Acne Keloidalis and Its Treatment

Acne keloidalis nuchae is one of the most traumatic and unsightly form of chronic skin disorder, which is also known as keloidal folliculitis and nuchal keloidal acne. This disease is characterized by inflamed lumps and scars throughout the nape and at the juncture of the scalp.

What It is

Although, there is no connection between this ailment and common acne; however, at the initial stages keloidal folliculitis show up like acne lesions with tiny inflamed hair follicles at the occipital scalp area and posterior part of the neck. If left untreated for a long time these small pimples turn into large blotches or keloids, occasionally discharging sinuses.

They frequently conflate to shape several large plaques, which gradually expand all over the neck area for years.

Who Gets It acne keloidalis nuchae

Acne keloidalis nuchae is most frequently found in Afro-American young adult men. However, to some extent it might also inflict among adult males with Latino or Asian origin. This traumatic skin disorder is seldom found in prepubertal stage or after the middle age of adult men. In USA 0.45% of all skin diseases faced by African Americans are shared by this dermatosis.

Along with men a less number of women are also reported to be affected by nuchal keloidal acne. The ratio of male to female patients is around 20:1.

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General Symptoms and Cause

acne keloidalis nuchaeThe clinical features of this disease had been described by Dr. Adamson in 1914. Initially round shaped eruptions appear on the upper posterior neck at the hair-bearing area in the form of elevated grayish red colored crosswise band. This band is usually hairless, smooth, and hard to touch.

The upper margin of the band contains crusted nodules and pustules of different shapes and these are fringed along the tufts of hairline at the upper neck area. The lower margin slopes down to normal skin. There is reason to believe that if anyone has a history of acne vulgaris or any other type of acne, then he or she might be prone to acne keloidalis nuchae.

Although, the definite reason behind this disease is still obscure; however, it is believed that the injury caused during haircut at the posterior of our head is mainly responsible for causing this disfiguring disease. Shaving the posterior hair with a razor in an attempt to give a close trim is a common practice among Afro-American young adults and this often causes injury to the hair follicles and contributes toward this unfortunate skin disorder.

Other etiologic factors which might also play their role in imparting acne keloidalis nuchae are constant friction and irritation from shirt collars, bacterial infection, and some autoimmune process.

Treatment Procedure acne keloidalis nuchae

Unfortunately it is quite difficult to treat this skin disease once it creates scar over the upper neck area. It is always advisable to consult with your physician as soon as you suspect that you have got acne keloidalis nuchae. This would not only prevent the possibility of larger scar formation but also help you to avert the likelihood of permanent hair loss.

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If detected in time the prognosis of this dermatosis could be done in a successful way.

The treatment procedure might involve the use of creams, lotions, or gels for external usage which might be of following genre:

a) A topical steroid or cortisone preparation

b) A cream or gel of topical antibiotic such as clindamycin

c) Topical retinoids, for example, tretinoin, tazarotene, and adapalene are also prescribed
Oral medications are often prescribed to treat folliculitis keloidalis. These include,

a) Oral antibiotic drugs, such as tetracycline

b) For severe conditions a short course of oral steroid medication, such as prednisone, often found to be helpful.

Several physical procedures including invasive medical processes and surgical excisions are frequently applied to repair or remove the whole skin affected by severe scarred tissue.

a) Intralesional steroid injections are often used into the larger lesions, inflamed bumps, and scars to shrink them down.

b) Surgical excision is another clinical option to remove individual lesions or large scars.

c) Surgical methods utilizing laser technology are also in use to heal acne keloidalis nuchae.

d) Cryotherapy using liquid nitrogen, vaporization, and radiotherapy are some of the other popular treatment procedures.

Self Help is the Best Help

It is always preferable to take a few precautionary measures as soon as you notice acne keloidalis nuchae on your neck. This could help you to avert possible aggravation of the initial mild nature of this disease.

  1. Try not to inflict any irritation into the affected area so as to avoid further formation of new lesions
  2. A hard scrubbing in an attempt to clean up the area could prove to be a backlash! Always use a mild cleanser to wash the area in a gentle manner.
  3. Stay away from head wears and clothes containing collars to avoid possible friction against the neck area.
  4. Do not ever go for a close shave at your upper neck area.
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Early detection and subsequent treatment in time along with some safe measures and years of diligent endeavor would definitely help you to get rid of acne keloidalis nuchae successfully.

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