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Acne Keloidalis Nuchae

What is Acne Keloidalis Nuchae (AKN)?

Acne Keloidalis Nuchae (AKN) is a unique disease with hair follicle inflammation that primarily  affects the nape of the neck causing a rash with hair bumps, pustules, scarring and hair loss. This condition can progressively spread and persistent for many years. AKN is more common in men than women but can affect both sexes.

What is the cause of Acne Keloidalis Nuchae (AKN)?

The cause of AKN is unknown but it starts as a type of bacterial infection of the hair follicles or folliculitis that causes chronic inflammation that leads to the development of individual keloids around multiple hair follicles.

The process can begin after close haircuts or edge ups with sharp razors and clippers, occlusion and other unknown factors. The condition sometimes develops in females who don’t match any of these characteristics.

What are the symptoms?

Feeling bumpy areas at the back of the hair line as well as itching, pain, or bleeding is what usually causes the condition to be discovered.

How is it diagnosed?

A physician can determine AKN visually based upon the presence of follicular pustules, crusting, bleeding or localized areas of scar tissue around the hair follicles at the back of the neck. Sometimes these lesions will grow together to form larger masses of keloid tissue.

What tests are needed?

No tests are usually necessary

What is the expected duration?

The recovery from Acne Keloidalis Nuchae can take a few months when treated early or as long as a year for more advanced cases.

How can it be prevented?

To prevent AKN in those individuals who are prone to this condition, avoid using a razor or very sharp clippers to cut or edge up the hair in this area.

If a job requires wearing a hard hat or helmet, it is best to place an absorbent material inside the head band to minimize the buildup of sweat and moisture at this area of the scalp. Shampooing with an antibacterial shampoo right away after prolonged periods of heat and sweating can reduce the incidence of bacterial infection.

In addition, clothing that touches the nape of the neck needs to be clean and free from chemicals.


Treatment usually includes oral and or topical antibiotics to clear up the pus bumps and infected hair follicles.

Corticosteroids applied topically or administered by intralesional injection can help to flatten the bumpy areas of keloid tissue and prevent progression of the disease process.

Large areas of keloid tissue can require surgical excision to improve the area.

Laser hair removal is done on a limited basis for stubborn resistant lesions as well.

When to contact a professional

An appointment with a doctor must be made at the first sign of persistent bumps, bleeding or irritation at the back of the hairline.


The earlier treatment is started the better. Improvement can occur in a matter of months, or it can take a year. Once it clears up, the very same rash can occur again if precautions are not made to avoid the usage of sharp razors and clippers in the area and minimize occlusion, heat and sweating.

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