, among other genetic syndromes such as Turner Syndrome and Acromegaly.

Chronic Inflammation: Persistent scalp infections with recurrent inflammations may affect the skin, developing CVG folds and ridges.

Symptoms of Cutis Verticis Gyrata (CVG)

Although CVG symptoms are distinctive and visible ridges and furrows, here are others to look out for:

Primary Symptoms

• Ridges and Furrow: These are very noticeable from the onset, with soft folds varying in prominence and depth. The ridges and furrows grow gradually over time.
• Thickened Skin: During the early stages, the skin on the scalp thickens and becomes sponge-like to the touch.

Secondary Symptoms

In the case of secondary CVG form, one might experience additional symptoms related to underlying disorders or conditions:

•   Hair loss or thinning on the affected areas.
•   Discomfort and itching
•   Other skin and hair conditions
•   Symptoms related to underlying disorders may include weight loss or gain, fatigue, and enlarged body parts. 

How is CVG Diagnosed?

Bulldog scalp syndrome is particularly easy and fast to diagnose. Dermatologists examine the scalp physically. The presence of furrows and ridges is sufficient to diagnose CVG.

In rare cases, a specialist will further assess other visible symptoms to classify them as primary or secondary CVG.

In the case of secondary CVG, diagnostic tests such as skin biopsy and blood tests may be ordered to check for underlying disorders such as thyroid, acromegaly, or other scalp inflammatory diseases.

Patients with CVG are advised to avoid self-treatment to ensure a correct diagnosis has been made by a certified dermatologist, who may, in turn, refer them to specialists based on the findings. 

What does Bulldog scalp syndrome look like? 

How Do You Treat CVG?

It is important to determine the form of Bulldog scalp syndrome/CVG diagnosed (primary or secondary) before proceeding with the treatment to ensure the methods used are effective.

To properly treat CVG, specialists are required to manage the cosmetic needs associated with changes in the scalp skin and the underlying conditions leading to the effects on the skin.

Cosmetic Treatment

1. Surgical procedures

The most effective treatment method is surgical intervention, which depends on the location and size of the CVG folds. Big folds may require skin grafts and local flap reconstructions, while smaller furrows can be managed with simple cuts out of the affected area.

Surgical procedures include:

• Scalp reduction to flatten the surface.
• Laser Therapy to make the scalp skin smooth.
• Hair transplant

2. Topical Treatments to manage dryness and itching.
3. Use of corticosteroid injections to reduce inflammation.

Managing Underlying Conditions

• Hormonal therapy
• Treatment of associated dermatological conditions
• Preventing progressive skin changes through essential treatment of underlying disorders.

Self-Care

• Patients are encouraged to practice scalp hygiene by cleaning between furrows and ridges to prevent bad odors and secondary infections. Ensure products used are mild to the skin to reduce irritation.
• Avoid tight headgear or hairstyles to minimize scalp trauma.

CVG patients, especially those with associated conditions, require regular monitoring by specialists to assess progress and address complications or adjust treatment.

Relationship Between CVG (Cutis Verticis Gyrata) and AKN (Acne Keloidalis Nuchae (AKN)

CVG and AKN are both scalp conditions prevalent in men and characterized by small and large folds on the back region of the head. A 2022 research study on the relationship between dermal thickening and excessive folding in both disorders revealed that the spreading of AKN lesions preceded the onset of CVG by two years for patients affected by the two disorders. 

In the wake of the research findings associating AKN and CVG, dermatologists have become more aware of the possibility of patients experiencing one after the other or both simultaneously. Specialists can now take precautions in addition to suggested treatment methods to manage the disorders. 

Frequently Cutis Verticis Gyrata Asked Questions (FAQ)

Is Cutis Verticis Gyrata treatable?

Treatment options include managing underlying conditions, symptoms, and cosmetic needs.

Is Cutis Verticis Gyrata hereditary?

Some forms of CVG contain genetic components. However, the disease is rare and patternless.

What causes Cutis Verticis Gyrata/Bulldog Scalp Syndrome? 

The exact cause is yet to be established. It can be either primary (spontaneous disease) or secondary (underlying conditions).

How can I treat Cutis Verticis Gyrata? 

Complete a free consultation for your hair loss with board-certified dermatologist Dr. Sanusi Umar by using this link: https://dru.com/hair-free-consultation/ or

Check out Dr. Bumpinator’s remarkable journeys with his patients using this link:  https://bumpinator.com/bumpinator/how-this-big-lucky-akn-bear-overcame-his-breaking-point-part-1/

References

Jeong, J., Daniela Tiemi Sano, Silvia Regina Martins, Antônio José Tebcherani, & Paula, A. (2014). Primary essential cutis verticis gyrata – Case report. Anais Brasileiros de Dermatologia, 89(2), 326–328. https://doi.org/10.1590/abd1806-4841.20142949

Koregol, S., Yatagiri, R., Warad, S., & Itagi, N. (2016). A rare association of scleromyxedema with cutis verticis gyrata. Indian Dermatology Online Journal, 7(3), 186. https://doi.org/10.4103/2229-5178.182365

Larsen, F., & Birchall, N. (2007). Cutis verticis gyrata: Three cases with different aetiologies that demonstrate the classification system. Australasian Journal of Dermatology, 48(2), 91–94. https://doi.org/10.1111/j.1440-0960.2007.00343.x

The post What is Cutis Verticis Gyrata (CVG) or Bulldog Scalp Syndrome? first appeared on Bumpinator.

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