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Articles about Acne Keloidalis Nuchae and other Skin and head-related bumps

Terminated Acne Keloidalis Nuchae Bump Still Gone 14 Years Later makes Man Happy

Can You Tell That This Man Had AKN Surgery? See His Final Scar Outcome

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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

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
This patient’s AKN is classified as a Class I plaque, according to Dr.Bumpinator’s categorization schema.

Dr.Bumpinator’s categorization schema helps patients by allowing them to be matched with the most appropriate treatment format. By pairing specific cases with fitting methods, it is possible to expect the best possible cosmetic outcome (1) reliably.

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!
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.
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
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.

Frequently Asked Questions – AKN Removal

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

  1. 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

Read More »Can You Tell That This Man Had AKN Surgery? See His Final Scar Outcome

After previous surgery at another doctor, her left earlobe keloid returned larger.

The Keloid Dilemma

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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
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 

black female - keloid risk in ethnic individuals
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

  1. Symptoms
  2. Aesthetics
  3. Size
  4. Ulceration
  5. 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) – 

  1. Massive ear keloid: One keloid lesion measuring greater than 10 centimeters.
  2. Large and semi-massive ear keloid: One keloid lesion measuring 2.1-10 centimeters.
  3. 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

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
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.
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 – 

  1. 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. 

Read More »The Keloid Dilemma