Acne keloidosis, technically called acne keloidalis nuchae, is a skin disorder involving firm discolored bumps developing on the back of the neck just above or below the hairline. Most cases occur in African-American men and in other men with curly short hair and dark skin, but anyone can develop the condition. Early treatment is important to prevent the disorder from progressing.
A keloid is a type of scar with pink, red or purple elevated skin. Keloidosis means "multiple keloids," while keloidalis means "keloid-like." The varying terminology indicates that scientists have not definitively determined the nature of this condition. Acne keloidosis is not actually a form of acne, as explained by Crutchfield Dermatology, but may be a form of folliculitis. Some dermatologists refer to the condition as folliculitis keloidalis nuchae. It seems to occur when hairs grow into the skin, and the skin becomes inflamed and develops scar tissue.
The first symptoms of acne keloidosis are small itchy round bumps on the back of the neck close to the hairline or within scalp hair near the neck. Bumps at the hair follicles can become inflamed and filled with pus. The bumps eventually become small scars that are keloids or similar to keloids. Hair does not grow on these scars, and they can be very obvious.
Dermatologists do not yet know the cause of acne keloidalis nuchae, according to Crutchfield Dermatology. People may have a genetic predisposition for the disorder. Since most cases involve ingrown hairs irritating the hair follicle and resulting in inflammation, acne keloidalis nuchae may be linked to chronic folliculitis. Skin in the posterior neck area tends to react with the scar-like bumps.
Certain lifestyle changes can prevent an early case of acne keloidosis from becoming worse. If you have early signs, avoid wearing hats, shirts or jackets that rub the skin on the back of your neck. Don't itch or pick at the bumps, as this irritates and inflames them further. Apply a topical anti-itch cream or gel if you need to. You also shouldn't use oily hair products while you have acne keloidosis or do close shaves in that area.
A dermatologist can help prevent the acne keloidosis bumps from growing larger and eventually merging together. You might consider having hair in the affected area removed by laser therapy. Your doctor may prescribe topical cortisone or steroid solutions to decrease inflammation and swelling, and a retinoid cream to improve skin appearance. Topical and oral antibiotics eliminate infection. The doctor also may recommend oral or injected steroid medications. Severe cases sometimes require surgical removal of the acne keloidosis bumps.
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