Acne keloidalis nuchae (AKN) is a condition characterized by follicular-based papules and pustules that form hypertrophic or keloid-like scars. AKN typically occurs on the occipital scalp and posterior neck and develops almost exclusively in young, African-American men.
ILS along with . isotretinoin and doxycycline decreased frequency in a couple of pateints. but resistant to treatment and recurrence make this difficult to treat.
superpotent topical steroids and intralesional steroids are the 1st option for me PLUS systemic doxycycline if 2ry infected PLUS instructuons to prevet irritation
Other lines: ablative Co2 laser, cryotherapy, surgical
In my experience Isotretinoin in common doses and an association of topical corticosteroid and antibotic is much more effective than I even expected.
Agree CO2 laser is effective. Should not be combined with isotretionin because of higer risk of scar. Excision is also a good alternative. P.o medication with isotretionin or a tetracyclin could be necessery to prevent further acne with following keloids.
Preventive: Do not shave or cut the hair short in the affected area. The process is
not acne, but a pseudofolliculitis.
I have seen good results after pulsed dye laser treatment in a patient with this problem without respond to several treatments with intralesional corticoseroids.
Radiofrequency ablation and after that at base give intralesional triamcinolone acetonide 40mg/ml gives complete clearance without recurrence
Laser therapy either by CO2, Er:YAG or long pulsed Nd:YAG lasers give very good results.
I prefer doing combination therapy with liquid nitrogen cryotherapy and intralesional triamcinolone acetonide.
It depends of the clinical stage. Always is better to treat at the very beginning. You must search the comorbidity or cause associated to it and try to modified. I used to employ surgical procedure as a third line therapy. And as a first line, topical steroids, antibiotic, oral antipruritic.
Article Acne keloidalis nuchae in Latin American women
Acne keloidalis nuchae and acne vulgaris is Systemic disease,Please check the plasma lipid profile, AKN patients are frequently associated dyslipidemia. （Acne patients frequently associated with abnormal plasma lipid profile, Journal of Dermatology, 2015, 42(3):296-299）, Topical steroids, antibiotic, oral antipruritic is not enough in treatment of AKN.
Dear Hao 浩 Jiang 姜 , thanks for your informative knowledge you offered.
What do you suggest to add with topical treatment? Thanks.
Try, first of all, isotretinoin at 0,5 mg / Kg /. Sometimes the results are surprising even for us.
If it didn't Works try everything you have already refered.
i think homemade tomato skin mask can be effective
https://goldsurgery.com/natural-skin-rejuvenating-treatments/
https://goldsurgery.com/natural-skin-rejuvenating-treatments/
Though medical, surgical and laser therapies are there, I personally prefer I/L Triamcinolone acetonide. Here is a good review on the topic, you could have a look into it:
Article Treatment of Acne Keloidalis Nuchae: A Systematic Review of ...
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