A viewer asks Dr. Sanusi Umar what makes up the tissue removed during acne keloidalis nuchae surgery and whether the condition can return. His answer addresses both the composition of an AKN lump and Anwar’s follow-up.
When a lump has been surgically removed, two questions often remain: What was inside it, and could it grow back? In this Baldcast Q&A, Dr. Umar responds to a viewer who raises those questions about acne keloidalis nuchae (AKN).
What Is Inside an Acne Keloidalis Nuchae Lump?
The viewer asks what lies within the removed skin. Dr. Umar explains that an AKN lump typically consists largely of abnormal scar tissue. In his words, it is “mostly … abnormally grown scar tissue.”
He adds that the removed tissue may sometimes include necrotic, or dead, tissue and pus. These are possibilities he describes, not findings confirmed for every AKN lump. His answer clarifies why the visible mass is more than a simple surface bump.

Can the Bumps Come Back?
The viewer also asks whether the removed lump will grow back. The question matters to people concerned about bumps that keep coming back, but the video does not establish a universal prediction for everyone with AKN.
Dr. Umar describes Anwar’s situation at the time of the recorded update. He says Anwar had been free of the condition for more than two years and expresses confidence that it would not return in his case. He also says he has seen a similar pattern among many of his patients. Those comments reflect his clinical experience and the follow-up he reports, rather than a guarantee for any individual patient.
What Anwar’s Follow-Up Tells Us
Anwar’s reported period without recurrence is an important part of this exchange. It answers the viewer’s concern with a specific patient update while leaving room for the reality that acne keloidalis nuchae can return in some cases.
For anyone searching for information about bumps on the back of the head, the key distinction is between understanding what a removed lump may contain and predicting what will happen after treatment. The video addresses the first question directly and provides Anwar’s reported follow-up for the second.

Watch the Chapter
Hear Dr. Umar answer the viewer’s questions about the contents of an AKN lump and Anwar’s follow-up.
Take the Next Step
To explore the rest of Anwar’s story, use the series playlist when available:
For individualized guidance, consult a qualified clinician.
Free ConsultationMedical Disclaimer
This article is for educational purposes and does not replace medical evaluation or individualized treatment advice. One patient’s follow-up does not guarantee the same outcome for others.
Further Reading
- https://dru.com/anwar-acne-keloidalis-nuchae-two-years-after-surgery/
- Umar, Sanusi et al. “A Retrospective Cohort Study and Clinical Classification System of Acne Keloidalis Nuchae.” The Journal of clinical and aesthetic dermatology vol. 14,4 (2021): E61-E67.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142833/



