Doctors report new methods for reliable and natural results

In a study by Dr. U Hair and Skin Clinic, new medical advances have the potential to improve Acne Keloidalis Nuchae (AKN), a condition that mainly afflicts men of color. Affected individuals often attribute it to prior episodes of close shaving of the scalp resulting in small “razor bumps” or “ingrown hair” on the back of the head and neck that worsen over time. In most cases, AKN manifests as debilitating bumps and keloidal masses in the back of the neck, which is challenging to cure. A recent series of publications by doctors at Harbor UCLA have shed light on new methods of obtaining consistent aesthetic and long-term outcomes.

According to Dr. Sanusi Umar, the condition is poorly researched and treatment success has been unpredictable: “Previously, the Acne Keloidalis Nuchae treatment field has lacked objective criteria for matching lesion type and severity to specific treatment techniques. Poor or unpredictable results can largely be attributed to this missing component.”

The efficacy of previous treatments is difficult to evaluate because they were deployed without an objective measure that guides the types of lesions to which these treatments are best suited. While one method could prove effective in one instance, it often fails dismally in another manifestation of the disease. To overcome this problem, the authors of these publication series not only developed measurable systems for qualifying patients but innovated surgical and laser methods for treating them.

One publication on JAAD CR captures a recommended surgical approach for smaller AKN lesions, which can be closed immediately after removal to create an aesthetically inconsequential scar. The authors introduced the innovation of trichophytic closure of wounds which causes hair to grow through the scar, thereby camouflaging it.

In a second publication on Plastic and Reconstructive Surgery Global Open, the group reported a comprehensive surgical approach to larger AKN lesions by introducing selection criteria as well as some innovative techniques for improving outcomes. According to Dr. Umar, we have found the BAT excision and tension suturing methods we described the result in a more natural looking posterior hairline and a faster healing time. A third paper also published in JAAD CR described a new selection criteria for using laser hair removal in treating AKN for a more consistent and predictable outcome. The authors also described methods for obtaining the most natural look as opposed to conventional laser treatment approaches, which have resulted in unpredictable outcomes and unappealing patchy treatment zones. According to Dr. Umar, the methodologies reported in all three papers resulted typically in the permanent removal of disease in most patients.

Dr. Sanusi Umar heads the Department of Cosmetic Dermatology at Harbor UCLA. He is also the Founder of Dr. U Hair and Skin Clinic where most of the published cases were seen and treated. Dr. Umar is an internationally recognized dermatologist and hair transplant surgeon engaged in research which aims to improve the understanding of AKN and develop new insights in disease prevention and cure.