The more chronic presentation will demonstrate dense dermal fibrosis with chronic inflammatory cell infiltrate, which includes numerous plasma cells. Hair shafts surrounded by microabscesses and or foreign body giant cells are present in the dermis. [dermatologyadvisor.com]

Characteristically, comedones are not present in the affected area. [oatext.com]

Scarring is typically present in the time patients present for medical evaluation. Scarring is manifested by variable sized keloidal papules, plaques, or nodules at the site of previously involved hair follicles. [statpearls.com]

Conclusion: The pattern of acne keloidalis nuchae in Nigerians is similar to that reported in the western literature, except for significant proportion of males presenting at the fibrotic phase with massive keloids initially. [ajol.info]

It presents with small, smooth, firm bumps with occasional pus on the posterior scalp and nape of the neck. [docs4hair.com]

• Surgical Procedure

  If Possible Avoid Cosmetic Surgery If you will be having a surgical procedure done and are prone to keloid scarring, let the surgeon know and discuss what can be done to minimize scarring. [byrdie.com]

  People with risk factors (outlined above) for getting keloids are advised to avoid skin trauma such as tattooing, body piercing and unnecessary surgical procedures / cosmetic skin surgery, particularly on high-risk areas such as the chest or earlobes. [britishskinfoundation.org.uk]

  If you plan to have a surgical procedure and are concerned about forming keloids, a silicone gel bandage can be used after the wound has healed for two to three months.” [standard.co.uk]

  This is a simple surgical procedure, done under local anesthesia as an out-patient. A scalpel is inserted parallel to the skin, cutting the fibrous base of the scar that is pulling down on the skin from below. [verywellhealth.com]

• Swelling

  Kenalog (steroid) is injected into acne or pimples and this helps in repressing the activity in the body which causes infection, redness, and swelling. This procedure helps to solve the problem instantly. [crmcaesthetics.com]

  Steroids also have powerful anti-inflammatory properties, which can help reduce swelling, redness, itching, or tenderness. Steroid injections are usually administered in a dermatologist’s office after a scar has healed. [nyulangone.org]

  Sylvia Mugwaneza, 23, a business administration graduate is not only tall but also stunningly beautiful, except for a big dark swelling on her left ear lobe. “Medics call it a Keloid scarring. [newtimes.co.rw]

• Asymptomatic

  The condition is often asymptomatic. The patient should be counseled to wear soft or no-collar skirts, avoid short haircuts, avoid picking/rubbing/scratching the affected area, and avoid wearing tight-fitting hats/helmet. [oatext.com]

  Dermatofibroma frequently develops on the extremities (mostly the lower legs) and is usually asymptomatic, although pruritus and tenderness can be present. It is actually the most common painful skin tumor. [symbiosisonlinepublishing.com]

• Acne Vulgaris

  Acne Conglobata and Rarer Forms of Acne See separate articles Acne Vulgaris. Acne conglobata is a type nodulocystic acne. [evidence.nhs.uk]

  The term acne keloidalis nuchae is somewhat of a misnomer because the lesions do not occur as a result of acne vulgaris, but rather a folliculitis. Moreover, histologically lesions are not keloidal. [pcds.org.uk]

  Although it is not related to common acne (acne vulgaris), acne keloidalis nuchae initially appears as acne-like lesions of inflamed hair follicles (folliculitis) on the nape of the neck (nuchal area) and, without treatment, can result in large scars [skinsight.com]

  […] relevant MeSH terms: Layout table for MeSH terms Dermatitis Acne Vulgaris Keloid Folliculitis Acne Keloid Skin Diseases Acneiform Eruptions Sebaceous Gland Diseases Collagen Diseases Connective Tissue Diseases Cicatrix Fibrosis Pathologic Processes Hair [clinicaltrials.gov]

  Unlike true acne vulgaris, comedones are not a common feature of AKN. [4] Pathophysiology The exact etiology of acne keloidalis nuchae (AKN) is unclear. [emedicine.medscape.com]

• Pruritus

  In both cases, close hair cutting was discouraged, and topical benzoyl peroxide 2.5% and adapalene 1% were prescribed, leading to a limited number of new lesions and a marked relief of pruritus. [casereports.bmj.com]

  Pruritus is common, and the constant scratching may lead to the breakdown of the papules and drainage. Finally, scarring alopecia results. [9] [statpearls.com]

  The onset is usually preceded by pruritus a few hours to days after a haircut or some form of mild irritation from use of a headwear such as a sports helmet. [dovepress.com]

  He did not give a history of pruritus. On examination, multiple follicle-based papules were observed over the occipital scalp [Figure 1]. An incisional biopsy confirmed the diagnosis of AKN. [parjournal.net]

  However, patients sometimes experience mild burning, pruritus, or pain [1]. Figure 1. Acne keloidalis nuchae with characteristic involvement of the posterior scalp and nape of the neck. The diagnosis is mainly clinical. [oatext.com]

• Irritability

  This is mainly because men often cut their hair very low as opposed to women, allowing the hair to prick the occipital scalp thereby causing irritation. [en.wikipedia.org]

  Self-Care Guidelines People who develop acne keloidalis nuchae should focus on avoiding irritation to the area in order to prevent the formation of additional lesions: Wash the area gently with non-irritating cleansers (no hard scrubbing!). [skinsight.com]

  How does it set up a localized mechanical irritation with subsequent inflammation? Chronic irritation from shirt collars, caps, helmets, and wooden combs have all been implicated in the pathogenesis of AKN, but not proven. [dovepress.com]

  Constant irritation. Regular irritation or friction caused by shirt collars and helmets may pull on the hairs and cause folliculitis and eventual scarring. Heat and humidity may make it worse. Certain medications. [healthline.com]

  It contains rosehip and sacha inchi oil, which can both help with the appearance of mild acne scars. £95 | Net-A-Porter | Available end of July La Roche Posay Cicaplast Baume B5 Best for: newly scarred skin While newly scarred skin is prone to irritation [standard.co.uk]

Treatment was repeated at 4-6 week intervals for 4 sittings. Pre-treatment and post- treatment photographs were taken during each visit. [ijdvl.com]

Keloid and Hypertrophic Scar Treatments Treatment for keloid and hypertrophic scarring comes in two stages, as it does for other acne scarring. [acnesupport.org.uk]

A second treatment sitting with the above settings was repeated after 3 weeks, using the same laser applications on each side of the scalp as in the first treatment. [parjournal.net]

Glenn MJ, Bennett RG, Kelly AP (1995) Acne keloidalisnuchae: Treatment with excision and second-intention healing. J Am AcadDermatol 33:243-246. Butler PD, Longaker MT, Yang GP (2008) Current progress in keloid research and treatment. [longdom.org]

The treatment also causes hypopigmentation and often requires months of treatment. Surgical excision may be performed, but mild recurrences are not rare. [statpearls.com]

Treatments Your Physician May Prescribe The prognosis of acne keloidalis nuchae is good if treatment is started early. Topical creams, lotions, or gels may include: A retinoid cream such as tretinoin, tazarotene, or adapalene. [skinsight.com]

If acne keloidalis nuchae is diagnosed and treated early, the prognosis is good. However, once scarring has developed, the treatment is difficult, and most patients are left with a major cosmetic problem. [statpearls.com]

Lesions manifesting prior to puberty or in persons older than 50 years is unusual. [4, 9] Prognosis The prognosis is good if acne keloidalis nuchae (AKN) is treated early and properly. [emedicine.medscape.com]

Prognosis Keloids are harmless, cosmetic problems that do not become cancerous (malignant). Once a keloid stops growing, it usually remains stable unless the area is injured again. [drugs.com]

What is the prognosis for keloids? Small keloids can be effectively treated using a variety of methods. Generally, a series of injections of steroids into the problem area is the simplest and safest approach. [medicinenet.com]

The definitive etiology of AKN is unknown. No specific genetic factor has been identified. In individuals with tightly curled hair, shaving or trimming the nape of the neck may initiate the presentation of AKN. [dermatologyadvisor.com]

The lesion occurs as a result of a folliculitis. [1] [2] [3] Etiology The exact etiology of acne keloidalis nuchae is unclear, but it might be triggered by chronic irritation or occlusion of the follicles due to hair cutting practices (e.g., close shaves [statpearls.com]

Post-Nd:YAG and -diode laser therapy; the lesion shows good resolution Discussion AKN has an unclear etiology, with a predominant occurrence in males. [parjournal.net]

Etiology of AKN Suggested etiologies include the following [1, 3, 4, 9, 12, 13, 14, 15, 16, 17] : Close shaving of the neck: This often exacerbates the condition. The sharp, curved hairs reenter the skin and invoke an acute inflammatory response. [emedicine.medscape.com]

Perceived etiological factors of folliculitis keloidalis nuchae and treatment options amongst Nigerian men. Br J Dermatol. 2015;173(Suppl 2):22–25. 7. Azurdia RM, Graham RM, Wesmann K, Guerin DM. [dovepress.com]

Over time lesions result in scarring hair loss and keloid scars Epidemiology ( 6, 7, 8 ) FK is most common in men of African descent age 20-50 years, although it can also occur in women. [docs4hair.com]

Keloid acne of the neck: epidemiological studies over 10 years. Int J Dermatol 2005;44:49-50. George AO, Akanji AO. Clinical, biochemical, and morphologic features of acne keloidalis nuchae in a black population. Int J Dermatol 1993;32:714-6. [e-journal.unair.ac.id]

Other potential contributory factors include autoimmunity, excess androgens or increased sensitivity to androgens, seborrhea, and medications (e.g., cyclosporine). [4] [5] Epidemiology Individuals with darkly pigmented skin, especially African Americans [statpearls.com]

This review highlights the epidemiology, clinical features, impact, and treatment challenges. Epidemiology AKN occurs majorly in those of African descent. [dovepress.com]

Keloid acne of the neck: epidemiological studies over 10 years. Int J Dermatol. 2005 Oct. 44 Suppl 1:49-50. [Medline]. Quarles FN, Brody H, Badreshia S, et al. Acne keloidalis nuchae. Dermatol Ther. 2007 May-Jun. 20(3):128-32. [Medline]. Kelly AP. [emedicine.medscape.com]

These two cases reinforce the hypothesis that androgens have a role to play in the pathophysiology of KAN in its rare manifestations in females. [ibimapublishing.com]

The pathophysiologic mechanism responsible for acne keloidalis is analogous to that of pseudofolliculitis barbae. Basically, it represents a foreign-body reaction as a result of the hair penetrating the dermis. [dermatologyadvisor.com]

Pathophysiology The repeated friction, trauma, and infection of the skin overlying the nape of the neck leads to acne keloidalis nuchae. [statpearls.com]

"Keloids and Hypertrophic Scars: Pathophysiology, Classification, and Treatment." Dermatol Surg 43 (2017): S3-S18. He, Yongjing, et al. "From Genetics to Epigenetics: New Insights Into Keloid Scarring." [medicinenet.com]

AKN appears similar to keloids, yet there are differences in pathophysiology. These two cases highlight a surgical treatment course for AKN that plastic surgeons can incorporate into their practice. [longdom.org]

Unfortunately, to prevent regrowth they need to be cut out widely and deeply. They heal best if left open, which can take weeks to months. Intralesional steroid injections or radiation treatment after surgery helps prevent recurrence of the AKN. [aocd.org]

Generally, persons with acne keloidalis nuchae should see their primary care doctor or a dermatologist for treatment in order to prevent progression of the condition. [skinsight.com]

Advanced treatments include removal of the scar by surgery, which can be followed by radiotherapy to prevent recurrence. Further information is available from the British Skin Foundation website.” [standard.co.uk]

As part of your treatment, your doctor may recommend certain over-the-counter products to help prevent the acne keloidalis nuchae from getting worse. [healthline.com]

How can you prevent keloids? If you tend to get keloids, it's best to avoid body piercings, tattoos, or any surgery you do not need. Keloids can grow after these procedures. To prevent keloids after a minor skin injury, start treating it right away. [uofmhealth.org]