Scalp bumps on the back of the head can look like a visible skin problem, but John’s story shows how much treatment history can exist behind what we see. In this chapter of Baldcast Episode 6, John explains what happened before he met Sanusi Umar, MD, Dr. U. John remembers receiving a steroid injection directly into the bump after it started getting bigger. He was also placed on different medications and recalls returning for injections about once a month. In John’s experience, there was no positive outcome. He says it felt like the bump either became worse or nothing changed. After approximately four months, John stopped returning for the injections. Then came an even longer gap. John says he went about two years without seeing a doctor because he had basically given up on finding an answer. For people searching terms such as **scalp bumps on back of head**, **painful scalp bumps**, or **“what is this bump on the back of my head?”**, this chapter highlights an important part of evaluation: understanding not only what the scalp looks like today, but also what treatments have already been tried and what happened afterward. John’s supplied diagnoses include **Acne keloidalis nuchae (AKN), Dissecting cellulitis of the scalp, and Cutis verticis gyrata (CVG).** These conditions can involve the scalp in different ways, which is why an individualized evaluation is important rather than assuming every bump on the back of the head has the same cause. In this conversation, Dr. U asks John to carefully retrace his previous treatment history, including what treatments he remembers receiving, how frequently he received injections, and whether he experienced any positive change. The emotional part of that history matters too. John did not simply stop one treatment. He describes reaching a point where he stopped seeking medical care for approximately two years. That is why a medical history can reveal more than which medications or procedures were previously attempted. It can also show how repeated disappointment affected a patient’s willingness to continue looking for answers. This chapter focuses only on John’s experience before meeting Dr. U. It does not reveal what happens later in his journey. This is one patient’s experience. It is not medical advice. Results can vary. Evaluation matters, and treatment should be individualized based on the diagnosis, clinical findings, severity, and patient history. What do you think was the bigger turning point for John: four months of treatment without the change he hoped for, or the two years when he stopped seeing doctors? Yes/No: should previous treatment experiences be discussed in detail during a new evaluation? Subscribe for the next chapter of John’s Baldcast journey. 00:00 “None of them did anything” 00:02 Dr. U asks about John’s previous treatments 00:10 John describes a steroid injection and medications 00:28 John recalls monthly injections 00:38 John describes having no positive outcome 00:39 John stops after about four months 00:43 John explains his two-year gap in medical care **Keywords:** scalp bumps on back of head painful scalp bumps what is this bump on the back of my head Acne keloidalis nuchae AKN
