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Acne keloidalis nuchae guide

Acne keloidalis nuchae treatment online in Virginia and West Virginia

Photo-based care for mild, early acne keloidalis nuchae — firm bumps and small pustules at the nape and occipital hairline — as one defined treatment course, after advanced scarring, abscess, deep neck-space infection, and other red flags are screened out.

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Start a $59 online review for Acne keloidalis nuchae.

Acne keloidalis nuchae is a long-term, recurrence-prone scarring folliculitis at the back of the scalp and neck, most common in adult men and linked to close shaving or clipping and collar friction. This online lane treats only the mild, early inflammatory stage as one defined course and refers ongoing or procedural care to in-person dermatology, because advanced disease, abscesses, and mimics need a hands-on exam.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visitSee response windows

Quick facts

  • You must be physically in Virginia and West Virginia at the time of request
  • Starts at $59
  • No insurance needed
  • No app download
  • Physician review around the clock
  • Non-controlled prescriptions can be sent to your pharmacy when appropriate
  • A work or school note can be included when medically appropriate
  • Response windows: 24/7, every day

Common symptoms

  • Firm, itchy or tender bumps along the back of the neck or occipital hairline
  • Small pustules that flare after close haircuts or shaving
  • A hairline that catches on collars, helmets, or hats
  • Bumps that keep coming back in the same nape area

May fit online care

  • Adults 18 and older
  • Mild, early firm bumps and small pustules only, on the nape or occipital hairline
  • Clear close-up and wider photos are available
  • No large keloid lumps, thick scars, bald patches, abscesses, or draining tunnels
  • Not pregnant/trying to conceive/breastfeeding, no tetracycline allergy, and not on isotretinoin

Look for another care setting

  • Large keloid-like lumps, thick raised scars, scarring bald patches, abscesses, or sinus tracts
  • Fever with spreading redness, red streaks, neck stiffness, or trouble opening the mouth
  • A weakened immune system or diabetes with an inflamed or infected-appearing lesion
  • Treatment for this condition within the last 6 months (needs in-person escalation)

What to have ready

  • A clear close-up photo and a wider photo of the back of the neck/hairline
  • How long the bumps have lasted and your recent shaving/clipping habits
  • Medicines you take (including blood thinners) and any tetracycline or minocycline reactions
  • Whether you are pregnant, trying to conceive, or breastfeeding

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer the fit questions, and choose the response window you want. If the concern still fits this service, a physician reviews it and sends a secure update after sign-in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

What can be prescribed?

The topical backbone is clobetasol 0.05% (solution or foam) used on the nape for no more than 2 weeks, plus clindamycin 1% solution, and tretinoin at night to complete the course. For more inflammatory disease, a single 4-week course of a tetracycline antibiotic (doxycycline, or minocycline only if you cannot take doxycycline) may be added. Every medicine is one defined course with no automatic refills.

Is this ongoing treatment for a chronic condition?

No. Acne keloidalis nuchae is a long-term condition, but this service provides only one defined treatment course. If the bumps do not improve, keep coming back, or start to scar, the right next step is in-person dermatology — which can offer steroid injections, laser, or minor surgery that actually halt progression — not repeated online courses.

Why is the oral medicine an antibiotic?

The oral option is a tetracycline antibiotic (doxycycline or minocycline) used for its anti-inflammatory effect, not to treat an ordinary infection. It cannot be used in pregnancy or with a tetracycline allergy, causes sun sensitivity, and must be taken with a full glass of water while staying upright. Stop it and get same-day emergency care for a severe headache with vision changes, and urgent care for severe or bloody diarrhea.

When is this not treated online?

Large keloid lumps, thick scars, bald patches, abscesses, or draining tunnels are advanced disease that needs in-person dermatology. Fever with spreading redness, neck stiffness, trouble opening the mouth, or crackly skin is an emergency. Bumps on the face or elsewhere, current isotretinoin, pregnancy, or a recent treatment course for this all route out of this lane.

How is this different from razor bumps or ordinary folliculitis?

Acne keloidalis nuchae starts as firm, recurring bumps specifically at the nape and occipital hairline and tends to scar, while razor bumps (pseudofolliculitis barbae) and ordinary folliculitis are usually more widespread and less scarring. If your bumps are really razor bumps or general folliculitis, that guide is the better fit.

Read the folliculitis (razor bumps) guide

How is this different from ordinary acne?

Ordinary acne appears on the face, chest, or back rather than only at the back of the neck, and is treated differently. If your bumps are facial or truncal acne, use the acne guide instead of this lane.

Read the acne guide