Dermatology Days with Dr PimplePopper, Another One!

Case #1 acne keloidalis nuchae is a condition that occurs on the occipital scalp (back of the scalp) creating keloid-like and pimple-like bumps often with scarring. Unfortunately this condition is often chronic and difficult/frustrating to treat. We don’t really know the cause of this condition, but we DO know that is it worsened by friction in the area. For example, from tight shirt collars around the neck, helmets, trauma from shaving or short hair cuts, chronic bacterial infections in the area. Majority of patients are male, and a good amount are African American or Hispanic, especially people with very coarse, curly hair. Treatment options include topical and oral antibiotics, injections of intralesional steroid (as you see here).

A milium (single for milia) is a small superficial cyst formed in the top layer of the skin called the epidermis. They appear as tiny, pearly-white bumps just under the surface of the skin. They contain keratin (skin protein) and are harmless. They are often seen on the face, in particular on the delicate skin around the eyes. They can be prevented or minimized with exfoliating like chemical peels, microdermabrasion or topical retinoids. However, they are sometimes difficult to remove without a physician’s help, since they cannot simply be squeezed out. Often, the surface of the skin has to be pierced first with a lancet, a sharp pointed blade, or a needle, in order to successfully remove the milium. Often a comedone extractor is used to express the milium.

A whitehead is also called a closed comedo (single for comedone). It is a completely blocked pore. Keratin (skin protein) and sebum (oil) combine to block the pore. Whiteheads can be extracted using a Schaumberg-type comedone extractor as you see here, but often, a superficial nick in the skin must be placed first in the skin to allow easy extraction.

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This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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