Published on March 21, 2023. Last Updated on March 21, 2023.

There are many types and classes of Acne Keloidalis Nuchae (AKN) lesions. To eliminate AKN lesions, the doctor must first evaluate the patient to determine the best AKN removal method for their specific presentation. In some patients, AKN laser treatment is preferred to surgical removal. 

Surgical removal may not be a practical or optimal approach when AKN lesions are smaller and scattered across the scalp. In these instances, the physician may consider the use of lasers. After determining laser treatment to be the most optimal approach,  the doctor would prescribe the laser treatment parameters and the number of treatment sessions needed, all based on that patient’s specific presentation.

Choice of AKN Treatment Laser

AKN treatment lasers must eliminate lesions and hair for the result to be long-lasting. Several studies have shown the efficaciousness of hair removal lasers in AKN. Many of these lasers fall into 755nm, 800nm, or 1064nm. While all these lasers are effective epilation tools, the longer wavelength lasers have the best utility in patients of color. Dr. Umar has published in the Journal of American Academy of Dermatology Case Reports the principle by which lasers work in acne keloidalis nuchae, including how to use them to produce esthetically optimal results.

Don’t Sacrifice Your Hair Aesthetics 

Another factor to consider when selecting patients for a laser AKN treatment is the patient’s AKN level. Patients are grouped in levels I – IV based on how much of the scalp the AKN has taken up. If the lesion is confined to the lowest part of the posterior scalp, then the patient is either level I or II. A more invasive AKN lesion would be classified as level III or IV. When the level of the AKN is considered for the laser treatment, it ensures more aesthetic results for the patients. 

For level I and II patients, laser treatment does not pose any aesthetic issues, as the posterior hairline does not get raised by too much. The operating expert would treat the AKN lesion and the areas surrounding the AKN. Typically, when AKN is treated by laser, the only area treated is the lesion. Since hair loss is a byproduct of laser treatment, doing so results in a patchy appearance at the back of the patient’s head. To avoid the visually undesirable outcome, Dr. Umar treats the whole area of the scalp until the point where the AKN lesion stops. This way, the patient doesn’t end up with patchy hair growth on the back of their head, and since AKN levels I and II don’t take up too much of the scalp, the new hairline is only slightly relocated and will be relatively natural-looking. 

Level III and level IV AKN patients can still benefit from laser treatment. 

Safe for Darker Skin Tones 

Another reason Dr. Bumpinator, AKA Dr. Umar, prefers the longer wave hair removal lasers. This is especially important because men of color are most susceptible to AKN. Less laser absorption by melanin means they get less skin damage in the process. 

Laser treatments can be an effective AKN treatment when administered with Dr. Bumpinator’s selection criteria, as they can yield consistent results. Although AKN is a genetically predisposed condition, it is triggered by hair getting trapped in the skin. With both surgical and laser AKN treatments, the goal is to eliminate the hair at the center of the lesion. With laser treatment, the energy penetrates the skin and gets just deep enough to kill the hair follicle at its root. When the roots of the hairs are destroyed, those hair follicles will fall out within a few days. Without the trapped hair in the skin, AKN should not have a reason to return.

Two Birds with One Stone

Since recurring bumps are often a major concern for AKN patients, laser treatment is practically godsent for many. It simultaneously: 

1. Removes the unwanted AKN liaisons,
2. Prevents AKN from reoccurring. 

By using his laser treatment approach, Dr. Bumpitator (AKA Dr. Umar) kills the ingrown hair, presenting the culprit, and frees his patients from the stubborn grasp of AKN. 

If you are suffering from AKN, book a free consultation with Dr. Bumpinator to find the best AKN removal technique specifically for you. Don’t wait until the AKN progresses, as you will be subjecting yourself to more pain and discomfort, and removing an AKN lesion at a later stage may leave a more prominent scar. 

Frequently Asked Questions

How does ND:YAG laser work?

ND:YAG is pulsating energy that destroys the root of the hair follicle and simultaneously attacks the sebaceous gland to decrease sebum production and prevent clogging. Those two combined ensure that the hair doesn’t get trapped in the skin and does not trigger AKN. 

I have small acne-like bumps on the back of my head. How can I know if they are regular acne, razor bumps, or laser-treatable AKN?

There is no sure way for you to know what the bumps on the back of your head are. You would need to be diagnosed by a medical professional to know what the bumps are and get appropriate treatment for them.

References

1. Aly R, Dawood G, Hh El-Mahlawy M, M. Swelam M. NEODYMIUM -DOPED YTTRIUM -ALUMINIUM GARNET (ND: YAG) LASER 1064 NM IN TREATMENT OF ACNE KELOIDALIS NUCHAE, CLINICAL AND HISTOPATHOLOGICAL EVALUATION. ReseachGate. https://www.researchgate.net/publication/341965119_NEODYMIUM_-DOPED_YTTRIUM_-ALUMINIUM_GARNET_ND_YAG_LASER_1064_NM_IN_TREATMENT_OF_ACNE_KELOIDALIS_NUCHAE_CLINICAL_AND_HISTOPATHOLOGICAL_EVALUATION. Published 2015. Accessed August 15, 2022.
2. Eremia S, Li C, Umar SH. A side-by-side comparative study of 1064 nm Nd:YAG, 810 nm diode and 755 nm alexandrite lasers for treatment of 0.3-3 mm leg veins. Dermatol Surg. 2002;28(3):224-230. doi:10.1046/j.1524-4725.2002.01162.x
3. Esmat SM, Abdel Hay RM, Abu Zeid OM, Hosni HN. The efficacy of laser-assisted hair removal in the treatment of acne keloidalis nuchae; a pilot study. Eur J Dermatol. 2012;22(5):645-650. doi:10.1684/ejd.2012.1830
4. Shah GK. Efficacy of diode laser for treating acne keloidalis nuchae. Indian J Dermatol Venereol Leprol. 2005;71(1):31-34. doi:10.4103/0378-6323.13783
5. Tawfik A, Osman MA, Rashwan I. A Novel Treatment of Acne Keloidalis Nuchae by Long-Pulsed Alexandrite Laser. Dermatol Surg. 2018;44(3):413-420. doi:10.1097/DSS.0000000000001336
6. Umar S. Selection criteria and techniques for improved cosmesis and predictable outcomes in laser hair removal treatment of acne keloidalis nuchae [published correction appears in JAAD Case Rep. 2019 Aug 29;5(9):809]. JAAD Case Rep. 2019;5(6):529-534. Published 2019 Jun 8. doi:10.1016/j.jdcr.2019.02.034
7. Woo DK, Treyger G, Henderson M, Huggins RH, Jackson-Richards D, Hamzavi I. Prospective Controlled Trial for the Treatment of Acne Keloidalis Nuchae With a Long-Pulsed Neodymium-Doped Yttrium-Aluminum-Garnet Laser. J Cutan Med Surg. 2018;22(2):236-238. doi:10.1177/1203475417739846