Table of ContentsView AllTable of ContentsTreatmentTriggers and CausesHair and Neck HygieneSymptoms of Infection
Table of ContentsView All
View All
Table of Contents
Treatment
Triggers and Causes
Hair and Neck Hygiene
Symptoms of Infection
Chronic acne keloidalis nuchae(AKN) is a condition in which the hair follicles on the scalp and/or neck are chronically inflamed. Hair follicles are the skin openings out of which hair grows. Chronic inflammation eventually weakens the follicles and can result in ingrown hairs, which burrow into the skin and lead to bumps.
These bumps look like pimples along the hairline on the back of the neck and can become infected. Treatments are available for managing symptoms and for reducing triggers of AKN.
This article discusses the treatment methods available for managing symptoms of AKN and preventing infection. It will also cover possible causes and triggers of AKN, signs and symptoms of infection, and what to do if you have an infection associated with AKN on your scalp and/or neck.
Petri Oeschger / Getty Images
Acne
Treatment: Managing Acne Keloidalis Nuchae
Your healthcare provider will do a physical examination to determine mild grade symptoms vs. severe or advanced AKN. They will look at the size of the affected area, bump size and number, and check forsigns of scarring, hair loss, and skin infection.
The American Academy of Dermatology Association (AAD) says treatment plans for managing AKN symptoms may include:
A combination of prescribed topicals and shaving changes that help avoid or reduce irritation in two study participants with alopecia or hair loss and AKN. Topical benzoyl peroxide 2.5% and adapalene 1% were prescribed.
Many of the treatments can take months and recurrences are common.
Treatment for AKN doesn’t always result in zero signs and symptoms. In these cases, you should know yourdermatologistmay recommend other treatment options including laser therapy, phytotherapy or light therapy, and laser hair removal to reduce keloid-like growths or bumps.
In severe cases of advanced AKN, in which there are large areas of scarred skin on the scalp and neck, standard treatment protocols may not work or may not work long term. If all other options have failed and your case of AKN is advanced, your dermatologist may discuss the option of low-dose radiation to kill the hair follicles.
Oral Acne Medication Options
Triggers and Possible Causes
AKN mainly develops in young men between the ages of 14 and 25. It is more prevalent in males than females, particularly men with coarse, stiff, or curly hair.
The AAD says more research is needed to understand how certain hormones more common in males contribute to AKN risk. Possible triggers and causes include:
AKN is not contagious and cannot be “caught” from unsanitary hair clippers, razors, or scissors.
Why Am I Breaking Out?
Hair and Neck Hygiene With Acne Keloidalis Nuchae
Hair and neck hygiene are additionally important when someone has AKN to prevent symptoms from worsening and to help maintain any treatment. Your healthcare provider or dermatologist will discuss hair and neck hygiene with you. The AAD says keeping AKN stable is possible with the following methods:
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet dermnetnz.org 2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet dermnetnz.org 2023.
Symptoms of Acne Keloidalis Nuchae Infection
Skininfection symptomsinclude:
AKN infection can, in some cases, also lead to pustules and abscesses.
There areother causes of neck lumpsto consider including back of neck cystic acne, boils, muscle knots, lipomas or painless growths under the skin, or in some cases, reactions to soaps and shampoos and detergents. Lumps left untreated can progress to sepsis or bacterial infection or growth and spread (metastasis) of cancer.
Skin Cancer
Treating Infection
If you suspect you have symptoms of infection, consult with your dermatologist about treatment options, including antibiotic medications and more invasive options if necessary such aslump or abscess draining.
Summary
Signs and symptoms of infection include redness, heat, swelling, pus, bleeding, and pain or tenderness. Consult with your healthcare provider or dermatologist for antibiotic treatment.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Acne keloidalis nuchae: causes.American Academy of Dermatology Association.Acne keloidalis: diagnosis and treatment.Chouk C, Litaiem N, Jones M, Zeglaoui F.Acne keloidalis nuchae: clinical and dermoscopic features.BMJ Case Reports. 2017. doi:10.1136/bcr-2017-222222Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE.Treatment of acne keloidalis nuchae: A systematic review of the literature.Dermatol Ther (Heidelb). 2016;6(3):363-378. doi:10.1007/s13555-016-0134-5Ogunbiyi A.Acne keloidalis nuchae: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2016;9:483-489. 2016. doi:10.2147/CCID.S99225Centers for Disease Control and Prevention.Skin infections.Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE.Treatment of acne keloidalis nuchae: A systematic review of the literature.Dermatol Ther (Heidelb). 2016;6(3):363-378. doi:10.1007/s13555-016-0134-5American Academy of Dermatology Association.Acne clinical guideline.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Acne keloidalis nuchae: causes.American Academy of Dermatology Association.Acne keloidalis: diagnosis and treatment.Chouk C, Litaiem N, Jones M, Zeglaoui F.Acne keloidalis nuchae: clinical and dermoscopic features.BMJ Case Reports. 2017. doi:10.1136/bcr-2017-222222Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE.Treatment of acne keloidalis nuchae: A systematic review of the literature.Dermatol Ther (Heidelb). 2016;6(3):363-378. doi:10.1007/s13555-016-0134-5Ogunbiyi A.Acne keloidalis nuchae: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2016;9:483-489. 2016. doi:10.2147/CCID.S99225Centers for Disease Control and Prevention.Skin infections.Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE.Treatment of acne keloidalis nuchae: A systematic review of the literature.Dermatol Ther (Heidelb). 2016;6(3):363-378. doi:10.1007/s13555-016-0134-5American Academy of Dermatology Association.Acne clinical guideline.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology Association.Acne keloidalis nuchae: causes.American Academy of Dermatology Association.Acne keloidalis: diagnosis and treatment.Chouk C, Litaiem N, Jones M, Zeglaoui F.Acne keloidalis nuchae: clinical and dermoscopic features.BMJ Case Reports. 2017. doi:10.1136/bcr-2017-222222Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE.Treatment of acne keloidalis nuchae: A systematic review of the literature.Dermatol Ther (Heidelb). 2016;6(3):363-378. doi:10.1007/s13555-016-0134-5Ogunbiyi A.Acne keloidalis nuchae: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2016;9:483-489. 2016. doi:10.2147/CCID.S99225Centers for Disease Control and Prevention.Skin infections.Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE.Treatment of acne keloidalis nuchae: A systematic review of the literature.Dermatol Ther (Heidelb). 2016;6(3):363-378. doi:10.1007/s13555-016-0134-5American Academy of Dermatology Association.Acne clinical guideline.
American Academy of Dermatology Association.Acne keloidalis nuchae: causes.
American Academy of Dermatology Association.Acne keloidalis: diagnosis and treatment.
Chouk C, Litaiem N, Jones M, Zeglaoui F.Acne keloidalis nuchae: clinical and dermoscopic features.BMJ Case Reports. 2017. doi:10.1136/bcr-2017-222222
Maranda EL, Simmons BJ, Nguyen AH, Lim VM, Keri JE.Treatment of acne keloidalis nuchae: A systematic review of the literature.Dermatol Ther (Heidelb). 2016;6(3):363-378. doi:10.1007/s13555-016-0134-5
Ogunbiyi A.Acne keloidalis nuchae: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2016;9:483-489. 2016. doi:10.2147/CCID.S99225
Centers for Disease Control and Prevention.Skin infections.
American Academy of Dermatology Association.Acne clinical guideline.
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