The efficacy of laser-assisted hair removal in the treatment of acne keloidalis nuchae; a pilot study

Background: Laser-assisted hair removal causes miniaturization of hair shafts which are the principal contributors to inflammation in acne keloidalis nuchae (AKN). Objective: To assess the efficacy of hair reduction by long pulsed Nd-YAG laser as a therapeutic modality for AKN. Methods: This interventional pilot trial included 16 patients with AKN who received 5 sessions of long pulsed Nd-YAG laser. Lesions were objectively and subjectively assessed at the third and fifth laser sessions, and 1 year after. Global response to treatment was rated using a quartile grading scale regarding the percentage improvement in the count of papules and the size of the plaques. Biopsies were taken before and 2 weeks after the fifth session to evaluate the pathological changes associated with improvement of the treated lesions. Results: All patients showed a significant improvement. The percentage of improvement in the early cases was significantly higher when compared to late cases. Two weeks after the fifth session, all biopsies showed a significant decrease in the inflammatory infiltrate except one case. Sclerosis was markedly decreased. Complete absence of hair follicles and adenexa was observed, apart from in 2 cases. Conclusion: Laser hair depilation can significantly improve this disfiguring chronic disorder. Starting treatment as early as possible achieves the best results and can stop the disease process if followed by maintenance sessions.