What is Folliculitis Decalvans: Folliculitis Decalvans (FD) is a rare, chronic (long-term) cicatricial (scarring) alopecia that occurs in adults. FD occurs on the scalp and… Read More »What is Folliculitis Decalvans?
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.
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.
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.
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
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
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.
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.
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
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:
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.
Redditors share dozens upon dozens of pictures of their bumps. And in some instances, they call their bumps something other than what it is. Those bumps could be a number of things. But it could also be Acne Keloidalis Nuchae, AKN, a skin condition where bumps or papules and pustules fuse into mass bumps and lumps.
According to Medscape, “the exact etiology of Acne Keloidalis Nuchae is unclear (3).” Therefore making it difficult to properly diagnose or treat. In Redditors’ defense, they could be misdiagnosed and not know they have AKN. Considering there is limited research, information, and treatment on AKN, it may be challenging to pinpoint the type of bumps on the back of the head or scalp. Most healthcare providers have even told patients there’s no cure for their AKN.
Patient of Dr.U with AKN bumps at the papular stage of his condition
This makes the bumps harder to treat. Worse of all, with improper treatment, they often come back with an ardent vengeance. In the same vein, people with bumps on the head struggle in silence and are often embarrassed by them.
Not Acne Keloidalis Nuchae : Other Types of Bumps Found on the Back of the Head
Dr. Sanusi Umar, also known as Dr. Bumpinator pointed out that bumps on the skin are common and in some cases harmless. He explained that bumps result from a number of conditions with the appearance and type contingent upon the cause. They vary from acne, infections, allergic reactions, skin cancer, or skin disorders.
Ultimately, when dealing, particularly with bumps on the scalp or back of the head, finding the exact type is tricky. So, what happens when your bumps aren’t the same as other Redditors and home remedies aren’t working? If the bumps on the back of the head persist or get worse –
“Don’t self-diagnose,” Dr. Bumpinator said. “You could have a more serious condition and it may require special attention.”
According to Dr. Bumpinator at Dr. U Hair and Skin Clinic in Manhattan Beach, Calif. –
“AKN is often associated with every other condition, but itself.“
Above all, AKN bumps, at first glance, are often confused for folliculitis more than other types of bumps.
1. The Folliculitis Debate
Living with these bumps in some instances, when trying to get a haircut, there are special requirements. For example, Reddit user, u/virgil_caine31/ said he’d been looking for a particular barber who wouldn’t get “weirded out” by his bumps.
“I’m looking for a barber who can accommodate my weird, if not embarrassing, situation. I have pretty bad folliculitis on my scalp and it gets especially bad in the summer. Basically it just causes red bumps and sometimes they scab and can bleed.”
Red-colored bumps seen on the neck area should be checked by a doctor who may confirm if they are folliculitis or not
Unfortunately, it’s hard to tell which is which, unless an expert specialist diagnoses the bumps. Nevertheless, when folliculitis occurs the hair follicles are inflamed. This skin condition is sometimes a bacterial or fungal infection that has small red or white pimples at the follicles. Common and benign, it forms bumps on the back of the scalp in the form of a rash. However, folliculitis with few pustules will resolve spontaneously within a few days, according to research (6).
Reddit user, /u/feedittothetree shared a picture of his small, but inflamed bumps and asked –
“Weird bumps on the back of my head. Anyone know [what]it is?”
“Probably folliculitis. That’s a common area for people to get it. You can try washing the area with an antibacterial soap and see if it helps. But otherwise a dermatologist would be the place to start. Usually it’s treated with antibiotics. Shaving the area can make it worse.”
According to Dr Bumpinator, there are also non-infectious causes of folliculitis. For this reason, Dr. Bumpinator recommends seeing a dermatologist instead of trying to self-treat.
2. The Bulging Boils
Concerned girlfriend, Danielle, u/daniellenicole18/, turned to Reddit for feedback on her boyfriend’s bumps –
“So my boyfriend, 25, used to have really nice hair. In 2016, he started to get these like pus filled boil/pimple type things on his head. They would burst and bleed it wasn’t pretty. He started losing hair where they would grow.”
By 2017-18, she said, he was prescribed Accutane to treat the acne/boils on the back of his head. But that’s when everything changed. If he didn’t take the Accutane, the boils would return. A recent visit to the dermatologist, Danielle explained, resulted in having to come to terms with long-term baldness.
Boils are usually large outgrowths on the skin which may be filled with pus
“My [boyfriend] is really, really sad,” she wrote.
Over 40 comments flooded Danielle’s post. While some offered diet tips, suggested supplements, and most encouraged a second opinion:
“Yeah, I don’t know if that’s acne. It’s just on his head? Sounds like a fungal or bacterial problem. Either way, Accutane is notorious for hair loss and changes in hair texture. So I’d definitely see another dermatologist for a [second] opinion on what to do. In the meantime look into supplements. Careful with biotin, too much can cause more acne and serums and shampoos help promote hair growth.” – u/EvieKnevie/
“How big are the pimples/boils? Not a doctor, but a med student lol so that still didn’t mean anything…but I’ve also had some folliculitis issues and his issue doesn’t quite sound the same. It seems like the Accutane helps but that doesn’t tell you what the underlying problem is, so it’s a good idea to get a second opinion, or chat with his derm again. I’ve seen other subs talk about switching shampoos, like ones with tea tree oil which is antimicrobial so could help if it has to do with bacteria/fungi.” – u/grilledcheeseolive/
Dr. Bumpinator said that furuncles, carbuncles, or boils may be similar to folliculitis, but often caused by bacteria. The boil usually causes the skin to swell and consists of accumulated pus and dead tissue. Above all, a furuncle is one boil on the skin, but a carbuncle is a cluster of boils. The carbuncles are typically the type of bump that needs medical attention as the infection gets deeper into the skin (5).
Furthermore, he explained, this often happens where the hair is rubbing on the skin like “the neck, breasts, groin, face and buttocks are common places where people get boils.”
“Boils on the scalp that won’t go away are a cause for concern,” Dr. Bumpinator said. “If the ‘so-called boils’ don’t go away after a short period of time. It’s time to see a doctor and if they keep returning after treatment, it’s time to consider they’re something else.”
3. The Slow Growing Bump: Sebaceous Cysts
Different types of skin bumps tend to grow at their own unique rates
Sebaceous Cysts are small growing bumps beneath the skin, but not to worry, they’re not cancerous. The good news, they are rare over the scalp (4). These types of bumps develop when the glands in the skin are damaged or blocked, and the oil is unable to leave the skin. According to Dr. Bumpinator, these types of bumps require surgical removal, and without it, the cyst will usually come back.
Dr. Bumpinator recommends that you should not try to self-diagnose. Always see a dermatologist for a diagnosis and management.
4. The Itchy Scalp Acne Or Allergic Reaction?
Scalp acne looks like zits and pimples, but on the scalp or back of the head. These bumps can be itchy and sometimes crusted, according to Dr. Bumpinator. Sometimes, like facial acne, there may be blackheads and whiteheads accompanied with papules and pustules or nodules and cysts. Scalp acne is treated with over the counter products, but if it lingers longer than the norm, consulting with a dermatologist is encouraged.
“…itchy acne on the scalp that turns into itchy rash/bumps on the rest of the body. I’ve had the acne type bumps for almost a month on my scalp and have been using hydrocortisone and Aloe Vera on skin but nothing seems to work and the smaller mosquito-like bumps appear sporadically throughout my body.”
“You probably need to see the derm; hard to eval the scalp with a photo. Could be folliculitis but it’s usually not super itchy. Could be psoriasis! You’ll prob need rx products” – /u/dinophile/
A Note On Psoriasis – Psoriasis is a skin condition where the cells excessively multiply and causes the skin to look scaly, dry, bumpy with red patches, and sometimes bleed (2). Dr. Bumpintor said, usually, psoriasis forms on the scalp, elbows, knees, and lower back. With unique cases of patients experiencing similar effects on the back of their head too. However, a more severe psoriasis case causes red bumpy skin. These types of bumps require different treatments that address psoriasis.
Other times, bumps similar to /u/Skill-Key could look like an allergic reaction to hair products. For example, if there’s shampoo residue from not washing it out appropriately, the excess, in the long run, could irritate the scalp and cause bumps.
An itchy scalp may sometimes incur bumps that should be assessed by a dermatologist.
5. The Fatty Lipoma
A lipoma is a non-cancerous, fatty lump that slowly grows between the skin and muscle. It occurs when there is an overgrowth of fat cells (1). Redditor /u/tylerfmarch/ vented his frustrations and said that after two surgeries to remove a lipoma in the middle of his neck, the alleged lipoma is back, after a recent surgery dating back to five months ago.
A bump on the skin or neck may turn out to be a lipoma that should be removed by a qualified specialist
“I can feel it back again. It’s probably about the size of a dime now but it has gotten up to the size of roughly a nickel-ish before, maybe a bit bigger. I’m getting really tired of this. It’s not painful or anything, so I guess I don’t NEED it removed.. it’s just gross. I just want it gone forever. Is this potentially the error of my surgeon missing some pieces? Or am I doomed to have this thing for the rest of my life?” – /u/tylerfmarch/
“I’m curious about this too. Mine is in a similar location. My derm blames weight gain, but given that mine grew back when I was in a steep caloric deficit I’m having trouble with that explanation. Parts of mine were definitely left behind though, since it was very “diffused” in shape my derm couldn’t get it all removed since I just had local anesthetic. I’m considering seeing a general surgeon and going completely under for my next surgery.” – Anonymous Redditor
Lipomas, after surgery, can sometimes come back, often because they were not completely removed. Dr. Bumpinator said seeking a second opinion, asking for a biopsy, and seeing the results can help better understand these types of bumps.
6. The Sore Razor Burns, Bumps, and Rashes
Anyone who shaves can get razor burn and the rash to match. Razor burn can cause an irritating and painful rash of small bumps on the skin. The red spots can feel sore and inflamed. The worse part, they could get infected and with large puss-filled bumps.
“I guess a barber didn’t clean his clippers and since that day I’ve had small razor bumps in the back of my head. I can’t have a low cut because the bumps make me self conscious but I hate having long hair. Does anyone have a method or product that can get rid of razor bumps?”
His post also generated a number of comments and insight from other Redditors who suggested he may have folliculitis or sebum build-up.
“Sounds more like folliculitis than razor bumps. This can be caused through bacteria getting into the skin but if it was 3 years ago it won’t still be present from the clippers, it’s likely that it’s present in your everyday life, which is completely normal. I have it all over my legs. I’d recommend going to your doctor and they should be able to diagnose you and give you something for it.” – u/emmaheath_mua1/
“Doesn’t sound like it had anything to do with your barber, you probably shouldn’t throw them under the bus. To me it just sounds like sebum build up, use exfoliants, Tend Skin is a great one. Or try switching shampoo, if you think about how you rinse off in a shower all the oils and suds run down your neck, perhaps it’s a mild allergy to sulfates, or you’re just not giving it the scrub it needs.” – /u/NatTreav/
Even though a person may – shave with the grain, use clean clippers or razors, not repeatedly shave the same area, practice proper shave care, or use proper moisturization post-shaving, the bumps can still come back. And that’s when Dr. Bumpinator advises getting an in-depth look at these rashes or bumps. The swelling, tenderness of the skin, itchiness, red bumps, and inflammation paired with bleeding and oozing puss can be signs of acne keloidalis nuchae – AKN or something more serious. Barbers often get blamed unfairly for causing AKN on account of using dirty clippers. But individuals who get AKN following a hair cut, develop it because not from dirtiness of the clippers used, but rather from a genetic predisposition to AKN which is precipitated by shaving the hair short especially in the nape areas.
AKN tends to affect males of color
AKN tends to affect males of color
Dr. Bumpinator has reviewed hundreds of Acne Keloidalis Nuchae cases and doesn’t associate barbers with the condition.
But Did You Know It Could Be AKN?
In some instances, men are unaware that they have AKN. It’s not that these other types of bumps aren’t caused for concern, but AKN is a beast of its own that may require a more aggressive treatment approach. To get a full understanding of your bumps, ask Dr. Bumpinator:
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Who is Dr.Bumpinator? The Bump Terminator
Cavaco Silva, Joana (January 2020). What is a lipoma? Retrieved from https://www.medicalnewstoday.com/articles/322551
Cole, Gary W., (n.d.) Scalp Psoriasis (Psoriasis of the Scalp) https://www.medicinenet.com/scalp_psoriasis/article.htm#what_is_scalp_psoriasis_when_can_scalp_psoriasis_begin
Satter, Elizabeth K (2019). Acne keloidalis Nuchae (AKN). Retrieved from https://emedicine.medscape.com/article/1072149-overview#a7
Singla, A., Singh, M., & Singla, S. (2015). Multiple Giant Sebaceous Cysts of Scalp. Journal of clinical and diagnostic research: JCDR, 9(11), PJ01–PJ2. https://doi.org/10.7860/JCDR/2015/15125.6798
What’s the Difference Between a Furuncle and a Carbuncle? (n.d.) Retrieved from https://www.healthline.com/health/furuncle-vs-carbuncle#treatmen
Winters RD, Mitchell M. Folliculitis. [Updated 2020 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547754/
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):
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.
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.
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.
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