Acne Necrotica Miliaris | Scalp Acne
Scalp Acne Miliaris presents itself as small vesicles or pustules, that appear on the scalp region in particular the central and posterior vertices. This formation is associated with staphylococcus aureus, demodex folliculorum (minute mites that live within the hair follicle) and yeasts of malassez. Irritation may well be present. As the pressure increases within the hair follicle the pustule ruptures resulting in a crust forming over the hair follicle. This may be the only diagnostic feature linking to this disease.
Those that are affect tend to be those adults of middle age. Culture may indicate the presence of Corynebacterium (Propioni-bacterium) or Staphylococcus Aureus. If this condition is allowed to continue, follicular necrosis (destruction) may occur.
Scalp Acne Necrotica Varioliformis
Acne Necrotica Varioliformis tends to be classified as a mixed alopecia by some, resulting in permanent hairloss and necrosis. Necrosis is the death or localised destruction of tissue and cells through disease or injury. Acne Necrotica is a chronic relapsing hairloss condition that tends to affect the frontal region. The early stages tend to present as several pustules. Signs of later stages are the presents of irregular scarring that may appear like that of small pox.
The etiology in cases of Scalp Acne Necrotica Varioliformis is not fully understood. Some suggest that the appearance of such a condition is a result of an unusual response to staphylococcus Aureus or propinnibacterium acne folliculitis. Others suggest that physical manipulation such as scratching where the underlying skin is affected by folliculitis may be another factor in cases of Varioliformis. Acne Rosacea is another suggested factor. It has been suggested that this hereditary condition may be from which acne necrotica varioliformis originates.
The frontal region tend to be most affect in men more so that women. Scalp Acne necrotica varioliformis presents as itchy or in some cases painful elevations which are small and tend to be solid without the present of pus. These papules present a central depression that resemble that of a navel with crusting. The frontal region tends to be most affected.
Early stages present small pustules which may be of a reddish brown colour. The follicle in time is destroyed leaving a crusting that is shed weeks later. Scarring may well leave leave visible evidence and disfigurement.
A skin biopsy should be sought in order to confirm diagnosis as similarities are seen with many scarring alopecia’s.
What can be done to treat Acne Necrotica Varioliformis?
Early intervention and diagnosis is critical. A scalp biopsy should always be obtained as soon as possible. The following treatments may assist: Oral tetracyclines, and antibacterial shampoos can offer some relief along with sebum secretion inhibitors (isotretinoin) which may lead to prolonged remission. Topical antibiotics may assist.