Intralesional Triamcinolone Acetonide in the Management of Acne Keloidalis Nuchae

Background: Acne keloidalis nuchae (AKN) is a chronic, scarring folliculitis that predominantly affects the occipital scalp and posterior neck, leading to significant cosmetic and psychological morbidity. Current treatment remains challenging, and recurrence is common.Objective: This article reviews the efficacy and safety of intralesional triamcinolone acetonide (ILTA) in AKN and presents clinical insights into its application as a practical, cost-effective therapy.Methods: A comprehensive review of the literature was undertaken using PubMed, Google Scholar, and regional databases. In addition, case experiences from patients treated with ILTA injections at a dermatology practice in Pakistan are highlighted.Results: ILTA demonstrates significant efficacy in reducing inflammation, pruritus, and lesion size, with high patient satisfaction. Side effects such as atrophy and hypopigmentation are rare when administered at appropriate concentrations. Combination approaches (ILTA with antibiotics, laser, or surgery) further improve long-term outcomes.Conclusion: ILTA is a cornerstone therapy for AKN, offering a safe and effective treatment option when delivered using proper technique and dosage.