Sun | Dec 11, 2016

Acne Keloidalis Nuchae in Men

Published:Monday | November 24, 2014 | 12:00 AM

They say beauty is skin deep, but for some men, this is the root of their problems. Over time, their skin betray them in the form of razor bumps at the back of their head. Those who notice these hideous signs run for the barber and opt to shave their entire head, not knowing that they may be experiencing acne keloialis nuchae.

John Martin* explained to Flair that he suffered this fate in his post-pubescent years during college. "This began in the 1970s, and at the time, I didn't pay it much mind, thinking the bumps rearing their ugly head were just razor bumps." Little did he know these bumps would become unsightly, causing a terribly unattractive infected swelling of the skin.

According to dermatologist Dr Dian Robinson, "Acne keloidalis nuchae, otherwise called AKN, is a annoying skin condition which predominantly affects men and women of African decent." Meanwhile, dermatologist Dr Heather Brown agreed, and added, "Acne keloidalis nuchae is a relatively common

condition in men of African descent."

It seems that the jury is still out on how the skin disease actually occurs. Robinson explains, "The condition is triggered by close shaving of the hair at the back of the head. As the curly hair regrows, they become ingrown into the skin causing small bumps called folliculitis, which represents inflammation around the hair root due to the ingrown hair."

INFLAMMATION

But according to Dr Brown,

"Persons who develop this condition often believe that they acquired it from the barber. Were that the case, it most probably would be more widespread throughout the scalp and would not affect all men in the same way."

Brown explains that the skin disease starts out as inflammation at the back the neck, also called the nuchal area, which leads to the development of fibrous or scar tissue. Little pinpoint follicular scars appear until they become larger and affect large areas at the back of the head, sometimes creating huge keloids, "Commonly, the hair stops growing because the follicle has been destroyed by scar tissue," she explains.

Martin experienced just that after joining the work force and later branching out into becoming an entrepreneur. It began to spread even more, and pretty soon, he realised that there was no hair growing at the back of his head. "The area would sometimes itch, and even produce pus, or bleed. I couldn't comb the back of my head because it was so tender; and the swelling would be exacerbated during the day because of the heat, and would cool down by nightfall."

He continued: "I visited a dermatologist for treatment and was given an injection, but that process took up a lot of funds and, in the end, it just wasn't working the way it ought to. I discovered that the antibiotics, special shampoos and creams would calm down the inflammation, but it didn't make them go away, so I was back at square one," he revealed.

Both doctors noted that his condition would have been too far along for the treatment in the form of the injection to work effectively, affirming that he would need plastic surgery to remove the damaged area.

TREATMENT OPTIONS

Here are a few treatment options he could have exercised before it became extreme. According to Brown: "Initial detection should be treated with oral antibiotics and sometimes a bacteriostatic shampoo which will clear up the infection, eliminating the pus. This is often combined with the application of an anti-inflammatory/

antibiotic cream."

Robinson also shed some light on treatment regimes: "Treatment at the earliest stage gives the best results and can prevent the development of AKN. Topical antibiotic solutions and oral tetracycline antibiotics would be prescribed by your physician. However, if the condition remains untreated and multiple bumps join and form the AKN lesions, and form hard bumps and plaques, then a series of steroid injections into the area is recommended."

She continued. "Unfortunately, this condition lasts a long time and keeps recurring. There is no known cure, but because it is related to the curly nature of the hair, I am now using my light sheer laser - FDA-approved for hair bumps in the beard - to thin the hairs in that area and make them grow straighter. It's a trial worth doing to ease the agony of this condition."

As for Martin, he hopes to one day put an end to this acne keloidalis neuchae once and for all, through plastic surgery.

* Name changed to protect identity.

krysta.anderson@gleanerjm.com