What is Acne Keloidalis Nuchae?

Acne keloidalis nuchae is a skin condition caused by chronic inflammation of the hair follicles around the head, neck, and chin. This condition is more likely among men, particularly in men with short, stiff hair and darker skin. It can cause significant scarring as well as plaques of hair loss. Treatments are available, and a dermatologist can help a patient develop an appropriate treatment plan.

In patients with acne keloidalis nuchae, chronic folliculitis develops as a result of ingrown hairs. This tends to occur as a result of shaving. Shaving leaves hair with a very sharp tip that may irritate the skin if the hair grows back curvy or crooked. The inflammation will cause a raised bump to appear. The bump may fill with pus and other fluids and is usually red and painful. Over time, the chronic irritation to the skin will destroy the follicles, making it impossible for hair to grow, and patients will have rough, painful skin.

The acne keloidalis nuchae will form plaques of irritated tissue. Patients may notice flakes and scabs around the inflamed area, and the skin can feel hot and coarse. It often starts around the back of the head, especially near the crease of the neck, and can spread if the patient does not take measures to address it. The first line of treatment is steroid injections or creams to curb the inflammation. Once the skin returns to a more normal condition, the patient can work on preventing recurrence.

Men are more at risk of acne keloidalis nuchae because they tend to clip or shave their hair very short to manage it. One option is to change grooming practices and allow hair to grow more naturally. For patients who cannot do this, it is important to wash the skin carefully with hot water and soap before any grooming activities. The heat will soften the skin and open the follicles, while the soap will remove dirt and organisms that could cause folliculitis. It is advisable to use a sharp razor or clipper and to avoid sharing personal hygiene products.

Taking special care with hair and skin regimens should prevent the acne keloidalis nuchae from flaring up again. The patient may be left with significant scarring if the original condition is allowed to progress. With time, the skin and hair may recover, as long as the patient prevents inflammation. For people concerned about the plaques and scarred patches, changing hair styles can help with concealment while the skin recovers.