This Hispanic male patient was suffering from a large AKN lesion at the nape of his head. The mass was 12cm in length and, being a stage 2 plaque, was taking up a significant part of his scalp. The patient was not happy with how unsightly the lesion looked. He also experienced itching and flaking because of it.
A Family Curse – AKN Lesions
This patient had a family history of AKN. Both his father and brother had AKN lesions, so although his initial thought was it the bumps were a result of razor burn, he had a theory that it must’ve been genetic. He was right about that, of course. AKN is not caused by razor burn, although skin-close haircuts can trigger lesion formation.
The young man had tried to eliminate or partially dissolve his AKN plaque with steroid injections but saw no improvement. That’s when he came to Dr. Bumpinator, AKA Dr. Umar, as his last resort.
The patient had a large AKN plaque at the nape of his head.*
AKN, begone!
If there’s one thing you can be sure of, it’s not AKN safe from Dr. Bumpinator – family history or not. When the patient came to him, Dr. Bumpinator first assessed the plaque to classify it. Based on its 5 cm height, the plaque fell under Class II categorization. As for its type, it’s a combination of keloidal and tumorous mass.
For this class and type of AKN, Dr. Bumpinator judged surgical removal as the best option.
He performed the surgery in his clinic in Manhattan Beach without any complications. Dr. Bumpinator excised the AKN plaque using the bat excision technique he developed. Once the mass was removed, he brought the wound edges closer and held them together with the Athena suture guards.
Dr. Bumpinator used his patented Athena suture guards for this AKN removal procedure.
The Athena suture guards ensure optimal wound healing and mitigate unnecessary stress on the procedure site. It is also used to dictate the scar’s shape that eventually results.
A Fresh Start
The patient could embark on a new, AKN-free chapter of his life through surgical removal. Despite his family history of AKN, he would be able never to have to worry about his AKN lesions again. He was delighted with the results and the way his wound healed. The scar looked subtle enough and was aesthetically acceptable.
This young man had a family history of AKN and was able to get his lesion removed with Dr. Bumpinator’s help.*
The video below demonstrates the excellent results of the patient’s AKN removal surgery.
Umar S, David CV, Castillo JR, Queller J, Sandhu S. Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions. Plast Reconstr Surg Glob Open. 2019;7(5):e2215. Published 2019 May 16. doi:10.1097/GOX.0000000000002215
Umar S, Lee DJ, Lullo JJ. A Retrospective Cohort Study and Clinical Classification System of Acne Keloidalis Nuchae. J Clin Aesthet Dermatol. 2021;14(4):E61-E67.
Frequently Asked Questions
Is AKN hereditary?
Although the exact causes of AKN are unknown, you may be genetically predisposed to having AKN lesions.
Is AKN a rare condition?
Unfortunately, AKN is relatively common in Black and Hispanic men. It is, however, rare in people of other ethnicities.
What is AKN: Acne Keloidalis Nuchae, often abbreviated as AKN, is a skin condition that manifests in the form of small or large painful bumps on the back of the head. In their initial state, the small bumps can be confused for razor burns. In reality, the condition is genetic, and buzz haircuts are just a trigger for it.
This 36-year-old patient had a large lesion for 10 years and didn’t know what had caused it. He came to Dr. Umar, also known as Bumpinator, to get his AKN plaque surgically removed.
Dr. Bumpinator, AKA Dr. Umar, started off by evaluating the patient with his AKN classification system. He identified the patient’s lesion as a flat follicular plaque with Class III distribution.
He then used his bat excision method to surgically remove the AKN lesion in a fashion that ensured the most optimal wound closure with secondary intention healing (SIH). As the patient’s plaque was relatively larger in height, Dr. Bumpinator used his patent-pending Athena sutures to assist with the SIH.
Dr. Bumpinator used his Athena suture guard-assisted bat excision technique to remove the AKN lesion. *
Taking care of the AKN operation side is critical for the optimal healing and fading of the scar. Here, the wound has assumed the natural shape of the posterior hairline. Already discernible natural look as the wound continues to heal several weeks after removal by Dr. Sanusi Umar *
You can see the patient’s results, which are nothing short of life-changing.
The AKN patient had his flat follicular plaque surgically removed by Dr. Umar. *
The patient’s post-op scar is clean and healed without any complications. As seen in Before and After comparison photos above, his hair growth after surgery completely covered up the scar.
Frequently Asked Questions
Can I use medication to treat my AKN?
You can use steroid medications to address the inflammatory aspect of your AKN. You can also try antibiotics if you notice a bacterial infection with your AKN. However, you are not likely to be able to get rid of the lesions with medications alone. If you have AKN and want to get rid of it for good, contact Dr. U (Bumpinator), who will assess your condition to come up with the most optimal treatment for you.
My AKN bumps keep growing. How big can I expect them to get?
Unfortunately, AKN is known to worsen over time, meaning that AKN bumps can grow in size ranging from their depth, width, the affected area, and more.
You can consult Dr. Umar, A.K.A., the Bumpinator, to determine how to permanently eliminate your AKN lesion using any of his techniques.
References
Umar S, David CV, Castillo JR, Queller J, Sandhu S. Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions. Plast Reconstr Surg Glob Open. 2019;7(5):e2215. Published 2019 May 16. doi:10.1097/GOX.0000000000002215
Umar S, Lee DJ, Lullo JJ. A Retrospective Cohort Study and Clinical Classification System of Acne Keloidalis Nuchae. J Clin Aesthet Dermatol. 2021;14(4):E61-E67.
What Is Acne Keloidalis Nuchae?. WebMD. https://www.webmd.com/skin-problems-and-treatments/what-is-acne-keloidalis-nuchae. Published 2022. Accessed August 3, 2022.
Multiple AKN bumps on the back of the head: Acne Keloidalis Nuchae, or AKN bumps, often appear in multiples. Since the condition often follows episodes of close shaving with a razor, it is called barber’s rash and AKN razor bumps, Those tiny bumps may grow eventually, and some of them may merge to form a plaque or even a tumor-like mass. Most individuals suffering from AKN will still be left with more than one bump.
That was the case for this young man of Hispanic descent. He had many small bumps scattered all over the back of his head. However, his main concerns were the two prominent lesions in the nape area. One of those was particularly big, and the patient was experiencing lots of pain and discomfort.
Dr. Bumpinator to the Rescue
Before coming to Dr. Umar, the patient had tried to get rid of those bumps through an unsuccessful surgery. After that attempt, he researched and learned about the Bumpinator (Dr. Umar). In 2019, he came to Dr. Umar’s Manhattan clinic for consultation, where he was told his AKN consisted of Class 2 plaques and tumorous mass, and consequently decided to get the masses removed by the doctor.
Figure 1 The AKN patient had two lesions and many small bumps, which he wanted to be removed by Dr. Umar. *
Dr. Umar used his unique technique to surgically remove the biggest plaque on the lower part of the patient’s head. One major problem AKN removal surgeries cause is wide and abnormally shaped scars that look out of place. Using surgical techniques he developed and tools that he invented, including the Athena Suture guards, Dr. U can control the wound healing process, ultimately resulting in the minimization of the scar and the bending of the scar to a closer shape to that of a posterior hairline. Dr. U recommended the patient wait for the removal of the smaller plaque until the incisions from the first surgery healed. He also recommended that the smaller scattered satellite lesions can be addressed by laser treatment.
Figure 2 Dr. Umar, AKA the Bumpinator, used the Athena sutures he invented to remove the AKN plaques successfully.*
After the first surgery incisions had healed enough, the patient came in for his second AKN-removal surgery. This time, Dr. Umar removed the patient’s smaller plaque and the much more minor AKN bumps on his head.
Figure 3 Dr. Umar surgically removed the AKN plaques and the bumps from the patient’s head.*
Dr. Bumpinator Pools out the Laser from his Tool Box for an AKN Coup De Grace
For the final task of mopping up the remaining satellite lesions, Dr. Bumpinator resorted to his laser toolbox. The doctor figured five laser sessions would be necessary for this particular patient. Those sessions were spread apart by 6-8 weeks each. Since ingrown hairs often trigger AKN, laser is an effective treatment for AKN bumps because it destroys the roots of those trapped hair follicles. Doing so addresses the cause of AKN instead of just alleviating its symptoms.
Below are the patient’s excellent AKN surgery results with long and short haircuts.
Figure 4 Only 9 months post-surgery, the patient’s scar is already looking much better. *
Figure 5 1 year and 8 months after his removal surgery and the scar is healing so well, the patient feels comfortable enough to have a short haircut. *
The patient was pleased with how his AKN-removal surgery results turned out. Living with the painful and visually unappealing plaques and finally getting those removed brought him a fresh breath of air.
The realization that he could even have a short haircut and not worry about people seeing the AKN bumps anymore was especially thrilling to the young man. He felt like he had a renewed sense of confidence and improved self-esteem.
Watch Dr. Umar administer a laser treatment after surgically removing the patient’s AKN lesions.
Frequently Asked Questions
Will antibiotics treat my AKN razor bumps?
Antibiotics can help if you have developed a bacterial infection due to your AKN. Doxycycline and minocycline are examples of antibiotics that have an additional anti-inflammatory effect. Antibiotics, in general, would only result in temporary relief and are not expected to result in a long-term resolution.
You should see a specialist who would determine the best long-term curative method for your specific presentation.
What are some signs of AKN worsening?
If your AKN bumps are getting bigger and/or merging, it is a clear sign that your AKN is growing in severity. The longer you wait, the more problematic the bumps will get. You should be diagnosed and treated as soon as possible.
References
Umar S, Lee DJ, Lullo JJ. A Retrospective Cohort Study and Clinical Classification System of Acne Keloidalis Nuchae. J Clin Aesthet Dermatol. 2021;14(4):E61-E67.
21 Types of Skin Lesions, Pictures, Causes, and More. Healthline. https://www.healthline.com/health/skin-lesions. Published 2022. Accessed August 3, 2022.
When a 28-year-old patient named Robert turned to Dr. Sandra Lee, AKA Dr.Pimple Popper, to remove the keloid scars on the back head and another on the left earlobe, Dr.Pimple Popper was shocked at the size and shape of the keloidal mass on his head. She quickly realized she’d need to enlist Dr. Umar, AKA Dr.Bumpinator, for help.
Dealing with It Since 9 Years-Old
Robert’s keloid scar on the back of his head had started forming when he got his ears pierced at 18. The one on the back of his head dated even older. When he was 9-10 years old, Robert had an accident and injured his head with a glass table. After he got medical help for it and the sutures were removed, that’s when the keloid started forming. Initially, it was only the size of a penny, and Robert figured he could get it surgically removed.
However, it turned out to be more complicated than that. Robert had to get five surgeries because every time doctors would attempt to remove the keloid scars, they would come back even more aggressively and invade more of his scalp. With each time, he was losing more hope of ever being free from the keloid lesions.
Figure 1 Robert’s big keloid bump started developing when he was only 9 years old. *
Robert didn’t like how he would get stares and judgemental looks because of his keloids. He covered it daily by putting his braids in a ponytail and then spreading the ponytail over the bigger keloidal growth to ensure it wouldn’t be so apparent from the back. But trying to hide the keloids from the world every single day felt tiring and humiliating.
A Job for Two
While the keloid on Robert’s ear was something Dr. Lee wouldn’t have a problem removing, she judged that the one on his back was outside the scope of her practice routine.
It was essential to remove the mass, but an equally important objective was to ensure the keloid wouldn’t return again.
Dr. Lee knew just who to reach out to for the job.
Resourceful Dr. Pimple Popper Calls Dr. Bumpinator
Dr. Sanusi Umar (aka Dr.Bumpinator) is a world-renowned dermatologist and head of scalp and hair disorders at Harbor – UCLA medical center and owner of the Dr. U Hair and Skin Clinic in Manhattan Beach California has developed several innovative surgical techniques to help sufferers of AKN and keloid bumps fight the battle effectively.
When Dr. Sandra Lee sent Dr. Umar photos of Robert’s keloids, Dr. Umar felt he’d be able to help the young man finally be free of the serpentine keloidal mass.
Figure 2 Dr. Umar sees Robert’s keloid in person for the first time. On the right: Dr. Sandra Lee, AKA Dr. Pimple Popper.*
However, when the day of the procedure arrived and both Dr. Lee and Robert – along with his girlfriend, arrived, Robert’s case proved to be particularly challenging.
“Looking at Robert’s keloid for the first time, I felt totally stumped. Robert doesn’t have any laxity on his scalp, so what will it take to make sure the keloid doesn’t come back this time” wondered Dr. Bumpinator.
Another worry about the case was how well the scar would heal and whether the scar healing itself would trigger another keloid regrowth or not. Dr. Pimple Popper explains how the wider the base of the keloid, the harder it is to cover up the wound in a way so that the scar heals in an esthetically acceptable way, but there isn’t too much tension to aggravate the area and prompt the keloid to grow back.
Is Sixth Time the Charm?
During the procedure, Robert was to stay awake. Dr. Umar and Dr. Sandra Lee thought there was no need to put him under general anesthesia. It would be best to keep the patient awake – he’d be aware of the procedure and could communicate any questions or concerns he might have.
Dr. Umar’s strategy for the case was to use a multitude of techniques. This was to ensure the keloid didn’t stand a chance. In other words, he strategically planned out an attack on all fronts. Dr. Umar decided to employ four advanced and unique techniques after discussing those with Robert and getting his consent.
The first technique employed for the procedure was using the Athena suture guards, invented by Dr. Bumpinator. Those guards diffuse tension so that the sutures themselves don’t put too much stress on the operation site or cut the tissue by pulling too much. If the pressure from the sutures pulling the scalp is too high, that may trigger the keloid to regrow, which Dr. Umar and Dr. Sandra Lee were trying to prevent.
Next, Dr. Umar will extract fat from Robert’s abdomen and process it into micronized form called nanofat. The nano fat would be injected into the keloid-removal wound to promote optimal healing. The stem cells in the nano fat would influence the healing process favorably. “Those stem cells influence how the area behaves for the next few weeks and promote optimal wound healing,” said Dr. Umar.
This Could’ve Potentially Been a Problem
The third innovative technique for minimizing the chance of keloid recurring proposed by Dr. Bumpinator involves the application of an extracellular matrix. This matrix is derived from the porcine (Pig) bladder. This has the potential to minimize scar formation. However, with Dr. Pimple Popper, he decided first to consult Robert about how he feels about using pig products in his body. The two doctors are mindful of the possible religious/ethical conflicts some may have about using pig products such as the extracellular matrix called Acell. The use of porcine products may be of concern to strict observers of kosher or halal restrictions. Fortunately, Robert confirmed that he was okay with using the extracellular matrix.
Finally, the 4th technique was to have Robert undergo radiation treatment to be administered locally to the wound created by the keloid removal. Dr. Umar and Dr. Sandra Lee decided that to add another layer of assurance that the keloid wouldn’t grow back, it would be best for Robert to undergo three rounds of radiation. Keloids are essentially non-cancerous tumors, and tumors – benign or malignant, tend to respond to X-rays. Although X-rays are not always 100% effective in keloid treatment, they significantly decrease the chance of the keloid returning. By administering radiation treatment on Robert’s post-operation site, in addition to all the other measures taken, Dr. Sanusi Umar (aka Dr. Bumpinator) felt more confident that the keloidal mass would be gone for good.
Patchwork with the Keloidal Skin
After removing the keloid scar, the next task on the table was closing the wound. Since the base of Robert’s keloid was quite large, bringing the edges together for primary healing wasn’t an option. Dr. Umar decided to use the top layer of skin on the keloidal mass to cover up the wound. The challenge was that the skin taken from the mass was not flat or wide. That made cutting out the shape needed to cover up the site impossible. This was nothing to stop Dr. Bumpinator, though! He figured out a way to cut out smaller pieces of the skin to use them for his unique patchwork.
Once done stitching up the skin pieces to cover up the wound, Dr. Umar put dressings all over the wound to hold the skin in place.
Figure 3 Dr. Umar uses the skin from Robert’s keloid to cover up the big wound that’s left behind after the surgery. *
Doing the Impossible
After undergoing five failed surgeries, including a previous post-operative radiation treatment for his keloids, Robert was starting to think he would never be permanently free from the lesions. The keloids affected his self-esteem and brought down his overall quality of life. It even took a toll on his relationship with his girlfriend. Because of his intense headaches, Robert sometimes had a cross-attitude. Despite his girlfriend Nailah being a patient and understanding woman, it was putting unnecessary strain on their personal lives.
Figure 4 Robert finally got his keloid permanently removed with the help of Dr. Umar, AKA Dr. Bumpinator. *
“I thought my keloids would be with me forever,” says Robert.
He explains how he had constant headaches and itching and didn’t feel good about himself.
“Dr. Umar’s (Dr. Bumpinator) special treatments did the trick! He’s a skin wizard in my eyes”.
Watch the Dr. Pimple Popper episodes covering Robert’s case below.
Frequently Asked Questions
What’s inside a keloid?
Keloids are formed when the skin is trying to heal itself and overproduces collagen. The site of the wound ends up with a raised scar. That scar can keep growing if the skin continues producing collagen. To answer your question, a keloid is a raised scar, so although it may ooze pus or bleed, it doesn’t have much junk inside like pimples or cysts do.
Do keloids go away naturally?
Keloids tend to grow and get bigger over time. Most of the time, even when a keloid stops growing, it doesn’t stay resolved. In rare cases, more minor keloidal bumps may flatten by themselves, but they won’t go away completely. If your keloid is bothering you, you should see an expert who can remove the keloid scar for you.
I have a tiny keloid. Would it be okay if I sanitize a scalpel and remove it myself?
The keloid formed because your injured skin failed to heal itself properly. It overcompensated for the injury by producing too much collagen, which then became the keloid. This means you are prone to developing keloidal bumps. Unless you’re a dermatologist, you most likely don’t know how your skin will react to you cutting off the keloid. The incision you’d have to make will essentially be registered as another injury to the skin. Unsurprisingly, this will likely trigger a bigger keloidal growth. Don’t try to remove the keloid scar yourself; seek a medical professional’s help instead.
The story of Dr.Bumpinator’s patient, Robert Peeters represents an extreme and unique case of severe AKN (Acne Keloidalis Nuchae) which he struggled with for nearly 20 years. His major turning point on this journey came when he discovered the work of Dr.Bumpinator.
Continue to the video below to witness the beginning of one man’s remarkable journey of personal transformation.
VIDEO: Acne Keloidalis Nuchae – The Story of Bob – Part 1
When It All Started
Robert (aka @thebigluckybear on Instagram) had a very normal childhood. He was just like all the other kids.
AKN patient’s mother proudly shows a picture of what he looked like as a toddler
However, things changed at age 10 when small bumps started to appear on the back of his neck. Doctors thought they were warts. They did not know that these seemingly harmless bumps were actually the initial signs of Acne Keloidalis Nuchae. As a result of this misdiagnosis, Robert’s condition grew progressively worse.
Between the ages of 14-16, Robert started experiencing baldness as his AKN continued to spread throughout his scalp, contributing to a condition known as CVG (Cutis Verticis Gyratum). He also developed a different form of follicular inflammation known as pseudofolliculitis barbae, along with severe rhinophyma.
Different dermatologists prescribed Accutane, antibiotics, and all types of steroids.
Yet, not one of them was able to offer surgery as a way to actually remove the worsening bump outgrowths.
Things Change For the Better – Meeting Dr.Bumpinator
Robert discusses his experience with Acne Keloidalis Nuchae
Robert felt terribly dismayed as his condition continued to get worse. Discharge and bleeding became issues for his choice of clothing (e.g. no white shirts) as well as bedding. Constant itching kept him up at night. Also, his condition adversely affected his professional and personal life. Uncomfortable social interactions became a regular part of his existence (e.g. children noticing and commenting, adults shying away from him, etc.).
Though he enjoys camping, hunting, and fishing, Robert’s severe AKN condition required that he remain in the city where he has easy access to hot running water and soap to keep up with his hygiene routine.
Robert’s AKN breaking point
Scar tissue destroyed many of the hair follicles on this AKN patient’s scalp
Inflammation associated with Robert’s conditions caused a back-of-the-head appearance that made him feel self-conscious.
Robert’s life started to change for the better when he learned that the term, Acne Keloidalis Nuchae applied to his condition. He decided to find a doctor who specialized in the removal of AKN. After conducting a search on You Tube, he discovered the doctor who would be able to actually help him, Dr. Bumpinator himself whom he described as “the only doctor who had the actual procedure done” and the only doctor that he noticed “who was actually physically treating the disease.”
Surgically removing the unwanted tissue growths on his head would pave the way for a more normal-looking appearance.
Dr.Bumpinator’s first line of attack was to assuage Robert’s symptoms and discomfort and observe how his condition would respond. He prescribed the following medications.
Antibiotics
An anti-inflammatory known as Colchicine
Finasteride
He also recommended a topical formulation of Turmeric to help reduce some of the inflammation associated with Robert’s condition.
Though radiation is used in cancer treatment, it can also be used in the treatment of AKN for certain situations, like Robert’s.
After seeing no improvement, Dr.Bumpinator had Robert undergo radiation treatment to help destroy unwanted tissue. This was then followed by surgery.
The next phase of Robert’s treatment and personal transformation would involve the physical removal of his AKN, CVG, and pseudofolliculitis barbae.
Beyond this, Dr.Bumpinator also wanted to help this special patient achieve a normal-looking appearance so that he could start to experience life just like everyone else.
Do You Suffer from Painful Bumps on Your Scalp or Back Head, Neck Area?
If you suspect that you have unwanted bumps, small or large, around your scalp area, or on the back of your head or neck, please feel free to consult with Dr. Sanusi Umar, AKA Dr. U, AKA The Bumpinator – some of these conditions, such as AKN, can be a relentless disease. It can easily worsen if left untreated, and still worsen if treated improperly through improper means.
With Dr. U AKA The Bumpinator, you rest assured that with over 20+ years of experience as a double licensed dermatologist and pioneer in the field of AKN research and surgery, Dr. U has got you covered.
If you suspect that you have any of these painful or annoying bumps on the back of your head, schedule a free video consultation with Dr. U using the button below.
A patient named Reginald turned to Dr.Pimple Popper to get rid of a massive tissue growth on the back of his scalp which had developed folds and extensions. Other doctors had told him that it was a keloid. However, according to Dr.Pimple Popper, this was the product of three conditions:
Reginald’s problem was too big for her to handle alone. So she decided to contact Dr.Bumpinator for help.
A Twenty Year Problem
According to Reginald, living with his AKN, CVG, and keloid growth was difficult. Not only was it tender and itchy when touched, but it was also sticky, smelled bad, bled, and oozed pus.
Radiation caused it to actually get bigger. Reggie’s devoted wife Carla even takes part in helping to manage it. Due to the fact that hair grew between the folds, she had to shave these areas and apply topical medication when it leaked.
Reggie also had to wear a hat all the time, even on his wedding day.
In fact, he never went anywhere without some type of hat. He and his wife did not like the fact that children would scream, stare, point, ask questions or comment that he looked like he is from the walking Dead.
Despite wearing a hat, Reggie still couldn’t hide his condition completely. Some AKN tissue started to form on his neck.
Acne Keloidalis Nuchae is not a condition that relents or really stops. Reggie’s problem continued to progress.
Too Big For Dr.Pimple Popper To Handle
Due to the size of Reginald’s tumor, Dr.Pimple Popper didn’t think she could get rid of it, saying that it was “beyond my abilities.”
There were two major issues associated with his excision.
Where to get new skin to close the final wound
The likelihood of recurrence.
She then decided to contact one of her dermatology colleagues
Dr.Pimple Popper Calls Dr.Bumpinator
Dr. Pimple Popper and Dr.Bumpinator team up in the fight against AKN
Dr.Pimple Popper decided to get in touch with her friend, Sanusi Umar MD (aka Dr.Bumpinator). She sent him photos of Reginald’s condition and asked if he could help.
Although Reggie’s case seemed dire, Dr.Bumpinator saw hope, noting, “the extra skin-scalp laxity helps.”
In other words, the excess skin surface area would prove useful for closing the excisional wound. At the end of his phone call with Dr.Pimple Popper, he confidently confirmed, “I’ll be glad to take him.”
Dr.Pimple Popper remarked, “I am really pleased that Reggie is going to be in the best hands.”
After meeting Dr.Bumpinator in person, Reginald was confident this new doctor could get the job done. Dr.Bumpinator helped him feel comfortable by “explaining more and giving more details [about] what he was gonna do.”
Reginald was very happy that he was finally getting the help he needed, saying that this was the “best news I’ve heard in years…This is going to change my life tremendously.”
Bumpinator – “We Have to Do This As A-Team”
Dr. Pimple Popper decided to be at Reginald’s procedure to watch his surgery. As a patient, he was given laughing gas to manage both anxiety and pain. Instead of being asleep, he was to remain awake.
Since the lower back of the scalp was prone to heavy bleeding, Carla was worried about what could happen. Due to this risk, Dr. Bumpinator and his team made sure to closely monitor Reginald’s heart rate and blood pressure.
To excise the massive bump, Dr.Bumpinator used a device to cut and cauterize the tissue. He managed to successfully remove the unwanted tissue mass all in one piece. Reggie felt lighter afterward due to its weight.
The Challenge: What To Do About the Big Hole
Excising the unwanted AKN tumor was a big milestone. But the actual hard part was closing the big hole which remained afterward. According to Dr. Pimple Popper, major complications could arise if large areas like this are not closed properly.
Dr.Bumpinator’s Athena Tension Sutures Made All The Difference
Dr.Bumpinator developed an amazing method for closing huge AKN wounds after surgery
So what is the best way to close a large-size AKN surgical wound?
Dr.Bumpinator explains, “When I remove the lesion, we’ll be left with a wide wound…And my goal is to bring those wound edges as close together as possible without actually having them touch each other…We have developed an implement to assist with that process.”
So what’s wrong with just using regular sutures alone?
According to Dr.Bumpinator, “If we use anything ordinary, the suture will just cut right through the tissue.”
The gap between the wound is an important detail needed for Reggie’s outcome. It was left open on purpose.
Dr. Bumpinator’s rationale for not closing AKN wounds completely following a procedure
Here’s the rationale, according to Dr.Bumpinator, “with the tension suture kit holding that wound just slightly apart, what happens is the wound now will try to do the rest of the work.”
Dr. Pimple Popper further explains, “It’s almost as if letting this heal a little bit is a signal to your body to really send more resources in there and help to fix that wound.”
Dr.Bumpinator devotes his work to help real people feel unashamed of the back of their head after their AKN removal
Says Dr.Bumpinator, “I want Reggie to come out with a back of the head that he will not be ashamed to show to the world.”
Due to his advanced innovative surgical techniques, Dr. Bumpinator’s patients are left with a discrete and natural-looking scar that they don’t have to feel self-conscious about.
Though Reginald’s case seems difficult, it was certainly not impossible for Dr.Bumpinator to handle.
This gentleman, a member of the U.S. Armed Forces, developed AKN bumps on the back of his scalp. Due to military shaved head requirements, these tissue lesions became a major source of distress. After undergoing failed treatment at a different provider, he then decided to seek help from none other than Dr.Bumpinator himself.
Before Photos – A Growing AKN Problem Prevents This Patient From Having A “Career Must” Military Crew Cut
Acne Keloidalis Nuchae bumps started to grow and merge on the lower part of this patient’s scalp, forming an awkward-looking region of thick, bumpy collagen.
Contrary to urban myth, this had nothing to do with dirty clippers. According to Dr. Bumpinator, AKN is a genetically predisposed condition that causes the skin to react adversely to a close razor shave.
Due to his Acne Keloidalis Nuchae lesion, this patient would not be able to wear his hair short, according to military shaved head requirements. His condition became an issue for his career path in the military.
Although another provider had prescribed Accutane, a toxic oral medication recommended for acne vulgaris (i.e., common acne), this treatment did not eliminate this patient’s AKN bumps.
The patient’s AKN lesions would show through a short military-style haircut.
The patient’s genetic predisposition led to the development of Acne Keloidalis Nuchae bumps.
For this particular patient case, Dr.Bumpinator decided to apply a surgical technique that he developed at his clinic, along with a proprietary tool that he invented [1]. Here he is at work.
Dr. Bumpinator assesses the affected AKN region on the back of this patient’s head.
Measuring the AKN tissue relative to scalp landmarks such as the occipital notch is an important step.
Dr. Bumpinator at work to remove the patient’s Acne Keloidalis Nuchae once and for all.
Before and After Photos – Dr.Bumpinator’s Natural Looking Signature Scar Replaces This Patient’s AKN Worries
Dr.Bumpinator’s special surgical approach not only eliminated the unwanted AKN tissue but also left a clean linear scar aligned with the patient’s posterior hairline. See his before and after photos below.
A straight, clean linear scar now replaces the former AKN region.
Dr.Bumpinator made sure that the edges of the patient’s AKN surgery wound closed into a natural-looking scar.
Dr.Bumpinator’s final linear scar aligns inconspicuously with the patient’s posterior hairline.
VIDEO – No More Military Shaved Head Career Stress Thanks to Dr.Bumpinator’s Triumphant AKN Removal
Watch the video below to learn more about this military patient’s journey with AKN and the feedback he provides about his experience with Dr.Bumpinator.
Frequently Asked Questions – Needing to Meet Military Crew Cut Regulations? What to Know About Treating Acne Keloidalis Nuchae
Why do drugs not work for treating AKN?
Acne Keloidalis Nuchae is a condition where the skin overreacts and profusely produces collagen. Drugs can’t subtract or eliminate this unwanted tissue. They can only address the issue of inflammation and symptoms of discomfort, such as pain, itching, and swelling.
It seems that everyone says that dirty razor clippers cause razor bumps and Acne Keloidalis Nuchae. Is this actually true?
AKN can develop whether or not the clippers used are clean or dirty. The real cause is not bacteria or microbes but how your skin reacts to the ingrowth of hair. This response is different from person to person and determined by genetics.
Are there any at-home treatments or over-the-counter products that can help with AKN?
This patient first came to see Dr.Bumpinator after an eight-year struggle with Acne Keloidalis Nuchae – AKN. Before this, he tried a nonsurgical approach at a different clinic using steroid injections. However, this did not get rid of his bump lesion. He then decided to choose Dr.Bumpinator as his service provider, hoping to achieve a discrete and inconspicuous linear scar. With Dr.Bumpinator’s surgical method to produce the best Acne Keloidalis Nuchae treatment results, this patient would also be able to have his final scar covered with his own hair growth.
Before Photos – AKN Class I Plaque
Due to the size and location of this patient’s bump lesions, this patient was categorized as an AKN Class I Plaque, according to Dr.Bumpinator’s system of classification.
The patient’s AKN bump is vertically narrow and located in the upper nuchal region.
This patient’s AKN is classified as a Class I plaque, according to Dr.Bumpinator’s categorization schema.
Procedure Photos – Dr. Bumpinator’s Acne Keloidalis Nuchae Treatment Results – A Thin, Discrete Linear Scar
For this patient’s procedure, the most obvious starting point was to remove the actual AKN bump lesion through surgical excision. Dr.Bumpinator’s innovative surgical method would then result in a thin linear scar covered by the patient’s own hair growth.
Dr.Bumpinator at work to TERMINATE this patient’s AKN for GOOD!
Using his trichophytic wound closure technique, this patient had the edges of his wound sutured on the same day right after his excision.
After Photos – A Well Camouflaged Final Linear Scar
Here are images of this patient’s outcome, taken 14 years after his procedure with Dr.Bumpinator. Due to the successful growth of hair through the final linear scar, it is not even obvious that this patient had undergone any surgical removal or that AKN was even a problem in the first place. Can you tell that he even had a procedure done?
AKN Patient With Thin, Unnoticeable Linear Scar
VIDEO: Acne Keloidalis Nuchae Treatment Results – No More Embarrassing Bumps
Watch this video to learn more about Dr. Bumpinator’s surgical journey and final scar outcome.
Should I see a dermatologist get rid of my AKN bumps?
Acne Keloidalist Nuchae removal requires a specialized treatment approach. Many doctors (dermatologists included) lack the expertise required to eliminate lesions and keep them from coming back permanently. Patients are often prescribed drug medications, injections, topicals, etc. However, these will not actually get rid of the unwanted tissue. Although AKN can be excised using surgery, Dr.Bumpinator recommends classifying each patient case to determine specific protocols for removal. It’s important to realize that the end goal is not just to get rid of the Acne Keloidalis Nuchae bumps but also to leave behind the most natural-looking final scar. This will require more advanced surgical methods. You will need to see a true specialist.
Is Acne Keloidalis Nuchae the same as razor bumps?
AKN starts as tiny bumps, resulting from close razor shaves on the back of the head. However, what makes them different from ordinary razor (shaved haircut) bumps is how the person’s skin responds. Affected individuals have a genetic predisposition to produce prolific collagen as a reaction to ingrown hair. Their immune systems mistake the hair shaft as a threat. The collagen is intended to heal the damage resulting from these attacks. So really, AKN does start as what appears to be regular razor bumps. But the bumps themselves (in predisposed individuals) are really starting a progressive and chronic skin issue.
Does AKN come back after surgical removal?
It really depends on how the surgical excision and wound closure was performed. Bumps are more like to return if the surgeon does not excise deeply enough to remove the affected tissue. Also, they can come back if the wrong wound closure method is used. Dr.Bumpinator has developed methods that aim towards long-term and permanent outcomes that patients can be happy with in the end.
References
Umar, Sanusi et al. “Patient selection criteria and innovative techniques for improving outcome and cosmesis in acne keloidalis nuchae lesion excision and primary closure.” JAAD case reports vol. 5,1 24-28. 4 Dec. 2018
Lawndale Teen Struggles With Embarrassing Ear Keloid Bumps: If you notice your skin thickening after a piercing, particularly ear piercing, you could be growing an ear keloid. One wouldn’t consider an ear-piercing a serious injury, but surprisingly the body actually does. According to Dr. Sanusi Umar at Dr. U Hair and Skin Clinic, keloids can develop afterbody piercing or even a tattoo. But the piercing of the ear is the most common cause of keloids.
After previous surgery at another doctor, her left earlobe keloid returned larger.
Before meeting Dr. U, also known as Dr. Bumpinator, Lawndale, Calif. teen had undergone an ear keloid removal procedure by a surgeon in Beverly Hills. Much to her chagrin, the keloids returned even more aggressive with disfiguration of her left earlobe. Frustrated, she turned to Dr. Bumpinator, for help.
“The Ear Keloids That Wouldn’t Go Away”
According to the teen, the first time she tried to remove the keloids, she was under anesthesia for a seven-hour surgery and was injected with steroids. But nothing seemed to work.
“They [administered] steroid injections and said it would go down, but it didn’t,” she recounted. “I think I may be allergic to steroid injections.”
The Rubbery Ear Keloids
It wasn’t that the steroid injections didn’t work or that she was allergic, Dr. Bumpinator explained, but in her case, she didn’t respond well to surgery. In conventional surgical methods, the keloids have higher tendency to not respond, get worse and grow much larger (1).
Rear view of left earlobe with large keloidal scar
The patient looked to Dr. Bumpinator to help with her ear keloid that wouldn’t go away despite a prior surgery and series of steroid injections.
The patient’s right ear also had a keloid from a piercing.
Aside from the left ear’s keloid, this Lawndale teen also had a right ear keloid from a piercingSeeing a second doctor to correct her first keloid surgery was not in her plans. The secondary keloids were worse than before. So worse that her left ear lobe had lost its shape – it was split with two keloids. She was frustrated and worst of all embarrassed by the unsightly bumps on her lobes.
As it turned out, Dr. Bumpinator confirmed her left ear had a massive shapeless keloid deformity caused by a split ear lobe. Her right ear also had a small keloid where once there was a piercing between the helix and snug region of the ear. Though benign, Dr. Bumpinator recommended excision of all lesions and repair of her left deformed earlobe.
Dr. Bumpinator’s Keloid Removal Approach
Earlobe keloids are the most common type of keloids. According to Dr. Bumpinator, the keloids start out as tiny bumps after a piercing. The actual act of piercing into the ear causes a wound or “small” trauma. The trauma coupled with the tension generated by the weight of the earring is enough to create a keloid during the healing. Sometimes irritation caused by the earring metals can aggravate the situation. The longer an ear keloid is present, the larger it will grow (1).
“I could tell she was stressed and disappointed by her worsen ear keloids,” Dr. Umar said.
Upon further examination of the patient’s multiple bumps, Dr. Bumpinator knew she would need two surgeries along with post-operative care. One surgery had to be dedicated to the left earlobe alone.
Dr. Bumpinator removes the left earlobe keloid without going outside the keloid lesion and creating a new area of wounding
Dr. Bumpinator cut into the keloid to remove it keeping all cuts within the confines of the keloid. He then reconstructed her earlobe using a keloid-harnessed flap.
By cutting into the keloids and using the keloid itself as a flap, Dr. Bumpinator said the procedure minimizes the potential of the keloid reforming. Because of the complex nature of the repair and the history of prior surgery, Dr. Bumpinator took the extra precaution of adding a post-surgical radiation treatment to eliminate the chance of the keloid returning.
“Conventional surgical approach would entail just cutting it out and then closing with a suture or even leaving it open to close by itself” Dr. Bumpinator explained. “What we did was to remove her keloids while avoiding cutting into new areas and then creating a new earlobe for her.”
Aside from reconstructing her earlobe, Dr. Bumpinator was faced with the next challenge of keeping the right ear’s natural curvature. Here again, he instituted several innovative techniques from his tool box of experience to accomplish the task. The result is a maintained ear’s shape and concavity.
Dr.U affixes a keloid-harnessed flap to close the remaining wound
Before and After Photos
Before and after images depicting keloid removal on the left ear
Before and after images depicting keloid removal on the left ear
FAQ
How do I know what type of procedure would be best for my keloids?
Dr. Bumpinator offers an individualized treatment plan to remove keloids. He acknowledges that not all bumps are the same for everyone. Therefore, after a consultation, he will be able to determine the best viable treatment options for your case. Schedule a consultation to find out what type of treatment you need.
I’ve had multiple surgeries and treatments to get rid of my keloids, but nothing is working. What should I do?
Unfortunately, there are so many patients that are going through their third and fourth round of treatment to permanently get rid of the pesky keloids. The good news is Dr. Bumpinators, innovative methods, have helped a hefty number of patients permanently get rid of their keloids for good.
References –
Tirgan, Michael. (2017). Massive ear keloids: Natural history, evaluation of risk factors and recommendation for preventive measures – A retrospective case series. F1000Research. 5. 2517. 10.12688/f1000research.9504.2.
Keloids are raised scars that primarily appear after trauma – a cut or wound. They’re firm, sometimes shiny, rubbery, and have fibrous nodules that are caused by the scar tissue. They range in sizes and in colors – pink, skin-colored, red, or dark brown.
What Is Keloidal Scarring?
As the body tries to repair the wound, there is a production of collagen. It’s the overproduction of collagen that forms a lump. Typically, keloids are also known as keloid disorder and keloidal scars can form in a variety of scenarios namely – severe acne, chickenpox scarring, infections, burns, vaccinations along tension during wound closure, or repeated trauma to the skin.
Keloid scar growth on patient’s earlobe
There have also been instances with something as simple as a pimple, mosquito bite, insect bite or a scratch can cause keloids. They appear on the chest, back, shoulders, earlobes, arms, pelvic region, and the collarbone. These types of keloids are not meant to be confused with Acne Keloidalis Nuchae, which has a different etiology.
How Do I Know if I Have a Keloid
Individuals of African descent may face a higher risk for keloidal scarring
Although injuries are attributed to the result of a keloid, they can appear spontaneously and prone to growth. Similarly, it can start as a small lesion on the skin and grow (slowly) with time (1). Keloids also tend to appear more so in the younger years, Dr. Sanusi Umar, also known as Dr. Bumpinator explained. Meaning that young girls between ages 10 and 20 have a higher frequency of keloids due to ear piercings.
Keloid symptoms include –
Itchy, stinging, or burning sensations on the skin.
There’s a ridged or bumpy area on the skin that’s unusually raised.
The skin is toned red or pink in color.
The scar tissue, in time, increases in size
The keloid can be unsightly or uncomfortable.
A qualified medical professional can diagnose and treat keloids. Although medical attention is not necessary to treat keloid. They’re generally benign, but seeking medical attention as a precaution is not a bad idea.
Reasons To Get Keloids Removed
Symptoms
Aesthetics
Size
Ulceration
Proximity and involvements of vital organs and functions
A keloid’s common area on the body includes – areas of high skin tension.
The Pierced Ear Keloid
Keloids are most common after ear piercing. The piercing itself causes a minor trauma on the earlobes in addition to the skin and cartilage higher on the ear. As the wound heals wider and larger than the initial pierced skin, it becomes uncomfortable and embarrassing too.
Because the way every person heals from wounds is different, the size of the developed keloid varies from person to person. This condition is commonly seen mostly among African Americans, Latinos, and Asians (1).
Ear keloids are broken down into three types (1) –
Massive ear keloid: One keloid lesion measuring greater than 10 centimeters.
Large and semi-massive ear keloid: One keloid lesion measuring 2.1-10 centimeters.
Small ear keloids: One keloid lesion measuring no greater than 2 centimeters.
Removing Keloids
Conventional methods of keloid removal call for surgical removal, but according to research, almost all ear keloids will “relapse” after surgery (1). When those keloids grow back they get worse and with time even grow larger. Ultimately, “the ear keloids will continue to relapse in many instances and at some point, the surgeon and patient or both will abandon therapeutic intervention,” research documents show.
Dr. Bumpinator disagrees. “With the appropriate treatment,” Dr. Bumpinator said. “the lesions or keloids respond well and never return.”
For this to occur special surgical and post-surgical protocols are necessary. At Dr. U Hair and Skin Clinic in Manhattan Beach, he’s implemented a keloid removal procedure that helps prevent the keloid from returning. The guiding principle is to get rid of all keloid tissue while avoiding the expansion of the zone of injury by keeping all surgical injuries to within the original borders of the keloid, minimizing tension and reductive the wound created less need to form a scar in the bid to cover itself.
“I want my patients to be left with an aesthetically pleasing earlobe with fast recovery time.”
The following photos show examples of patients surgically treated by Dr Bumpinator using the espoused surgical principles:
Dr.Bumpinator is on a mission to terminate all unwanted skin bumps, including keloid scars! *
This young lady no longer has an embarrassing bump on the back of her earlobe thanks to her Dr.Bumpinator surgery *
Keloid scar bumps on the earlobe can grow to be quite large. Dr.Bumpinator not only removes them, but also refashions the final earlobe to appear as natural-looking as possible.
There are other (non-surgical) keloid removal options, including:
Cryotherapy: Freezing of the keloid. This is the better option for smaller keloids, i.e. caused by acne. Risks lightening of the skin.
Corticosteroids: Injection of medicine into the keloid. This is one of the most common approaches to remove keloids. It is also often used in conjunction with cryotherapy or post-surgery.
Medication: Though not as effective as corticosteroids, other medications that have been used to treat keloids includes: verapamil, fluorouracil, bleomycin, and interferon alfa-2b shots.
Radiation: Radiation of the Grenz zone, is the most effective if done within 24-72 hours after excisions. It is actually quite an effective treatment with a low chance of recurrence. Dr. Bumpinator uses this treatment option with more complicated wound closures.
Furthermore, Dr. Bumpinator’s unconventional method pushes for a keloid free patient who didn’t have a need for steroid injections.
Keloid Questions?
Dr. Bumpinator encourages anyone with a growth of a keloid on the ear or other parts of the body to consult with a medical professional. Ask your keloid questions at
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FAQ – Understanding Keloidal Scarring
Who is a candidate for keloid removal? Any person with a keloid can be a candidate for keloid removal.
How much does a keloid removal cost? Cost varies and depends on the size of the keloid. In other instances, at other clinics, the cost may also depend on the location of the scar and the method the doctor decides to use. The average cost could range between $350 to $3500. Unfortunately, insurance doesn’t cover cosmetic procedures.
What keloid removal procedures are available for Dr. Bumpinator patients? Dr. Bumpinator, an expert in bumps, also has experience in keloid removal and offers individualized treatment plans. In order to determine your procedure or best removal method, schedule a consultation:
References –
Tirgan, Michael. (2017). Massive ear keloids: Natural history, evaluation of risk factors and recommendation for preventive measures – A retrospective case series. F1000Research. 5. 2517. 10.12688/f1000research.9504.2.
