What to know about acne keloidalis nuchae in skin of colour

Small itchy or tender bumps usually begin around hairs at the back of the neck or scalp. They may enlarge, join together, crust, or form firm raised scars. Close shaving, tight collars, helmets, hard hat straps, sweat, and repeated rubbing can irritate the follicles. In deeper skin tones, inflammation may leave dark marks after a bump settles, making colour change more noticeable even when active swelling improves.

Despite its name, this condition is not ordinary facial acne. Ongoing inflammation can damage follicles and create permanent-looking areas of reduced hair growth, so early assessment helps guide care before the bumps become extensive.

Avoid close shaving over affected skin and choose a hairstyle that does not pull or rub the nape. Reduce friction from collars, straps, and sports equipment; keep the area clean after sweating without scrubbing. Do not squeeze, scratch, or pierce the bumps. A dermatologist may prescribe an anti-inflammatory or antimicrobial treatment, and selected procedures may flatten established lesions. Use pigment-safe advice for dark marks rather than unregulated lightening products.

Arrange a dermatology appointment when bumps persist, multiply, become painful, drain, or begin forming a firm ridge or scar. Seek prompt care for spreading warmth and redness, pus, fever, severe pain, or rapidly changing swelling. Earlier review is sensible when hair loss is developing or the condition is affecting confidence, sleep, work, or grooming choices.

Ask whether the bumps are acne keloidalis nuchae or an infection, which shaving and hair practices are safest, and whether treatment aims to calm active inflammation, flatten scars, or both. Ask how to prevent dark marks and when improvement should be reassessed.