Pseudofolliculitis barbae is the medical term for razor bumps. It is most noticeable around the beard and neck. It causes small papules and pustules that can be confused with bacterial folliculitis. It is occurring in up to 60% African American men and other people with curly hair. It can also affect some white men and hirsute black women. Pseudofolliculitis pubis is a similar condition occurring after pubic hair is shaved. Curly hair tends to curl into the skin instead of straight out the follicle. PFB can make the skin look itchy and red, and in some cases, it can even look like pimples. These inflamed papules or pustules can form especially if the area becomes infected. Pseudofolliculitis barbae can further be divided into two types of ingrown hairs: transfollicular and extrafollicular.
The extrafollicular hair is a hair that has exited the follicle and reentered the skin. The transfollicular hair never exits the follicle, but because of its naturally curly nature curls back into the follicle causing fluid build-up and irritation. PFB can be treated with warm compresses and manual straightening of hairs with scissors or tweezers.
Use of an electric shaver may also help the condition. Use the electric razor on high setting to avoid close shaving and prepare beard with electric razor pre-shave. At night, apply a lotion containing glycolic acid to the affected areas. This exfoliates the surface skin cells and reduces the likelihood of new inflamed spots. Use a polyester skin-cleansing pad twice a day. Or, use a moisturising shaving foam. Mild topical corticosteroid creams reduce inflammation of papular lesions.
Electrolysis and laser hair removal should be considered when all else fails. Topical eflornithine HCL 13.9% cream (Vaniqa) has been used for excessive facial hair and in patients with PFB. Glycolic acid lotion 8% is effective (Alpha-hydrox, Neo-Strata, others). Oral antibiotics can be useful to counteract both an anti-infectious and anti-inflam-matory agents. Tetracycline is a common choice for a systemic antibiotic. Prescription antibiotic gels (Benzamycin, Cleocin-T) or oral antibiotics are also used. Retin-A is a potent treatment that helps even out any scarring after a few months. For women with hirsutism and associated PFB, an ornithine decarboxylase inhibitor can block the instigating hair growth. Use as tolerated, as it is somewhat irritating.
Pseudofolliculitis Barbae Treatment Tips
1. Use a razor with a single blade.
2. Electrolysis and laser hair removal should be considered when all else fails.
3. Glycolic acid lotion 8% is effective (Alpha-hydrox, Neo-Strata, others).
4. Use a polyester skin-cleansing pad twice a day.
5. Shave in the direction of the follicle, not against it. Do not stretch the skin.
6. Mild topical corticosteroid creams reduce inflammation of papular lesions.
7. Retin-A is a potent treatment that helps even out any scarring after a few months.
8. Use short, rapid strokes against the direction of hair growth. Keep shaving instrument moist but wiped clean.