Acne keloidalis nuchae is a condition most commonly found in men because they generally have shorter hair. AKN is more common in people with stiff or curly hair and those with darker skin. Acne keloidalis nuchae (AKN) refers to the occurrence of keloidlike papules. The term keloidalis means “keloid-like" or “scar-like." The term “nuchae" simply means “neck."AKN is a medically benign but often psychologically devastating dermatosis. Squamous cell carcinoma has developed secondary to radiation therapy in rare cases. Chronic pruritus, scarring, and drainage may occur. AKN most often occurs in African Americans. Hispanics are the next most common group, followed by Asians and (least often) whites. Cause of AKN is speculative. Injury produced by short haircuts (especially when the posterior part of the hairline is shaved with a razor.



Treatment options include topical preparations, pills by mouth, injections, laser treatment, the removal of single bumps, and, if severe, the complete surgical excision of the involved area. Cryotherapy has also proven to be successful in some cases. The area is frozen for 20 seconds, allowed to thaw and is then frozen again a minute later. Hair removal lasers may prove to be a very useful tool in early AKN. One way to prevent the occurrence is to make sure the hair is a minimum of 1/4" in length as anything less may be too close of a cut and could leave the individual susceptible to acne keloidalis nuchae. In addition, laser hair removal may actually prevent acne keloidalis nuchae from recurring. Kenalog (10-40 mg/mL) is also injected into the postoperative site or sites every 2-3 weeks for 4 sessions. Keloidlike scarring, scarring alopecia, and chronic discharge are complications of AKN.

Acne Keloidalis - Prevention and Treatment Tips

1. Intralesional steroid injections or radiation treatment after surgery helps prevent recurrence of the AKN.

2. Oral tetracycline or antibiotics for secondary infection.

3. Hair removal lasers may prove to be a very useful tool in early AKN.

4. Laser therapy has been successful for some patients.

5. Intralesional steroid injections (10-40 mg/mL) are another method of therapy.