Pseudofolliculitis barbae
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| Pseudofolliculitis barbae | |
|---|---|
| Specialty | Dermatology  |
Pseudofolliculitis barbae (Template:Pron-en) (also known as barber's itch,[1] folliculitis barbae traumatica,[1] razor bumps,[1] scarring pseudofolliculitis of the beard,[1] and shave bumps[1]) is a medical term for persistent irritation caused by shaving.[2]
Etiology
PFB is most common on the male face, but it can also happen on other parts of the body where hair is shaved or plucked, especially areas where hair is curly and the skin is sensitive, such as genital shaving (more properly termed pseudofolliculitis pubis or PFP).
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. These inflamed papules or pustules can form especially if the area becomes infected.
This is especially problematic for men of African, Mediterranean and Near Eastern descent, and other peoples who have naturally coarse or tightly curling hair. If left untreated over time, this can cause keloid scarring in the beard area.
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.
Prevention and treatment
Prevention and treatment varies by person.
Prevention
Many dermatologists recommend using products that are alcohol-, fragrance-, and oil-free. Alcohol can dry out the skin significantly, and fragrance is a well-known skin irritant that can exacerbate PFB. Products with oil can clog pores and prevent release of the hair from the follicle. Some men use shaving powders (a kind of chemical depilatory) to avoid the irritation. Others may use a razor with a single blade or special wire-wrapped blade to avoid shaving too closely. Some men trim or grow a beard instead of shaving. In severe cases, some men get electrolysis or laser hair removal, or use exfoliating products to minimize PFB.
An effective prevention is to let the beard grow. Once the hairs get to be a certain length they will not grow back into the skin. For most cases, totally avoid shaving for three to four weeks until all lesions have subsided, while applying a mild prescription cortisone cream to the involved skin each morning.
Shaving every other day, rather than daily, will improve pseudo-folliculitis barbae. If one must use a blade, water-soften the beard first with a hot, wet washcloth for five minutes or shave while showering in hot water.
Electrolysis and laser hair removal should be considered when all else fails, but these are expensive and take repeated visits. There is a risk of skin discoloration and very small risk of scarring. A few insurance companies will cover some or all of the cost.
Over-the-counter products like Barc Bump Down and Tend Skin have been effective in helping many sufferers. Medications are also prescribed to speed healing of the skin. Glycolic acid lotion 8% (Alpha-hydrox, Neo-Strata, Innovcool, others) is effective. 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. It is added as a nightly application of Retin-A Cream 0.05 - 0.1% to the beard skin while beard is growing out. Use as tolerated and avoid sunlight, as it is somewhat irritating and can cause peeling.
Treatment
Existing razor bumps can often be treated by removal of the ingrown hair. Extrafollicular hairs can usually be pulled gently from under the skin, with tweezers. Complete removal of the hair from its follicle is not recommended. Severe or transfollicular hairs may require removal by a dermatologist.
Related conditions
Razor burn is a less serious condition caused by shaving, characterized by mild to moderate redness and irritation on the surface of the skin. Unlike PFB, it is usually transient and there is no infection involved.
There is also a condition called folliculitis barbae. The difference between the two is the cause of the inflammation in the hair follicles. Folliculitis barbae is caused by viral or bacterial infections, where pseudofolliculitis is caused by irritation from shaving and ingrown hairs.
A related condition, pseudofolliculitis nuchae, 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 where hard, dark keloid-like bumps form on the neck.
The Eighth Circuit Court of Appeals found that, because African Americans suffer from pseudofolliculitis barbae more than whites, Domino's Pizza's no-beard policy violated the 1991 Civil Rights Act, Title VII [3].
See also
References
- ^ a b c d e Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ "pseudofolliculitis barbae" at Dorland's Medical Dictionary
- ^ http://openjurist.org/926/f2d/714/bradley-v-pizzaco-of-nebraska-inc-bradley