Painful or itchy bumps at the back of the head and neck are a common problem among men, especially those who keep low haircuts or visit the barber frequently. Many people think it is just “razor bumps” or an infection, but when these bumps keep returning, harden, or form scars, the condition is often Acne Keloidalis Nuchae (AKN).

AKN is a chronic inflammatory condition that affects hair follicles at the back of the scalp and neck. Without proper treatment, it can worsen over time and lead to permanent scarring and hair loss.

What Is Acne Keloidalis Nuchae?

Acne keloidalis nuchae is a condition where inflamed hair follicles at the back of the head develop into:

Small itchy bumps
Painful pustules
Thickened scars
Keloid-like plaques

Despite the name, it is not acne and not a true keloid, but it behaves like both.

Why AKN Is Common in Men

AKN is most common in:

Men with coarse or curly hair
Men who shave the back of the head closely
People who get frequent barbing or razor line-ups
Individuals exposed to friction from collars, helmets, or caps

In Ghana, frequent barbing, close shaves, and hot weather make this condition particularly common;.

What Causes Back-of-the-Head Bumps?

AKN develops due to a combination of factors:

1. Close Shaving and Razor Trauma

Cutting hair too low causes hair shafts to re-enter the skin, leading to inflammation.

2. Chronic Irritation

Repeated friction from:

Clippers
Collars
Helmets
Headrests

keeps the area inflamed.

3. Infection and Inflammation

Bacteria can infect damaged follicles, worsening swelling and scarring.

4. Delayed or Wrong Treatment

Using harsh creams, steroid misuse, or squeezing bumps often makes AKN worse.

Early vs Advanced AKN

Early stage:

Small itchy bumps
Mild redness
Occasional pus

Advanced stage:

Hard scars
Thick plaques
Permanent hair loss
Painful nodules

Early treatment is critical to prevent permanent damage.

How to Treat Acne Keloidalis Nuchae

1. Stop Close Shaving

This is the most important step.

Avoid razor cuts or skin-level trims
Keep hair slightly longer at the back
Use clean clippers only

2. Medical Treatment

Depending on severity, treatment may include:

Topical anti-inflammatory medications
Antibiotic therapy
Targeted steroid injections (done medically, not creams abused at home)
Anti-itch treatment

Self-medication often worsens scarring.

3. Laser Hair Reduction

Laser treatment helps by:

Reducing hair regrowth in affected follicles
Decreasing inflammation
Preventing new bumps

Laser therapy is especially effective in early to moderate AKN.

4. Treat Infections Early

Any pus-filled or painful lesions should be treated promptly to avoid abscess formation and scarring.

5. Lifestyle and Barber Habits

Avoid tight collars
Reduce helmet friction
Ensure barbers disinfect clippers
Avoid frequent line-ups on the neck

What Not to Do

Avoid:

Squeezing or popping bumps
Using bleaching creams or unknown steroid mixtures
Applying multiple random creams
Ignoring early symptoms

These often lead to worse scarring.

When to See a Doctor

You should seek medical care if:

Bumps keep returning
Scars are forming
Hair loss is developing
Pain or pus is present
Home remedies have failed

Early intervention prevents progression to severe, permanent scarring.

Clinics such as Elitecare Medical Center provide proper diagnosis and structured treatment plans for Acne Keloidalis Nuchae, including medical therapy and laser options suited for dark skin.

Final Thoughts

Acne keloidalis nuchae is not just a cosmetic issue — it is a chronic scalp condition that worsens without proper care. The good news is that early treatment, correct shaving habits, and medical intervention can control symptoms and prevent permanent damage.

If you’re dealing with recurring bumps at the back of your head, professional assessment can make the difference between manageable treatment and lifelong scarring.