Acne Keloidalis Nuchae: causes, symptoms and treatment

In brief

• Acne keloidalis nuchae (AKN) is a chronic inflammation of the hair follicles.
• Occurs mainly on the neck and back of the head.
• Characterized by small inflamed bumps that can grow into hard scars.
• More common in men with curly hair.
• Treatment ranges from medication to laser therapy.

What is acne keloidalis nuchae?

Acne keloidalis nuchae (AKN) is a chronic inflammation of the hair roots, mainly on the back of the head and neck. The term "acne" is actually incorrect, as the disease process primarily affects the hair follicles and not the sebaceous glands, as in common acne. It often begins as small red bumps that gradually enlarge and may progress to hard, scar-like thickenings (keloids). The condition is more common in people with curly or straight hair and can lead to permanent scarring if not treated promptly.

What do you notice in acne keloidalis nuchae?

Typical features of acne keloidalis nuchae are:

• Small, itchy or painful bumps on the neck and back of the head.
• Gradually growing nodules that may form scar tissue.
• Hair loss in the affected area.
• Possible pus formation in inflamed bumps.
• In severe cases, enlargement of scars (keloids), which can lead to cosmetic and functional problems.

Possible causes of acne keloidalis nuchae

The exact cause is unknown, but several factors may contribute to the onset and worsening of the condition:

• Mechanical irritation: repeated rubbing by clothing or tight collars.
• Shaving techniques: Shaving short or using blunt razors can cause ingrown hairs.
• Genetic predisposition: is more common in people of African or Latino descent.
• Bacteria, yeasts and fungi: used to play a possible role, but are now considered less relevant.
• Hormonal factors: may possibly contribute to development.
• Wounds during cutting: can cause inflammation.

Is acne keloidalis nuchae serious?

Acne keloidalis nuchae is not dangerous, but can lead to unsightly scarring and localized hair loss, which can be both cosmetically and psychologically stressful. Without treatment, the inflammation can worsen and lead to permanent scarring. In severe cases, the condition can be painful and affect daily life.

What can you do yourself for acne keloidalis nuchae?

Although medical treatment is often necessary, self-care measures can help:

• Avoid tight collars: to minimize friction and irritation.
• Use a sharp razor or clippers on longer setting: prevents ingrown hairs.
• Clean the neck and back of the head daily: use a mild antibacterial soap.
• Avoid harsh hair products: which can irritate the skin.
• Hydrate the skin: with a non-greasy, soothing lotion.
• Avoid short shaving: acne keloidalis nuchae has nothing to do with ingrown hairs (pseudofolliculitis barbae).

Medications for acne keloidalis nuchae

Depending on the severity, a dermatologist may prescribe medication:

• Topical corticosteroids: To reduce inflammation and itching.
• Antibiotics (creams or tablets).: especially useful in early stages with pus formation.
• Retinoids: help renew the skin and reduce ingrown hairs.
• Intralesional injections.: corticosteroids to reduce thickened scars.

Acne keloidalis nuchae treatment

Treatment depends on the severity and degree of scarring:

• Mild cases: topical creams and good skin care.
• Moderate cases: antibiotics or corticosteroid injections.
• Severe cases: laser therapy, cryotherapy or surgical removal of scars.
• Laser treatment: can help reduce scarring and ingrown hairs.
• Surgical treatment: Extensive scarring may require surgical removal.

When do you call your doctor for acne keloidalis nuchae?

Contact a physician if:

• The bumps get bigger and do not disappear on their own.
• You suffer from pain, itching or pus formation.
• You notice the scars getting hard and bigger.
• Previous treatments have no effect.

Make an appointment with an experienced and certified online dermatologist

Want to know quickly if you have acne keloidalis nuchae and what treatment is best? Or do you doubt whether you should take further action? Then request a consultation via our app.

Check out the options.