Acne on my head

[jnnjnnjnn]

First of all, I am a 60 year old man.  For about a year now I have this nasty condition on my head from the top down the back and on the sides.  It acts just like acne.  I've always had acne and still do but never this condition.  As I said, this particular condition just started about a year ago.  I went to the doctor and he gave me antibiotics and that solved the problem.  Unfortunately, one can't take antibiotics indefinately.  This condition is painful and embarresing.  Fortunately, I have a full head of hair so cosmetically it's only a problem when I get a haircut.  I've tried to figure out what could be causing this so I've tried stopping certain foods like sugar, and fish oil and a few other things.  Nothing works!  I've tried medicated shampoos and special concoctions that people have made for me to curtail acne.  Again, nothing works.
My routine now is to take antibiotics for 1 1/2 weeks before my haircut.  After the haircut I stop and it comes back full blast within 5 days.  It seems like this problem is not solvable by using an external treatment.  This is definately coming from the inside and is some kind of allergy or infection that antibiotics do kill.
This is really getting old and nobody seems to know what to do here.
Any help would be greatly appreciated.

Thank you,
Jeff

[Bhupinder Kaur, MD]

Hello,
You can apply the antibiotic cream after confirming the diagnosis and it can be applied once or twice a day. If you do not have significant improvement in 4-5 days, a bacterial culture of the involved area should be performed and specific antibiotics prescribed. Also gentle shampoos containing benzoyl peroxide  or alpha-hydroxy acids can be used but consult a dermatologist first.

I hope it helps. Take care and please do keep me posted on how you are doing.

[jnnjnnjnn]

Thank you for your response.  How often does one apply the antibiotic cream?  It sounds like a difficult thing to do to apply Neosporin in your hair.  You obviously can,t walk around with this goo on your head.  How much time should it be on the scalp at one application?
Also, isn't it dangerous to take oral antibiotics over a long period of time?  It requires constant antibiotic useage or it returns immediately.

Thanks again,
Jeff

[Bhupinder Kaur, MD]

Hello,
One possibility that needs to be ruled out is acne keloidalis nuchae(AKN). Treatment of AKN includes suppression of the inflammation with antibiotics and steroid gels or intralesional steroid injections. So apply antibiotic cream like Neosporin or bactroban. If the symptoms persist then oral antibiotics and steroids may be needed. Please consult a dermatologist in that case.

Larger bumps of AKN present for a while or if not responding to treatments may need surgical removal.
I hope it helps. Take care and God bless.