Folliculitis keloidalis nuchae (FKN) is a chronic condition characterized by the formation of small, raised bumps or keloids on the back of the neck, scalp, or other areas where hair grows. The exact cause of FKN is not known, but it is believed to be related to irritation and inflammation of the hair follicles.

Folliculitis keloidalis nuchae (FKN) is a chronic inflammatory disorder that affects the hair follicles on the back of the head, specifically the nape of the neck. It is characterized by the formation of small, raised, firm bumps that may develop into keloid scars.

Causes

The exact cause of FKN is not well understood, but it is believed to be related to a combination of genetic, hormonal, and environmental factors. It is more common in men and individuals with tight hairstyles or with a history of shaving, plucking, or waxing the hair in the affected area.

1. Trauma: Trauma to the hair follicles, such as rubbing, friction, or tight hairstyles, can lead to inflammation and the development of FKN.
2. Genetics: Some people may be more susceptible to developing FKN due to a genetic predisposition.
3. Hormonal changes: Hormonal changes such as puberty and pregnancy may contribute to the development of FKN.
4. Infections: Folliculitis, a bacterial or fungal infection of the hair follicles, can lead to the development of FKN.

Symptoms

Symptoms of FKN include itching, pain, and tenderness in the affected area. The bumps may become infected, leading to further inflammation and scarring. In some cases, the condition may also cause hair loss.

1. Small, raised bumps or keloids on the back of the neck, scalp, or other areas where hair grows.
2. Itching or burning sensation in the affected area.
3. Scarring of the affected area.
4. Hair loss in the affected area.
5. In some cases, the affected area may become red and swollen.

FKN can be difficult to manage and may require a combination of treatments to achieve the best results, such as topical and oral medications, laser therapy, or surgery. Consultation with a dermatologist is important for an accurate diagnosis and personalized treatment plan.

Diagnosis

FKN is typically diagnosed based on a physical examination of the affected area. A skin biopsy may be performed to confirm the diagnosis and rule out other conditions. The diagnosis may also be confirmed by the presence of multiple small, firm, reddish-brown papules or nodules, which may be accompanied by itching and/or burning.

Treatment

Treatment: Treatment for FKN may include:

1. Topical Medications: Topical creams, lotions, or ointments containing steroids or antibiotics may be used to reduce inflammation and itching.
2. Oral Medications: Oral antibiotics or corticosteroids may be prescribed to help control the inflammation.
3. Laser therapy: Laser therapy can be used to reduce the size of the keloids and improve the appearance of the affected area.
4. Surgery: In some cases, surgery may be necessary to remove the keloids. This can include surgical excision, cryotherapy, and electrodesiccation.
5. Preventive measures: Keeping the affected area clean and avoiding tight hairstyles or friction can help prevent further irritation. This can include the use of a wide-toothed comb, avoiding tight hairstyles, avoiding friction from clothing, and wearing soft clothes.

It is important to consult with a dermatologist for an accurate diagnosis and personalized treatment plan, as FKN can be difficult to manage and may require a combination of treatments to achieve the best results. It is also important to understand that FKN can be recurrent and may require long-term treatment and management.

Treatment for FKN typically involves addressing the underlying cause and managing symptoms. Treatment options may include:

1. Topical medications: Steroid creams, lotions, or ointments may be prescribed to reduce inflammation and itching. Antifungal or antibacterial creams may also be used if an infection is present.
2. Oral medications: If the condition is severe or does not respond to topical treatment, oral medications such as antibiotics, antihistamines, or corticosteroids may be prescribed.
3. Phototherapy: Ultraviolet light therapy may be used to treat FKN in some cases.
4. Hair care: Avoiding tight hairstyles, using mild shampoos, and avoiding harsh hair products may help to reduce symptoms and prevent further damage to the hair shafts.
5. Surgery: In some cases, surgery may be necessary to remove the keloids.

It is important to consult with a dermatologist for an accurate diagnosis and personalized treatment plan, as FKN can be difficult to manage and may require a combination of treatments to achieve the best results.