Acne
keloidalis Nuchae (AKN) occurs when hairs on the back of the head
and neck grow into the skin, become inflamed cause scar tissue. AKN
is more common in people with stiff or curly hair and those with
darker skin. These ingrown hairs are usually start following a short
haircut on the back of the head and nape of the neck. The ingrown
hairs lead to scar tissue that is a form of hypertrophic scar or
keloid.
Treatment of AKN includes suppression of the inflammation with
antibiotics (Tetracycline, Doxycycline, Cleocin-T, others) and
steroid gels or intralesional steroid injections. Larger bumps of
AKN once present for a while or if not responding to treatment need
to be surgically removed. Unfortunately, if you don’t want them to
grow back they need to be cut out widely and deeply. They heal best
if left open to heal from the inside out, but this takes weeks or
months. Intralesional steroid injections or radiation treatment
after surgery helps prevent recurrence of the AKN.
Hair removal lasers may prove to be a very useful tool in early
AKN. Once you know you are prone to AKN, but before you have an
advanced case, you should consider having laser hair removal to
prevent further AKN.