What is Acne Keloidalis Nuchae?
Acne Keloidalis Nuchae is essentially a condition where the hair follicles on the base of the scalp and back of the neck become inflamed. Folliculitis is a general term referring to the inflammation of hair follicles. However with AKN, the initial bumps that form later develop into scars, plaques and large tumor-like masses of tissue. These are referred to as lesions (abnormal tissue growth)
Who is affected by Acne Keloidalis Nuchae?
Acne Keloidalis Nuchae occurs mostly in males of African descent. However, it can also affect Latinos and Asians. In very rare cases, it occurs in whites and females.
The age of onset is usually 13-25.
What causes Acne Keloidalis Nuchae?
The exact causes of AKN are not clear. Many times, the bumps occur after closely shaving the hair in the back of the neck. Close shaving is really not a cause, but an environmental event that contributes to the manifestation of the symptoms. Some people may have a high concentration of mast cells in the back of their head. This contributes to the skin sensitivity and the overreaction to the contributing environmental stimuli. (e.g. close shaving, collars, sport gear etc.)
Hair that is course or wavy will sometimes re-enter the skin. The immune system, which is supposed to defend against harmful invaders will attack the hair shaft and the hair follicle causing the inflammation.
Another possible cause is the presence of bacteria, viruses or fungi which infect the hair follicles. The original source of these microbes may come from shaving equipment that is not properly sanitized.
High levels of testosterone have been found in a study published by Plastic Reconstructive Surgery (1997). Excess amounts of this hormone may also be a contributing factor.
What should I do if I notice bumps on the back of my head?
You should see a dermatologist as soon as possible, especially if the area is itchy and or painful. Aggressive treatment in the early stages can help prevent the condition from progressing into the horizontal plaques and tumors you see in pictures of AKN patients.
Although the bumps may not necessarily mean that you will have Acne Keloidalis Nuchae, it is certainly worth the time and effort to have a dermatologist inspect the symptoms and make necessary recommendations.
What types of treatments are available for AKN?
Treatments for Acne Keloidalis Nuchae depend on the clinical stage of the condition. They include:
* Oral antibiotics
* Topical creams and cleansers
* Injections of the lesions
* Laser procedures
* Surgical excisions of the lesions
How do oral antibiotics help with Acne Keloidalis Nuchae?
Oral antibiotics are only helpful in the initial stages of the condition. They are administered to kill bacteria which may be causing inflammation in the hair follicles.
How do topical creams and cleansers help with Acne Keloidalis Nuchae?
Again, this is another set of solution intended for the beginning phases of AKN. The cleansers are supposed to help minimize itching and possible infections due to bacteria and other microbes. Common ingredients include benzoyl peroxide, alpha hydroxy acids or tar. The affected area should be washed daily.
Topical creams like steroids and cortisone reduce inflammation by tightening the width of the blood vessels. Keep in mind that the blood which is transported through the vessels contains white blood cells which attack anything that is perceived to be a foreign invader. This is what causes inflammation. Constricting the blood vessels minimizes the blood flow and the availability of white blood cells to the affected area.
Retinoids help promote the development of normal skin cells and may also be recommended as part of a treatment program.
These creams are not intended to cure the AKN. They simply reduce the itching and discomfort.
How do intralesional injections help with AKN symptoms?
Intralesional injections will be recommended for more intermediate phases of Acne Keloidalis Nuchae. For example, the drug Prednisone is often used. It works by enhancing the cellular processes that work to suppress overactive immune activity, so that the inflammation can subside. However injections do not clear the appearance of the lesions.
How can lasers help with Acne Keloidalis Nuchae?
Lasers can destroy the infected hair follicles or remove the problematic hair shafts. Lasers are a wonderful tool in dermatology which can affect and change tissue beneath the surface of the skin in a controlled, precise fashion.
How does surgery help with Acne Keloidalis Nuchae?
Surgery is really the only way to clear the lesions on the back of the neck. The excision of the affected area is a promising acne keloidalis nuchae cure for the most advanced stages of the condition