Treatment
Acne Keloidalis Nuchae
Early Intervention
Early treatment is crucial to prevent AKN from worsening. Treatment options include:
- Patient Education: Identifying and avoiding activities that irritate the skin, such as close shaves and wearing tight collars or helmets.
- Antimicrobial Cleansers: Using products like benzoyl peroxide washes to prevent infection.
- Medicated Products: Applying products to soften coarse hairs, often containing alpha-hydroxy acid or retinoids.
- Corticosteroids: Topical or injected corticosteroids to reduce the size and firmness of bumps.
- Antibiotics: Topical or oral antibiotics to treat or prevent bacterial infections.
Advanced Treatments
For severe cases, additional treatments may include:
- Surgical Excision: Removing keloid-like scars and replacing the removed tissue with healthy skin from elsewhere on the body.
- Drainage of Abscesses: Draining painful, swollen areas and prescribing medication to treat the infection.
- Laser and Phototherapy: Emerging treatments like laser therapy, phototherapy, laser hair removal, and radiotherapy for resistant cases.
Persistent Cases
Despite various treatments, folliculitis keloidalis often persists. Measures to alleviate symptoms include:
- Avoiding high collars and helmets that rub the back of the neck.
- Washing the affected area with antimicrobial cleansers.
- Using topical steroids for small papules.
- Administering intralesional steroid injections for larger papules and plaques.
- Taking oral tetracycline or other antibiotics for secondary infections.
- Considering laser-assisted hair removal to prevent folliculitis.
- Employing a three-month course of clindamycin and rifampicin for severe cases.
