Acne keloidalis nuchae treatment, in London.

Acne keloidalis nuchae is a chronic inflammatory reaction centred on the hair follicles at the nape of the neck and the lower back of the scalp. Despite the name it is neither acne nor a true keloid. Repeated mechanical irritation appears to be the main driver: close clipper or razor work at the hairline, friction from shirt collars, helmets and headwear, and in some people tightly curved follicle geometry that makes an emerging hair more likely to provoke inflammation. The follicle wall becomes inflamed, and as that inflammation repeats the body lays down fibrous tissue, which is what makes the papules feel firm. It is reported most often in men of African-Caribbean descent with afro-textured hair, and is also described in men of Hispanic, Middle Eastern, Mediterranean, Asian and Pacific descent. A clinical assessment is needed to confirm the diagnosis, because several conditions look similar. Results may vary.

No. Acne keloidalis nuchae is not contagious and cannot be passed to another person by contact, by sharing clippers, or in a barber's chair. It is an inflammatory reaction in your own hair follicles, not an infection you catch. Individual lesions can become secondarily infected, which is a different matter and is worth having looked at, but the underlying condition itself does not spread from person to person.

There is no treatment that reliably cures acne keloidalis nuchae, and any clinic promising a cure is overstating what the evidence supports. It is best understood as a long-term condition that is managed rather than cured. Early papular disease is the stage where intervention is most useful, because the aim is to reduce inflammation and limit the fibrous scarring that follows it. Once firm plaques, nodules or areas of scarring hair loss have formed, those changes are generally permanent and the goal shifts to preventing further progression. This is why getting assessed early matters more than which product you buy. Results may vary.

It usually does not. Left alone and with the mechanical trigger continuing, acne keloidalis nuchae tends to persist and slowly progress from scattered firm papules to larger plaques, and in some people to bands of scarring hair loss along the nape. The single most useful thing most people can do early is to change what is irritating the area, which usually means stopping very close clipper work at the hairline and reducing collar or headwear friction. That alone will not reverse existing fibrous change, but it removes the driver.

Not in the sense of spreading to another person or to another part of the body. What it does do is extend locally. New papules appear alongside existing ones at the nape and lower occipital scalp, and over time separate papules can coalesce into a plaque or a raised band. That local extension is what most people mean when they say it is spreading, and it is a reason to have it assessed rather than to wait.

Acne keloidalis nuchae is not a dangerous condition in the sense of threatening your general health, and it is not a cancer. What it does carry is a real risk of permanent cosmetic change: firm plaques, raised bands at the hairline, and scarring hair loss that does not regrow. Individual lesions can also become secondarily infected, with increasing pain, heat, spreading redness or discharge, and that does need prompt medical attention from your GP. The case for treating it early is about preventing permanent change, not about danger.

Yes. Advanced acne keloidalis nuchae is a form of scarring alopecia. Repeated inflammation around the follicle can destroy it and replace it with fibrous tissue, and once that has happened the hair does not grow back in that area. This is the main reason the condition is worth assessing early, while it is still papular, rather than once bands of smooth scarred skin have formed at the nape. If hair loss along the hairline is your main concern, our page on traction alopecia and thinning edges covers the other common cause. Results may vary.

No. Acne keloidalis nuchae is an inflammatory and fibrosing condition of the hair follicle, not a fungal infection. It is a reasonable question, because a fungal infection of the scalp can also produce bumps and hair loss and is treated completely differently. Bacterial folliculitis, ordinary acne, pseudofolliculitis barbae and a true keloid can all look similar at a glance too. Telling them apart is a clinical assessment, and getting it right at the start avoids months of the wrong treatment.

Assessment is with Arman Zaki, Founder and Lead Clinician, GMC-registered Physician Associate (Ref A8131967), who has a declared special interest in Skin of Colour across Fitzpatrick I to VI. Melatone does not prescribe for this condition and does not manage established plaque or nodular disease; both belong with your GP, who can refer you to dermatology. Where laser hair reduction is an appropriate adjunct to treatment your GP or a dermatologist has prescribed, it is delivered by Catia Zaki, our VTCT Level 4 Laser and IPL lead, after a patch test. Melatone Skin Clinic is at Unit 13A, Battersea Business Centre, 99-109 Lavender Hill, London SW11 5QL.