The best way to decide on a treatment approach is to first gain clarity on your condition through an accurate diagnosis. What many people think are keloids on the back of their head can actually turn out to be Acne Keloidalis Nuchae (AKN). The tissue that develops with AKN is not keloidal. The condition occurs due to aggressive immune system attacks on the follicles, causing the skin to produce large amounts of thick collagen. AKN medications as described may help alleviate the discomfort, itchiness and swelling. But surgery is often necessary to get rid of the bump(s).I have included a link below with an example of the condition and its treatment.