What Is the First Treatment for Acne Keloidalis Nuchae?

Acne keloidalis nuchae causes firm, itchy, or tender bumps around the back of the neck and hairline. Repeated inflammation can make the bumps enlarge and join into thickened scars. An intralesional steroid injection places medicine into selected lesions to reduce inflammation and soften the raised tissue.

The condition is not the same as ordinary facial acne. Friction, close shaving, tight collars, and repeated irritation can aggravate it, so treatment usually combines lesion care with changes that protect the hairline.

Avoid close shaving over the affected skin and reduce rubbing from collars, helmets, or tight clothing. Do not squeeze or scratch the bumps. Your clinician may plan more than one injection visit, depending on how the lesions respond. Laser hair removal can sometimes help reduce hair-related irritation, while oral antibiotics may be used when inflammation or infection needs broader treatment.

Book a dermatology review if bumps are spreading, draining, very painful, bleeding, or leaving expanding scars. Seek prompt advice for fever, rapidly increasing redness, or pus. Early assessment helps distinguish active inflammation from established scarring and allows the plan to be changed before the hairline becomes more difficult to treat.

Ask whether the bumps are active inflammation or mainly scar tissue, how many areas need treatment, and what shaving method is least irritating. Ask about injection aftercare, possible skin-colour changes, and whether laser hair removal or oral antibiotics fits your situation.