What is Pseudofolliculitis Barbae?

Pseudofolliculitis barbae (PFB), more commonly referred to as razor bumps or shaving rash, is an inflammatory reaction of the skin to ingrown hairs resulting from shaving. It can occur on a man's facial area or neck and it is more often found on men who have very curly facial hair. Pseudofolliculitis barbae has the appearance of small, round bumps. There are a variety of ways to treat this condition, including topical applications; however, patients should also take measures to prevent the bumps from recurring.

This skin disorder may occur in one of two ways: a facial hair may emerge from the hair follicle and curl back into the skin, which the body will treat as a foreign object, resulting in inflammation and irritation. Pseudofolliculitis barbae may also occur if the hair enters the skin prior to emerging on the face or neck from the hair follicle. Some patients may at first confuse this disorder with acne; however, a blackhead or whitehead will not develop. The bumps will be irritated, inflamed, and may be mildly painful. A doctor or dermatologist should examine the patient to rule out the possibility that it is a more serious skin disorder.

Patients who experience painful pseudofolliculitis barbae may benefit from applying a warm compress to the skin. They can also remove the ingrown hair, if it is visible, with a pair of sterilized tweezers. Those who suffer from frequent ingrown hairs should consult a dermatologist about available medications. Often, an oral antibiotic can help control the inflammation and irritation.

There are several topical medications that can also provide relief, such as cortisone cream. Retinoic acid or benzoyl peroxide can also be applied to the affected area. In some cases, the dermatologist may recommend using eflornithine hydrochloride cream, which may alleviate the condition by slowing the growth of the hairs.

While the skin is healing, the patient should refrain from shaving. Severe cases of pseudofolliculitis barbae may require avoidance of shaving for several months or even a year. When the skin is healed, patients may switch to an electric razor, which can help prevent the development of pseudofolliculitis barbae. Otherwise, they should use a sharp, clean triple-bladed razor or a razor made especially for the prevention of PFB. Generous amounts of a moisturizing shave gel should be applied to the face prior to shaving.

Patients may also consider other methods of managing their facial hair. Chemicals for hair removal are an option, however they should be tested on a small area of skin prior to use. If irritation, burning, or discoloration occurs, the patient should discontinue use immediately. Professional laser treatments or electrolysis are other possibilities; however, the cost may be prohibitive, as not all insurance companies will cover these procedures.