Frustrated customers with “barber’s rash” have always pointed the finger at their barbers and attributed the cosmetically unsightly and itchy bumps to unhygienic conditions at the barber shop.
But that’s not the case. Those bumps on the back of your head may have nothing to do with your barber’s clippers.
Unbeknownst, AKN sufferers, blame their barber’s “dirty clippers” for the bumps on the back of their heads.
Frustrated customers with “barber’s rashes” have always pointed the finger at their barbers and attributed the cosmetically unsightly and itchy bumps to unhygienic conditions at the barber shop. But that’s not the case.
According to Dr. Bumpinator, the superhero alter ego of Dr. Sanusi Umar of Dr. U Hair and Skin Clinic in Manhattan Beach, Calif.; those bumps are called Acne Keloidalis Nuchae or- AKN.
It’s Not The Clippers Causing Bumps on the Back of the Head
Believe it or not, dirty clippers are NOT the reason men, primarily men of African, Hispanic, and Asian descent, are struggling with AKN. Instead, men who get close to taper haircuts or skin fades are at risk. In actuality, the constant close cutting of hair “causes ingrown hair irritation and creates an acute inflammatory reaction,” according to Medscape, a medical news guide (1).
And while the cause of AKN is still unsettled, Dr. Bumpinator believes that fundamental to the disease is a predisposition that causes any trauma of ingrown hair to cause a healing response that is in overdrive. The result is an exaggerated inflammation and scarring, which causes more of the same in a vicious cycle that causes the lesion to expand without relent. This may explain why some think it is a keloid when it is not. The ingrown hair occurs when the person shaves their head, and the regrowing hair causes ingrown hair due to frictional rubbing by neck collars and pillows. It has nothing to do with the cleanliness of the clipper or shaver. If you shave your head and have a genetic predisposition, you will develop AKN.
Seven-year-old Arhmani from Stockton, Calif., a few years ago, got a haircut at a barbershop in Sherwood Mall. It was a typical and routine haircut, but what ensued after came as an utter shock to his mom, Princess Redic.
“I was terrified. I didn’t know what it was. I thought it was dry scalp,” Redic told local news channel KCRA 3. “It was bleeding, and he had pus bubbles, and people were telling me it’s a ringworm, but I’m like, ‘that’s an infection.”
Reddic rushed her son to the hospital, where he was diagnosed with folliculitis. Frustrated and outraged, she filed a complaint to the California Board of Barbering and Cosmetology. The co-owner of the Exclusive Barber Shop disputed the claims. Unfortunately, these sorts of stories happen frequently, and the barbers have repeatedly accused the cause of scalp infections and bumps on the back of the head. Unfortunately, these bumps are also often misdiagnosed, leaving men and sometimes young teens to suffer in silence.
Dr. Bumpinator has reviewed hundreds of Acne Keloidalis Nuchae cases and doesn’t associate barbers with the condition.
Sometimes, it looks like a simple razor rash that has progressively worsened. Aside from being referred to as barber’s rash, some people have often referred to it as razor bumps, tinea barbae, Nestle Crunch, or confused it with boils, scalp acne, and folliculitis.
As the condition progresses, the bumps get more extensive and mold together. Over time, the bumps are more like lesions or even keloid-like plaques that become disfiguring and often painful. In more severe stages, clear pus or bloody discharge may leak from the affected areas. Patients with severe AKN cases also have talked about waking up to bloody pillows. Often, patients develop alopecia or irreversible hair loss with scarring.
Barbers are the front line of AKN Bumps.
Barbers are the front line in helping their customers understand the bumps on the back of their heads that may appear particularly after a short or tapered haircut.
The barbers aren’t ruining your lives. Barbers are the allies, not the foes, in this battle against AKN. Dr. Bumpinator, although vigilant of AKN complications and treatments, does recognize the need for proper sanitation of grooming tools like combs and hair-cutting shears. But points out that when frustrated barbershop customers walk out of the shop with a barber’s rash, pointing the finger isn’t the answer. It’s not that the clippers were dirty or that the barber had unhygienic grooming tools. Although the barbers aren’t ruining their scalps, “what these customers need to realize is that they have a condition that needs medical care,” Bumpinator said.
Barbers are essential. They are the ones that notice the problems on the scalp first. This means whether it’s the early signs of balding or dandruff; this includes any symptoms of AKN. They can recommend patients seek early intervention by dermatologists specializing in AKN treatment before the condition grows out of control.
Do you believe you have acne keloidalis nuchae or an undiagnosed bump in the back of the head? Click the button below to get started on a bump-free life with Dr. U (The Bumpinator):
FAQ
How do I know that my short haircut did not cause the bumps on my head?
A common mistake is that certain bumps after a haircut are just razor bumps. Sometimes, the bumps could be just razor bumps after a haircut and eventually go away on their own. But there are instances they don’t. And while the exact cause of AKN is unknown, the bumps are inflammations of the hair follicles that, if left untreated, can grow into a large mass. If you’re seeing these bumps repeatedly after haircuts or have gotten worse since a particular haircut, consider seeing a specialist that can better assess what they are.
References
[1]Satter, E. K., MD MPH. (2019, August 14). What causes acne keloidalis nuchae (AKN)? (D. F. Butler, MD, Ed.) [Fact sheet]. Medscape.
A man bedeviled by the pesky bumps or masses on the back of the head along with constant itching, burning and squicky oozing pus is so rustrated with the bumps on the back of his head – he’d try just about anything to get rid of them. The medical term for this condition is acne keloidalis nuchae or AKN, according to treatment expert Dr. Sanusi Umar, also known as Dr. Bumpinator at Dr. U Hair and Skin Clinic where he has been permanently terminating these bumps for many years, with proven long-lasting results.
Some home remedies may help alleviate some of the symptoms, but in the long run do not help get rid of all of the bumps on the back of the head.
Dr. Bumpinator’s Review of Reddit and Quora Home Remedies
Treating the bumps at home with the expectation to permanently eradicate them is unrealistic. Dr. Bumpinator reviewed suggested online forums, Reddit and Quora, user suggestions and provided professional insight as to what may help versus outright outrageous.
After an in-depth study of Reddit and Quora to review what home and over the counter remedies people have tried on their scalps, Dr. Bumpinator was astonished at the array of efforts to combat this condition.
These bumps go by many names on the streets, such as scalp, folliculitis, barber’s itch or razor bumps on the back of head. According to Dr. Bumpinator, although many of the posters did not show photos, they are most likely talking about AKN. Sometimes people including doctors have confused this condition with another related condition called folliculitis decalvans which tends to affect the vertex portion of the head rather than the back of the neck which is where AKN commonly resides.
1. Fungicide Approach
Online forums like Reddit and Quora are filled with questions and interactions of desperate people with bumps on the back of their heads, doing drastic things.
“Don’t make your bumps worse,” Dr. Bumpinator said. “Some home remedies can irritate the bumps and make them grow bigger or increase infection.”
One Reddit user, “/u/darktrait,” described his bumps as “pus filled bumps that feel like a scene from an alien-movie, where the baby alien rips through the host’s stomach.”
Following his comments, he shared photographs of his bloody and dried pus crusted pillows. Waking up to bloody and pus crusted pillows is a commonality amongst men who may have AKN. In the same post he talked about his misadventures in bouncing around doctor to doctor and medication to medication. He even accumulated a medical bill debt. He was frustrated that nothing was giving him the relief he needed.
Using chemicals used for fungicides and pesticides on the skin has caused skin irritations, bleeding and in some instances hospitalized people.
Desperate, he announced he was going to “experiment” with 30 Second Outdoor Cleaner that is used to clean algae, mold and mildew on a variety of surfaces like wood decks, concrete, driveways, plastic outdoor furniture and more.
“Wish me luck,” /u/darktrait shared. “I will be spraying the chemical and let it sit for one minute and then rinse it off in the shower. Let’s see if this works and kills this.”
This is dangerous. According to Dr. Bumpinator, creating treatments or self-remedies are very risky and can make you sicker beyond the scope of AKN. Dermally applying fungicides or other chemicals is like applying pesticides on the skin.
This can cause skin irritation, redness on the localized area of application, bleeding, swelling or mild skin pain. According to the Poison Control Center, In more severe cases, the chemicals develop blisters, burns – large or deep and severe skin pain. Such developments may require ER attention.
“Don’t put your health at risk by applying hazardous chemicals on your skin,” Dr, Bumpinator said.
2. The Quora Answer and the Hypodermic Needle
The constant picking and probing of the skin may leave the skin vulnerable to other infections not associated with the already painful bump on back of head.
A Quora answer was concerning to Dr. Bumpinator. An unidentified Quora user asked for suggestions on how to manage the bumps on his scalp, that’s when a Quora user, Joe, shared what he referred to as the “components to his cure.” Joe said he has struggled with the bumps on the back of his head for the last 35 years. Although he has consulted with a dermatologist who suggested not to use antibiotics or to pick at his bumps, it didn’t deter him from picking at them. But worse of all, he even said he used hand sanitizer and a hypodermic needle to treat the bumps on the back of his head.
“If a pustule develops, I use a hypodermic needle cleaned with Purell to pierce it,” Joe detailed in his post. “I then clean the area with more Purell and apply some antibiotic, even though the last dermatologist said not to use it.”
That’s a hard no. No, no – NO. First things first, hand sanitizer is meant to be used as a hand sanitizer when soap and water are not available. It kills bacteria and most viruses. Above all, the frequent use of hand sanitizer, long term, can dry out the skin; practically stripping it of its natural oils.
Combining hand sanitizer with a needle can open the skin to more serious bacteria and vulnerable to a number of infections. According to Dr. Bumpinator, putting this on your skin can cause significant dryness and irritation, but needling the area would worsen dryness and irritation further. There is an increased chance of inoculating your skin with unwanted organisms.
Despite routinely creating his own solution, it hasn’t cured his bumps and Joe admitted there is a constant cycle of scabbing, drying, peeling.
There’s no such thing as quick DIY AKN fix
Treating your own bumps on the back of the head can create more problems than there already are. Find a knowledgeable specialist and ask questions.
Oftentimes, Primary Care Physicians, PCP’s, prescribe topical creams, lotions or gels that include – a retinoid cream, a prescription-strength steroid or cortisone preparation, or an antibiotic such as clindamycin (1) – such treatments are not effective long term.
Furthermore, there have been instances in which oral medications may be prescribed in the form of antibiotic pills or a short course of steroids. In efforts to reduce inflammation and reduce or remove scar tissue, some AKN patients have received steroid injections directly into the inflamed bumps or scars. Those treatments are also temporary, with lesions returning bigger and sometimes more aggressive than before.
Other PCP’s have tried to treat it by performing a surgical excision of the bumps or larger scars or even used liquid nitrogen/cryotherapy to freeze the bumps. But because there hasn’t been a standard procedure to treat the bumps, it’s hit or miss.
The problem with the aforementioned treatments, while they may temporarily subside some of the symptoms, it is not a permanent fix. On the back end, patients are spending hundreds of dollars looking for a remedy, only to see the bumps return again; this time bigger, more irritating, more painful and harder to manage.
Other Reddit Tested Remedies
3. Choline supplement, Fish oil and Hibiclens wash
Nothing seems to help u/rcarter22/ who’s been experimenting with a number of supplements and an antiseptic skin cleanser.
“Have you started any new supplements recently? I started a Choline sup and being more regular with my fish oil, trying to figure out which may have been a factor. I’m going to start trying Hibiclens as a rinse to see. Also, changing pillowcase daily.
4. Dog shampoo, Oregano oil, Tea Tree oil and other oils did not work.
According to u/dmk, he tried using medicated dog shampoo, tea tree and oregano oil without much avail. He however found a solution using Neutrogena BP invisible mask, called Rapid Clear Stubborn Acne Daily Leave on Mask, unfortunately, when he stopped using it, the bumps returned.
“I bought that with a Neutrogena BP cleanser which is not too strong and doesn’t dry out my head. I have very short hair that I clip myself, likely a contributing factor to my folliculitis. So it was easy to rub this in and it absorbs completely. Within two days my head was clear. I really couldn’t believe it. I stopped using it and my folliculitis started to reemerge. Used this again-gone. Like 100% gone. Better than low dose doxycycline.”
5. Apple Cider Vinegar, Corticoid Injections and a concoction of things
Apple cider vinegar can treat the bacteria on the scalp, as it has antibacterial and antifungal properties that can keep the area where the bumps are clean.
Thirty-one year-old IT executive, u/Tchakpalo, from Africa opted to combine apple cider vinegar coconut oil, with corticoid injections. But unfortunately, the bumps eventually returned.
“I had to do my own diagnosis with the internet. But the folliculitis gradually evolved into a fibrosing shit leaving a lot of little keloid scar bumps. I tried home remedies for keloids, Apple cider vinegar, coconut oil, tea tree essential oil and other stuff: it flatten the bumps a lot but they remain visible through hairs. Then, Corticoids injections in the scalp cleaned everything the day after. Corticoids injections make them disappear completely, but come back after a while.”
6. They blamed the barber
So many times, men blame the barbers for the bumps on the back of their heads.
Three years ago, u/uyzi alleges his barber didn’t sanitize the hair clippers. The bumps appeared after that haircut. But what if it wasn’t his barber’s fault? Read more on how barber’s are the frontline of combating bumps on the back of the head.
“I started getting bumps all over my scalp that were filled with pus. I’ve tried everything in the book. Antibiotics, accutane, and etc. as many of you have experienced these are short term relief, because as soon as you get off them meds they flare back up. What worked for me was mixing 100% tea tree oil and aloe Vera gel with T/Sal shampoo.
For u/Caseacinator/ his bumps started two years ago after his barber shaved his head bald. Since then he claims the haircut caused the bumps and since let his hair grow. He’s used Neosporin, Tend Skin, conditioner, and moisturized his scalp with shea butter.
“I admit that I’ve picked at it and I believe that it is caused by ingrown hairs. But I’m open to any suggestions as to what else this may be. What is causing this? How to get rid of it? I’m losing my hair and I wish to go bald, but only after I figure out how this is happening. I’ve let my hair grow for months before or I trimmed it just a bit a while ago, never low to irritate the bumps, but it seems that when I go low this starts up again.” – u/Caseacinator/
7. He went herbal
When he decided to experiment with ashwagandha, u/NBNC2 was balding on the back of his head and with one bald spot in the middle of the back of his head from a red bump.
“A month ago I started consuming ashwagandha. About a week later, I noticed that every bump on my scalp was gone. None. Today the back of my head is full and those rough lines have gone.”
Meh, it didn’t work.
Other Reddit users commented on u/NBNC2’s post with words of indifference.
“This is probably a coincidence. I’ve [been] taking ash for the past year or two a day it makes zero difference.” –u/MuteMouse
One Reddit user admitted to buying over the counter aspirin to apply to his bumps.
While some opted for essential oils or prescription antibiotics, to treat the bumps on the back of head, u/BULL3T2B1NARY tried a simpler approach – over the counter, OTC, aspirin. He makes a topical paste out of two aspirin and rubs it on his head after shaving.
“Yup. Bought cheap Walgreens aspirin. Put two in my hand and let them soak for about 45 seconds and they become a paste. Then I rub it on my head. Good for exfoliating too. “It’s helped me a lot.” –u/BULL3T2B1NARY
The best way to deal with the bumps on the back of your head or to find out if you have AKN is to schedule an appointment with a healthcare provider that has a deeper understanding of the condition. It’s time to stop self-diagnosing or realizing that some of those treatments aren’t providing long lasting results. Curious to know more about AKN? Ask Dr.Bumpinator by clicking the button link below.
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FAQ –
Is there any over the counter medication or home remedy that can help me permanently get rid of the bumps? No. Here’s the thing, a bulk of the over the counter, prescription and natural/holistic remedies only provide temporary relief of the AKN symptoms. Furthermore, some people haven’t been properly diagnosed with AKN and think they may have other scalp conditions. Hence treating them inappropriately. This in turn can cause the bumps, in time, to worsen or grow bigger in size.
Resources –
Maranda, E. L., Simmons, B. J., Nguyen, A. H., Lim, V. M., & Keri, J. E. (2016). Treatment of Acne Keloidalis Nuchae: A Systematic Review of the Literature. Dermatology and therapy, 6(3), 363–378. https://doi.org/10.1007/s13555-016-0134-5
“It’s incurable” – that’s what doctors and specialists said about the raging Acne Keloidalis Nuchae, AKN, on the back of his head. Defeated, Adalid from Anaheim, Calif. hid the big bumps on the back of the head by keeping his hair long and suffered in silence for approximately 12 years. It seemed that no matter the number of specialists he consulted, no one knew how to cure bumps on the back of the neck.
“They kept saying there was no solution for it,” Adalid said.
Adalid spent 12-years looking for a treatment and cure for his itchy and foul-smelling bumps on the back of his head. All the doctors he consulted told him his condition had no remedy or cure.
AKN is a skin condition that affects the majority of African American, Latino/Hispanic and Asian men. The condition itself starts as small itchy bumps along the back of the neck that eventually grow into painful, itchy papules and pustules. In severe cases, the bumps grow bigger, can thicken, take over the entire back of the head and cause patchy hair loss.
In Adalid’s case, the bumps formed along the nape of his neck and fused on the back of his head. He described them as large, itchy and foul-smelling lesions. With time, he grew frustrated with the lack of medical treatment.
Becoming his own Advocate
Taking the matter into his own hands, he began to deeply research AKN – the condition and alternative types of treatments. That was when he stumbled upon Dr. U’s Bumpinator videos and saw what many told him was impossible – a treatment… a solution … a cure.
Armed with hope for relief for the first time in years, Adalid called Dr. U Hair and Skin Clinic in Manhattan Beach, Calif. to schedule an appointment with Dr. Bumpinator, also known as world renowned board certified dermatologist, Dr. Sanusi Umar.
Before being seen by Dr. Bumpinator, Adalid’s bumps spread and got larger on the back of his head.
Dr. Bumpinator has spent a number of years researching and treating patients with AKN. His innovative and transformative treatment options have changed the lives of hundreds of AKN patients who, like Adalid, had given up on a bump free head.
Dr. Bumpinator Saves the Day: The treatment others said didn’t exist
Dr. Bumpinator provides all patients with every possible treatment option. In some cases surgery is inevitable, depending on the type of pustules and papules level of distribution throughout the scalp.
During the consultation Dr. Bumpinator examined the bumps and determined that the type of lesions were in the merged papules and nodules stage on the verge of entering Stage II of the distribution phase. Meaning the papules and nodules were expanding and covering a larger part of the back of his head than before. According to Dr. Bumpinator, “the papules and nodules were progressively getting worse.”
Dr. Bumpinator has characterized five common variations of Acne Keloidalis Nuchae.
Dr. Bumpinator has also identified four different stages of AKN that help determine the type of treatment needed.
The thing to remember, according to Dr. Bumpinator, every AKN case is different. Therefore type of treatment varies from patient to patient. In Adalid’s case, after discussing all his options with it was decided that the best option was surgery. While in surgery, Dr. Bumpinator used his specialty BAT excision method to create a clean, natural-looking scar and neck hairline with the use of tension sutures that directed the wound closure process. The BAT excision method als minimizes the chance of the bump returning.
Living Bump Free
Ten weeks following surgery, Adalid met with Dr. Bumpinator. Upon review, Dr. Bumpinator determined, for the first time in years, Adalid finally had the relief he sought – to be bump free. During the follow up, Adalid informed Dr. Bumpinator of his plans to cut his hair and keep it short.
Ten weeks after undergoing AKN surgery and treatment with Dr. Bumpinator, Adalid showed tremendous improvement and reported he no longer had any AKN symptoms.
“Now I just wash my scalp like nothing ever happened,” he said confidently.
Finally, bump free, Adalid told Dr. Umar that he was going to finally cut his hair.
Adalid's post surgery results
“I recommend it 100 percent, [because] of the results I have today,” Adalid said.
The most noteworthy outcome of his treatment was the permanent disappearance of lesions and malodorous pus weeping, according to Adalid.
“Definitely a confidence booster,” Adalid said. “It makes you feel better. Overall it’s something you don’t have to worry about anymore.”
Due to Dr. Bumpinator’s life changing treatment options to treat AKN, more men, like Adalid, are stepping out of the shadows. No matter the size of the bumps, Dr. Bumpinator is readily available to answer questions. Submit questions and treatment inquiries by clicking the button link below:
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FAQ
How do I know if my bumps on the back of my head are acne keloidalis nuchae?
Those bumps didn’t show up big on day one. AKN actually starts out as small bumps that with time grow larger. As they get bigger, they can have a variation of symptoms that includes bumps that ooze foul smelling pus, bleed, are itchy and are inflamed. If they do not subside despite the number of doctors and treatments a person has tried, they should consider consulting with a specialist that can appropriately diagnose the bumps. Though it’s not life-threatening, they can be quite irritating and embarrassing to have.
Besides surgery, what other alternative treatments are available to treat the bumps on the back of my head, AKN?
Before any type of treatment is recommended by Dr. Bumpinator, he determines the severity of the AKN. In some instances, he may recommend a combination of treatments. Ultimately, because not all AKN cases are the same, finding the best type of treatment may require a one-on-one examination and in some instances a biopsy of the bumps. Treatments can range from surgery, laser or radiation treatment. Read more about Dr. Bumpinator’s treatment options:
