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AKN: acne keloidalis nuchae CVG: cutis verticis gyrata RT: radiation therapy INTRODUCTION Acne keloidalis nuchae (AKN) is a folliculocentric scalp disease mainly affecting men of color. Numerous studies have shown that it is not a true keloid; when all follicular structures within the lesion are eliminated by surgery or laser, the lesion is permanently eliminated. Millan-Cayetano et al reported the use of radiation therapy (RT) in a patient with an isolated AKN lesion with no recurrence. Permanent killing of lesional hair by radiation coincided with lesion regression and permanent elimination of the disease, further supporting the folliculocentric foundation of AKN,which is resolved by focusing the treatment objective on removing hair located within the lesion. We describe the use of low-dose RT to cure AKN in a patient who failed years of medical therapy and who was not a candidate for primary surgical intervention.