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Keloid acne is a disease that begins with inflammation of the hair follicles, in which hypertrophic or keloid scars develop. The cause of the ailments is unknown, but the factors that increase the risk include short haircuts and irritation of the skin by collars and skin care preparations. The lesions are located on the nape and skin of the back of the head.
What is keloid acne?
Acne is a problem that affects many people today, especially young people (juvenile acne). The reason for its formation is blockage of pores with dead cells and sebum. It is most often found on the face, back, neck and chest, which is where there is a large number of sebaceous glands. Scar acne is a condition that begins with inflammation of the hair follicles and is a more severe form of acne. It leads to the formation of hypertrophic or keloids scars.
Although the cause of its formation is not fully known, it is said about the effects of a short haircut and the use of irritating care cosmetics. Keloid acne occurs almost exclusively in black men.
The causes of keloid acne
The ailment is related to genetic factors, and the basis of its occurrence is associated with the closure of the sebaceous glands. This leads to keratinization of the epidermis and thus the accumulation of secretions inside the sebaceous gland and a secondary accumulation of bacteria causing inflammation and suppuration. This results in the destruction of skin tissue and the formation of scars that are very difficult to remove.
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Androgens, i.e. sex hormones, also play an important role in the formation of keloid acne. This is because the cells of the sebaceous glands have receptors for these hormones in their structure, and their stimulation increases seborrhea.
Factors that increase the risk of keloid acne:
- short haircut,
- the use of irritating skin care cosmetics,
- skin irritation, e.g. through the shirt collar
- regular visits to a dermatologist – they will help prevent ailments.
Make an appointment today with a dermatologist who will help you choose the right medications and acne care.
Symptoms of keloid acne
The location of changes in the course of acne is the nape and the skin of the occiput. The condition begins with inflammation of the hair follicles on the skin around the nape of the neck and adjacent to the scalp. Then there are inflammatory papules, pustules and unbearable itching. Then the lumps become harder, spread and transform into scar plates, keloids and alopecia foci. The lesions can take various forms: they can be located under the skin and have no mouth (white “tip”), and they can be dark lesions with an open mouth, or black “tips”.
In the early stages – signs of acute folliculitis, later – damage to the walls of the follicles, perifollicular inflammation, then the development of scars and keloids. There are infiltrations composed of “plasma cells”, neutrophils, lymphocytes, the absence or reduction of sebaceous glands, later damage to the hair follicle wall and granulomatous infiltrates around hair fragments, weaving of collagen fibers at a later stage as in scar tissue. Damage to the dermis in the place where keloids are formed causes alopecia. Keloids in some people can grow and merge together, creating unsightly growths.
Additionally, there are certain factors that can worsen keloid acne symptoms, including:
- taking antiepileptic drugs, corticosteroids;
- the use of certain cosmetics (especially powder or foundation);
- hormonal contraception in the form of birth control pills;
- pregnancy,
- excessive sweating,
- humid climate,
- menstruation.
Diagnosis and treatment of keloids acne
Some men in the course of keloid acne have elevated serum testosterone levels. The disease should be differentiated from folliculitis.
Treatment of ailments should be started as soon as possible, because unsightly changes on the skin often cause complexes in young people. Therefore, in the event of its symptoms, it is necessary to visit a dermatologist as soon as possible and implement appropriate treatment, which is often long and tedious. Acne patients are given general and local antibiotics. Oral agents are most commonly tetracyclines, which have anti-microbial and anti-sebum properties – this drug should be taken for weeks or months.
In local treatment, gels, creams and ointments are used. Erythromycin, minocycline and clindamycin are most commonly used. In addition, some vitamins, such as B2, C and PP, have a good effect, and should be taken for a minimum of six months. Topical and intralesional corticosteroids are also preferred.
Another equally effective method of treating keloid acne is cryosurgery It consists in local freezing of tissues, the temperature of which should be reduced to -20 degrees Celsius. This procedure does not require special preparation of the patient and is safe. The different freezing methods are listed below:
- spraying method – the tissue is frozen with a spray 1 cm away from the scar,
- contact methods – a method that is effective in treating major acne lesions,
- method with the use of a cotton swab – a wooden swab should be wrapped in a cotton swab, and then immersed in liquid nitrogen and small scars should be removed.
Freezing (cryosurgery) works best with fresh keloids. Usually, the therapeutic cycle consists of 5 to 12 treatments, and the duration of the treatment depends on the volume of the lesion.
In some patients, a better method is gradual surgical excision of keloids, with tissue stretching, grafting and granulation healing. Both cryosurgery and surgical treatment give an aesthetic end result.
Other treatments for keloid acne:
- laser treatment,
- local application of injections to diseased areas (they alleviate symptoms and reduce scarring),
- home remedies: using face cleansers after consulting a doctor,
- periodic cleaning of the skin at the beautician.
DIG. T-51. Scar acne.
DIG. T-51. Scar acne.
Lit.: [1] Cunliff e W.J., Gollnick H.P.M.: Acne. Diagnosis and management. Martin Dunitz Ltd. 2001. [2] Webster G.F., Rawlings A.V.: Acne and its therapy. Informa Healthcare USA, Inc., 2007.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House