Acne Keloidalis Nuchae, or hair bumps, is a condition that arises at the juncture of the scalp and the back of the neck (nape). Often seen in African American men, this problem can arise when hair, at the nape of the neck is cut or shaved quite short, typically less than 1/4 inch in length. In curly haired individuals, the hair is able to corkscrew back into the hair follicle where it causes irritation, much like an acne lesion. In the occasional unfortunate person prone to developing keloids, (firm raised scar tissue), this inflamed bump turns into a permanent ball of scar tissue. In severe cases, hair can be permanently lost in areas of widespread inflammation. Treatment is best aimed at preventing the ingrown hair in the first place. And if the ingrown hair does arise, it is equally important to prevent the development of inflammation.

Hair should be kept at least over 1/4 inch in length. For shaving in this region, try using DERMAdoctor Ain't Misbehavin' Medicated AHA/BHA Acne Cleanser followed by California North Razor Shavecream which can help reduce the amount of acne which may arise and ultimately create the scar tissue. Also, prescription topical products such as Azelex Cream, Cleocin T lotion and topical erythromycin products can help prevent the inflammation. Some patients even need oral antibiotics. The use of a product, such as DERMAdoctor Ain't Misbehavin' Medicated Acne Control Serum, (which contains both salicylic acid as well as oleanolic acid & Tea Tree Oil) can also help reduce the inflammation.

Once the scar has formed, it is very difficult to eradicate it. The use of steroid injections into the larger lesions can help shrink it down, but for very tiny bumps, it is often impossible to get rid of these. If possible, simple camouflage by covering the area with long hair is the best way to hide the condition. The use of steroid impregnated tapes, and steroid ointments (Cortaid Advanced Maximum Strength Cream) can also be used in place of the injections. However, I find the injections the most helpful. For disfiguring cases, excision of the scarred area can be performed by a competent surgeon.

Thank you for taking the time to read my article. I hope that you have found it informative.

Audrey Kunin, M.D.

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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