Pseudofolliculitis Barbae: is a foreign-body inflammatory reaction surrounding ingrown facial hairs, which results from shaving. It can also occur on any body site where hair is shaved or plucked, including axilla, pubic area, and legs. It is also known as shaving rash or razor bumps.
So Who Gets this Condition?
Folliculitis barbae and pseudofolliculitis barbae can occur in any ethnic group; however, individuals with tightly coiled hair (Aftrican descent) are predisposed to the condition. African American men will experience PFB at some point during their lifetime. Hispanic, Asian, and Middle Eastern men are frequently affected as well. Some women may develop PFB, especially those with hirsutism or those who routinely shave their bikini area. Although PFB is not life-threatening, hypertrophic scarring, postinflammatory hyperpigmentation and keloid formation may occur in chronic or severe cases, resulting in cosmetic disfigurement. Both disorders can also affect women of all races. They are associated with improper shaving practices and are more common when a blade razor is used rather than an electric shaver.
Transfollicular: when shaving too close and by stretching the skin, the sharpened curved hair retracts below the surface of the skin and pierces the follicle wall from inside. This occurs mainly in people with curly hair because the curl of the hair means that the sharp pointed end of a recently shaved hair comes out from the skin and re-enters the skin close by causing a foreign body inflammatory reaction. It can also occur in the skin folds and scars.
The injured follicles often will become infected, causing PFB.
Extrafollicular: when shaving is infrequent, the hair may grow back in a curve towards the skin and can poke through from the outside. Hair that has exited the follicle and reentered the skin.
After a hair has been shaved, it begins to grow back. Curly hair tends to curl into the skin instead of straight out the follicle, leading to an inflammation reaction. PFB can make the skin look itchy and red, and in some cases, it can even look like pimples.
Pseudofolliculitis nuchae: is a related condition, occurs on the back of the neck, often along the posterior hairline, when curved hairs are cut short and allowed to grow back into the skin. Left untreated, this can develop into acne keloidalis nuchae, a condition in which hard, dark keloid-like bumps form on the neck. Both occur frequently in black men.
Symptoms that can occur:
- Raised red bumps
- Darkening of the skin
- Small papules (solid, rounded bumps)
- Pustules (pus-filled, blister-like lesions)
- Razor bumps can appear anywhere that has been shaved. Waxing, tweezing, threading and even chemical depilatory creams may cause the condition.
The most common areas PFB is found:
- Face (particularly the chin, neck and lower cheeks)
- Bikini line
- Prescription antibacterial lotions
- Warm compresses
- Steroid creams
- Sterile incision and extraction sometimes necessary
- Laser or electrolysis hair removal
- Avoid shaving too closely
- Shave in the direction of hair growth rather than “against the grain”
- Use a non-irritating shaving cream with a sharp new razor each time
- Use an electric razor
- Avoid pulling skin while shaving
- Shave less often
Laser hair removal is also an option and provides excellent results. It is recommended to treat with a 1064 Yag as they are safe for dark skin and heavy, dark, dense hair growths.
NOTE: most of my practice was treating clients of color with excellent results and no overtreatment to the skin. After the first treatment, in most cases, 50 – 60 percent of the hair is expelled and provides immediate relief of Pseudofolliculitis Barbae.
Laser hair removal has been available for all skin types since early 2000 and it has been very rewarding to achieve maximum hair reduction for full beards and the skin calming down, lightening of pigmentation marks and ingrown hair immediately. Some clients shaving once to twice daily are down to one time a week after only one treatment.
Success in these cases comes down to using the correct laser, timing of treatments, skill and knowledge of the technologist to apply the correct settings and completing the case 100% with electrolysis as an option.
Finally a solution for so many that have suffered from this condition.