Acne keloidalis nuchae treatments are available for men who suffer from this condition and can’t figure out how to deal with it. The condition is far more prevalent in men than women and is especially noted in young men of African ancestry.
Acne keloidalis nuchae (AKN) is a misnomer because it isn’t acne per se. It’s actually a form of folliculitis which involves an inflammation of the hair follicle.
A great resource on AKN is on the DermNet NZ website which also explains the different nomenclature that is used and why they prefer the use of the word folliculitis keloidalis. For the purpose of this post we’ll refer to Acne Keloidalis Nuchae since that’s what people tend to look for when searching for an answer.
Acne Keloidalis Nuchae Treatments
As always your best bet is to consult a medical professional first before embarking on any specific treatment.
Currently no single medical treatment for AKN exists that is used solely with a high degree of success. Certain treatments may work better for some men than others. Thus, medical treatments for AKN tend to focus on several methods. Here’s a list in progression from least invasive to most invasive:
Over the counter treatments: Shampoos that fall into the category of keratoplastics and antimicrobial soaps that contain ingredients like benzoyl peroxide or chlorhexidine may be prescribed by your doctor. Since these are topical treatments, these would be incorporated into your daily cleaning and washing routine.
Topical Treatments: Topical steroids are often prescribed to treat the affected area(s). This could be in the form of a cream applied directly to the skin. This treatment tends to be for small breakouts.
Antibiotics: Oral antibiotics such as doxycycline or minocycline may be prescribed to treat infections.
Oral Corticosteroids: Tablets may be prescribed for larger, inflamed breakouts as corticosteroids help deal with skin inflammation.
Steroid injections: Tends to be used in the more serious AKN breakouts.
Surgery: Clearly the most invasive option, AKN surgical options are generally reserved for the most difficult AKN conditions. Surgical options include electrosurgical excision where an electrical current is used to cut out the lesion(s) or a surgical excision where a scalpel is used to remove the lesion(s).
Acne Keloidalis Nuchae Triggers and Avoidance
Traditional management of the disease focuses on preventing disease progression, including avoidance of mechanical irritation from clothing and use of antimicrobial cleansers to prevent secondary infection [13]. Treatment usually involves use of topical, intralesional or systemic steroids in combination with retinoids and/or antibiotics to decrease inflammation.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972740/#CR13
The exact cause of AKN is currently unknown. Researchers however believe that skin injury and immune system reactions could be the main culprits. So one of the believed causes – skin injury – may be at least in part preventable because this cause is focused on things we can potentially change.
As the quote above shows, management of AKN usually focuses on avoiding certain activities that may help to aggravate its progression and thus make it worse. These include:
- Wearing shirt collars, hats, helmets or other items that cause friction and rub against the back of the neck.
- Close shaving the back of the neck that causes hairs to grow back underneath the skin leading to ingrown hairs.
- Frequent and short haircuts. Similar to point number 2, the close shaving of skin can exacerbate the condition.
- Using thick and greasy hair products that can inhibit hair growth.
- Irritating the skin by excessively rubbing the back of the neck and not properly drying your neck and allowing it to remain damp.
While these actions might be at least somewhat preventable, certain professions like the military require short haircuts and may be difficult to avoid. Other professions and industries may not have actual policies on hair length and shaving but it’s an understood reality.
Conclusion
- Acne keloidalis nuchae (AKN) generally affects adult men of African ancestry but other races are affected too.
- Acne keloidalis nuchae treatments include topical solutions applied to the skin, medication as well as surgical options for more extreme cases.
- AKN also has certain triggers that lifestyle choices may help to alleviate ie. less shaving of the neck area and avoidance of short haircuts, avoidance of wearing tight-fitting collared shirts and hats.
- Shaving with acne can be troublesome in general but not as serious as acne keloidalis nuchae.