What Are the Bumps on the Back of My Scalp?

Understanding Acne Keloidalis Nuchae

What Is It?

Acne Keloidalis Nuchae, or AKN for short, is a condition that causes bumps on the back of the scalp. Even though the word acne is in the name, it is not acne. The hair follicles become irritated and inflamed leading to these bumps. Over time and without treatment, the bumps can form into a type of scar called a keloid. It is not due to dirty hair clippers or infection. The small bumps can merge into larger, raised scar-like plaques that are difficult to treat and, in some cases, can lead to permanent hair loss in the affected area. The earlier it is caught, the better the outcome.

Who Gets It and Why?

AKN most commonly affects Black men, though it can occur in anyone with tightly curled hair. It tends to develop in young adulthood, and certain factors are known to trigger or worsen it. Frequent close shaving of the neck and scalp is one of the biggest contributors, as the curved hair follicle can become irritated or grow back into the skin. 

Friction from clothing collars, hats, helmets, and athletic gear also plays a role. Heat, sweat, and the use of heavy pomades or hair grease can further inflame the area. In some cases, there may be a genetic predisposition, meaning some people are simply more susceptible than others. Understanding your triggers is the first step toward getting this condition under control.

What You Can Do at Home

While AKN does require medical treatment to manage fully, there is a lot you can do at home to keep it from getting worse.

Allowing the hair to grow out instead of a low, tapered cut in the area will help prevent the condition and help with treatment. If haircuts are required for work or personal preference, talk to your dermatologist about a treatment plan that can help you manage AKN even with a short haircut. Reduce friction by wearing collarless shirts, skipping neck chains or lanyards, and choosing hats that sit above the affected area. Cleanse the back of your scalp gently with a benzoyl peroxide wash, which can decrease inflammation. If itching is a problem, resist the urge to scratch. Instead, apply a cool, damp washcloth to the area for about 10 minutes to calm the irritation. Finally, keep the area as dry as possible, since heat and sweat are known to aggravate the condition.

When to See a Dermatologist

Home care alone is not enough to treat AKN. A board-certified dermatologist can evaluate how far the condition has progressed and create a plan tailored to you. Medical treatment options may include topical or injected corticosteroids to reduce inflammation, topical or oral antibiotics to address inflammation, topical retinoids to help normalize the hair follicle, and procedures such as laser therapy or, in more advanced cases, surgical removal of larger plaques. The goal is always to stop the progression, reduce symptoms, and preserve as much of your natural hairline as possible.

AKN is manageable. With the right care plan and a few changes at home, most people see meaningful improvement. If you have been living with bumps on the back of your scalp and wondering what to do next, this is your sign to make an appointment.

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