Pseudofolliculitis Barbae - Causes, Symptoms and Treatment

Definition

Pseudofolliculitis barbae is also known as razor bumps or shaving bumps. It is a common condition of the beard area. It occurs in up to 60% African American men and other people with curly hair. The problem results when highly curved hairs grow back into the skin causing inflammation and a foreign body reaction. Over time, this can cause keloidal scarring which looks like hard bumps of the beard area and neck. Shaving sharpens the ends of the hairs like a spear. The hairs then curve back into the skin causing pseudofolliculitis barbae. Most skin care products that claim to cure pseudofolliculitis barbae and ingrown hairs have acid, alcohol and other chemicals to exfoliate the skin. While this may work short term, it is actually compounding the problem by drying and hardening the skin. It is a less serious condition caused by shaving, characterized by mild to moderate redness and irritation on the surface of the skin.

Causes

1. Blade shaving sharpens the ends of the hairs like a spear. The hairs then curve back into the skin causing pseudofolliculitis barbae.
2. The inward-curving hair punctures the skin, causing an inflammatory reaction, irritation, and unsightly bumps.
3. Women of color who tweeze or pluck their facial hair will find that the hair breaks below the surface of the skin, pierces the hair follicle and then produces the same inflammatory response and bumps.

Symptoms

1. An inflammation of the hair follicles in the beard area, pseudofolliculitis barbae affects men with curly beards.
2. It develops when shaved hairs curve back into the skin, leading to inflammation.
3. It makes dark raised scars on the face and neck in rare cases.
4. Pseudofolliculitis barbae predominantly affects black men.
5. These are most common in men. This disease affects the women very rarely.
6. It causes small papules and pustules that can be confused with bacterial folliculitis. Diagnosis is by physical examination.
7. Erythematous or hyperpigmented papules become repeatedly irritated by shaving. So, take a professional’s consult on this issue.
8.  The lesions often itch, and scratching can lead to bacterial super infection.

Treatment

1. Barium sulfide powder depilatories of about 2% strength can be made into a paste with water and applied to the beard area. This paste is removed after 3-5 minutes.
2. Calcium thioglycolate preparations come as powder, lotions, creams, and pastes. The mercaptan odor is often masked with fragrance. Calcium thioglycolate preparations take longer to work and are left on 10-15 minutes.
3. In Severe cases, topical antibiotics may successfully reduce skin bacteria and treat secondary infection. These topicals include erythromycin, clindamycin, and combination clindamycin/benzoyl peroxide and erythromycin/benzoyl peroxide agents.
4. When you resume shaving, use a single blade razor. Double blade razors cut the hairs too short allowing them to grow in.
5. Use electric hair clippers or a razor with an attachment that leaves the cut hairs long. Aim to have a 5 o'clock shadow immediately after shaving.
6. If the above measures fail, accept that you have to grow a beard! In certain occupations where beardedness is not approved of, a medical certificate may help.