What is the role of triamcinolone acetonide injection in the treatment of acne keloidalis nuchae (AKN)?

Updated: Nov 13, 2020
  • Author: Elizabeth K Satter, MD, MPH; Chief Editor: William D James, MD  more...
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Answer

Intralesional triamcinolone acetonide injection can be helpful to reduce the size and firmness of papules and nodules. Doses range from 5 mg/mL up to 40 mg/mL for more firm and large lesions. Pretreatment anesthesia with topical lidocaine cream may reduce pain during injection. Alternatively, triamcinolone may be diluted in lidocaine to provide anesthesia with injection. Risks include skin atrophy and hypopigmentation. Liquid nitrogen may be administered to lesions to create edema and ease the injection process. [16]  Lesions may also be debulked by shaving or curetting prior to injection with triamcinolone.


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