Pseudofolliculitis Barbae

Commonly referred to as razor bumps, shave bumps, barber’s itch, or ingrown hairs, PFB is a common chronic disorder occurring most often in the beard area of men who shave. It favors those of African descent with darkly pigmented skin and tightly curled hair. However, it may also develop in other shaved areas, in women, and in any racial group. The cause is tightly curved hairs curving back into the skin when shaved. Hair plucking and electrolysis can induce the same type of problem.

Presentation:
Ingrown hairs irritate and inflame the skin causing lesions that range from pus bumps to firm bumps. This may lead to darkening of the skin and scarring in the affected areas. The skin appears bumpy and discolored. Commonly, the cheeks, chin, jawline and neck areas are affected.

Treatment:
Although the only way to cure the disease is to stop shaving, shaving techniques can be optimized. These include avoiding close shaving, using a sharp single blade razor, shaving daily, and shaving in the direction of hair growth (not against it). The strokes should be short and even (do not shave back and forth over the same areas). Plucking is not a recommended method of hair removal. Various prescription strength topical creams may be of some help. They include benzoyl peroxide, hydrocortisone, tretinoin, and eflornithine. Laser hair removal provides more long-term results, although it is possible for hair to regrow. Additionally, in darker-colored individuals laser can cause light or dark areas to appear.

Reference:
Taylor SC. Brown Skin. New York, HarperCollins Publishers Inc., 2003.

Celeste Angel, D.O.
Department of Dermatology
Philadelphia College of Osteopathic Medicine/Frankford Hospital
Philadelphia, Pennsylvannia.