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Folliculitis keloidalis (acne cheloidalis nuchae, and acne keloidalis)


Folliculitis keloidalis which is also known as acne cheloidalis nuchae, and acne keloidalis is an unusual skin condition affecting the nape of the neck. It commonly affects adult Afro-Caribbean males with curly hair and other dark-skinned individuals, but it can occur in any individual. This condition may persist for many years.

It generally occurs in African American men between the ages of 15-30 but can last longer. Folliculitis keloidalis nuchae is very difficult to treat.

What are the causes of Folliculitis keloidalis

  • The use of hair pomade containing lanolin can contribute to this problem. Check the label on any pomade you are using and make sure it does not contain lanolin.
  • Folliculitis keloidalis nuchae occurs in people with very curly hair. The hair grows back into the scalp or neck causing inflammation and tenderness which can lead to infection. Over a long period of time the areas form keloidal scars that look like hard bumps.
  • The condition is more common in people that have a tendency toward acne.
  • The cause of folliculitis keloidalis nuchae is not known perfectly still.

Symptoms of Folliculitis keloidalis

Initially, itchy round small bumps appear within or close to the hair-bearing area of the back of the neck (occipital scalp). Sometimes there are pustules around the hair follicles ( folliculitis ). As time goes on the bumps become small scars and then the small scars may greatly enlarge to become keloids. The scars are hairless and can form a band along the hairline. It may be a form of dermatitis or a form of acne. In most cases there are ingrown hairs which irritate the wall of the hair follicle resulting in inflammation.

Treatment of Folliculitis keloidalis

  • Cortisone injections can help minimize keloidal scarring.
  • Surgery (ie surgically removing all the affected skin)
  • Laser excision or vaporisation Some areas may require surgical drainage.
  • Antibiotic lotion or antibiotic pills can help keep the condition under control. There is no cure; however the problem usually improves with time.
  • Washing the back of the neck and scalp with Lever 2000 soap using a Buf-Puf helps raise the hairs from under the skin and prevents them from growing back into the skin. This should be done twice a day. You can find Buf-puf at any retail drug store without prescription.

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