Acne Keloidalis Nuchae Treatment in Atlanta, GAStopping the Bumps and Scarring at the Nape

Calm the bumps, prevent scarring and keep the back of your neck smooth.

Common In:
Men with curly, coarse hair
Primary Causes:
Close cuts, friction, inflammation
Treatment Time:
Visits of 15-60 minutes
Results:
Flatter bumps in 2-6 months
Man having the back of his neck examined for acne keloidalis nuchae bumps at SOCAH Center in Atlanta, GA
Close view of firm bumps along the back hairline from acne keloidalis nuchae, evaluated at SOCAH Center in Atlanta, GA

What Is Acne Keloidalis Nuchae?

Recognizing the Signs

Acne keloidalis nuchae (AKN), also called folliculitis keloidalis, is a chronic inflammatory condition of the hair follicles at the back of the neck and lower scalp. Despite its name, it is not true acne. It starts as small, firm, itchy bumps around hair follicles that can turn into pustules and, over time, merge into raised, scar-like plaques where hair no longer grows.

Many people first notice it a few days after a fresh haircut: a line of tender bumps along the back hairline, bleeding after a clipper cut or several hairs sprouting from one opening. Left untreated, AKN can leave permanent scarring hair loss at the nape.

AKN is most common in men with curly or coarse hair from the teen years into middle age, and it is especially frequent in men of African descent. It also affects Hispanic, Asian and white patients and, less often, women. On deeper skin tones the bumps may look dark brown or purple, on lighter skin pink or red, and dark marks can linger after they settle. It is one of the scalp and hair conditions we treat in Atlanta.

Medically reviewed by Dr. Nikki D. Hill, MD, FAAD. Last updated: October 2026.

Why Acne Keloidalis Nuchae Happens

Understanding the Root Causes

01The Science

AKN starts at the follicle. Curly hair can curve back into the skin after close cutting, and sharp, short hair tips at the nape can pierce the follicle wall. The immune system treats that hair as a foreign body, creating the kind of follicle inflammation described in the MedlinePlus guide to folliculitis.

Ongoing inflammation signals fibroblasts, the cells that build scar tissue, to lay down excess collagen. Research on AKN tissue has identified specific immune cells and fibroblasts that drive this scarring. As fibrosis builds, follicles are destroyed, bumps fuse into firm bands and the area becomes a scarring alopecia. That is why our medical hair and scalp care aims to stop inflammation before plaques form.

Friction keeps the cycle going. Collars, helmets and hats rub the nape, heat and sweat add irritation, and every close haircut reinjures healing follicles.

02Deeper Understanding

How We Diagnose and Treat AKN at SOCAH Center

Exam, Staging and a Layered Plan

AKN is usually diagnosed with a careful exam of the nape and scalp. Dr. Hill looks at the number and size of bumps, any pustules or drainage, whether plaques have formed and how much hair has been lost. Trichoscopy can show tufted hairs and lost follicle openings. A culture of active pustules can guide antibiotic choice, and a biopsy is reserved for unusual cases, such as separating AKN from dissecting cellulitis of the scalp.

Treatment is layered to match the stage. Early bumps respond to topical corticosteroids, topical retinoids and antibacterial washes, with oral anti-inflammatory antibiotics for flares. Firm papules are often flattened with corticosteroid injections placed into each bump over several visits. Because hair inside the follicle keeps inflammation going, laser hair removal for AKN reduces regrowth at the nape and can help prevent new bumps. Our article on how laser hair removal protects every skin tone explains how settings are matched to each skin type.

Large plaques that do not respond to injections may need surgery. With keloid and scar removal, Dr. Hill can excise the plaque, often followed by injections and laser hair removal to lower the chance of recurrence.

What Raises Your Risk of Acne Keloidalis Nuchae?

AKN rarely has a single cause. These factors work together to keep inflammation active at the nape.

  1. 01Close Cuts and Edge-UpsVery short cuts, edge-ups and razor lines at the nape leave sharp hair tips that curl back and pierce the skin.
  2. 02Curly or Coarse HairTightly curved hair shafts are more likely to grow back into the follicle wall after cutting.
  3. 03Friction at the NapeCollars, helmets, hats and headrests rub the back of the neck all day and reinjure irritated follicles.
  4. 04Heat and SweatGeorgia heat, workouts and sweating under helmets or uniforms raise irritation and can trigger flares.
  5. 05Associated ConditionsStudies link AKN with hidradenitis suppurativa and thyroid disease, so your provider may ask about related symptoms.
  6. 06Picking and ScratchingPicking or squeezing bumps adds injury and inflammation, which pushes lesions toward scarring.
Modern treatment room at SOCAH Center dermatology in the Northlake area of Atlanta, GA, prepared for scalp care

Why Choose SOCAH Center for Acne Keloidalis Nuchae Care in Atlanta, GA

At SOCAH Center, Dr. Nikki D. Hill, MD, FAAD, a board-certified dermatologist with deep expertise in scalp and hair loss disorders, diagnoses AKN and performs injections and surgical care herself, while our trained laser team works under her supervision.

Scalp and Hair Specialists
AKN is a scarring hair disorder, and medical hair loss is the core of Dr. Hill's practice.
Every Stage in One Practice
Topical care, injections, laser hair removal and surgical removal are coordinated in one plan.
Laser Matched to Your Skin
Laser settings are chosen for your skin tone and hair type to reduce hair safely at the nape.
Barber-Friendly Guidance
We give practical grooming advice you can share with your barber to avoid triggering new bumps.
Comparison of medical care, laser hair removal and keloid removal for acne keloidalis nuchae at SOCAH Center, Atlanta

Treatment Options Comparison

Compare the treatments SOCAH Center offers for acne keloidalis nuchae, from early bumps to firm plaques.

TreatmentBest ForSession TimeResults TimelineMaintenance
Hair Loss TreatmentEarly bumps and flaresVisits of 15-30 minCalmer in 4-8 weeksDaily topicals
Laser Hair RemovalPreventing new bumpsAbout 15-30 minFewer bumps in monthsSeries, then touch-ups
Keloid RemovalFirm plaques and bandsAbout 15-60 minFlatter over 2-6 monthsInjections every 4-6 weeks

Signs You May Have Acne Keloidalis Nuchae

Bumps at the back of the scalp that return after every haircut are different from razor bumps in the beard area and deserve a dermatology exam before firm scars form.

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  • Bumps After Haircuts

    Small, firm, itchy bumps appear along the back hairline within days of a fresh cut or edge-up.

  • Pus or Bleeding

    Some bumps fill with pus, crust over or bleed when clippers or a comb catch them.

  • Firm Raised Bands

    Bumps have merged into a hard, raised ridge across the nape that feels thicker than the skin around it.

  • Tufted Hairs

    Several hairs seem to grow from one opening, or hair grows in clumps between bumpy, scarred areas.

  • Hair Loss at the Nape

    The lower back of the scalp has smooth, shiny spots where hair no longer grows back.

  • Itch and Tenderness

    The back of your neck itches, burns or feels sore against collars, hats, helmets or pillows.

Related Treatment

Keloid Removal

Flatter, calmer keloid scars, with a plan built around how your skin heals.

  1. Combined Care
  2. Lower Recurrence
  3. Symptom Relief
Learn More

Frequently Asked Questions

Is acne keloidalis nuchae contagious?
No, AKN is not contagious and cannot spread to other people through barber tools, towels or contact. It is an inflammatory reaction around your own hair follicles. Bacteria can infect open bumps, though, so clean clippers and avoiding shared razors still help prevent flares and secondary infection.
Can I keep getting haircuts?
Yes, but how you cut matters. Ask your barber to skip edge-ups and razor lines at the nape, use a longer clipper guard, and avoid cutting against the grain. Clean tools and a gentle cleanser after each cut also help. Many patients find these changes alone reduce new bumps within a few months.
Does laser hair removal help AKN?
Yes, laser hair removal can be one of the most effective ways to reduce new AKN bumps. By shrinking hair growth at the nape, it removes the ingrown hairs that drive inflammation. Settings are matched to your skin tone, including skin of color, and several sessions are usually needed. Individual results vary.
Will the bumps go away on their own?
Usually not. AKN tends to persist and slowly worsen while the triggers continue, and early bumps can turn into firm plaques and permanent hair loss. Starting treatment early, when bumps are small, typically gives the smoothest result and the lowest chance of needing surgery.
Can AKN come back after surgery?
It can, which is why surgery is paired with prevention. After a plaque is removed, Dr. Hill may recommend corticosteroid injections, topical care and laser hair removal, plus grooming changes, to lower the chance of new bumps. Follow-up visits catch early recurrence while it is still easy to treat.
Does insurance cover AKN treatment?
Often, for the medical parts of care. AKN is a medical diagnosis, so visits, injections, biopsies and surgical removal may be covered, while laser hair removal is usually self-pay. Exact pricing is discussed at your consultation, and CareCredit and Cherry payment plans can help with self-pay costs.
Location2296 Henderson Mill Rd, Suite 300Atlanta, GA, 30345
Emailinfo@socahcenter.com
Phone(404) 474-2301

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Scientific References

  1. Alves et al., J Cutan Med Surg. (2022). Acne Keloidalis Nuchae. PMID: 36124546.
  2. Brahe et al., Cutis. (2020). Acne keloidalis nuchae in the armed forces. PMID: 32603383.
  3. Hong et al., J Invest Dermatol. (2024). Profibrotic Subsets of SPP1(+) Macrophages and POSTN(+) Fibroblasts Contribute to Fibrotic Scarring in Acne Keloidalis. PMID: 38218364.
  4. Kridin et al., Arch Dermatol Res. (2021). Hidradenitis suppurativa is associated with acne keloidalis nuchae: a population-based study. PMID: 32676745.
  5. East-Innis et al., Int J Dermatol. (2017). Acne keloidalis nuchae: risk factors and associated disorders - a retrospective study. PMID: 28664654.
  6. Skin of Color Society. (2026). Patient education on acne keloidalis nuchae, its triggers and treatment options.