Pseudofolliculitis barbae
Encyclopedia
Pseudofolliculitis barbae (icon), also known as barber's itch, folliculitis barbae traumatica, razor bumps, scarring pseudofolliculitis of the beard, and shave bumps, is a medical term for persistent irritation caused by shaving
.
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 people 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.
) 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, because they are expensive and take repeated visits. There is a risk of skin discoloration and very small risk of scarring.
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.
. Complete removal of the hair from its follicle is not recommended. Severe or transfollicular hairs may require removal by a dermatologist.
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.
found that, because African American males suffer from pseudofolliculitis barbae more than Caucasian males, Domino's Pizza
's no-beard policy violated the 1991 Civil Rights Act, Title VII.
Shaving
Shaving is the removal of hair, by using a razor or any other kind of bladed implement, to slice it down to the level of the skin. Shaving is most commonly practiced by men to remove their facial hair and by women to remove their leg and underarm hair...
.
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 genitalPubic hair
Pubic hair is hair in the frontal genital area, the crotch, and sometimes at the top of the inside of the legs; these areas form the pubic region....
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
African people
African people refers to natives, inhabitants, or citizen of Africa and to people of African descent.-Etymology:Many etymological hypotheses that have been postulated for the ancient name "Africa":...
, Mediterranean and Near Eastern descent, and other people who have naturally coarse or tightly curling hair. If left untreated over time, this can cause keloid
Keloid
A keloid is a type of scar, which depending on its maturity, is composed mainly of either type III or type I collagen. It is a result of an overgrowth of granulation tissue at the site of a healed skin injury which is then slowly replaced by collagen type 1...
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
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 depilatoryChemical depilatory
A chemical depilatory is a cosmetic preparation used to remove the hair from the skin on the human body. Currently, a common active ingredient is calcium thioglycolate, which breaks down the disulphide bonds in keratin and weakens the hair so that it is easily scraped off where it emerges from the...
) to avoid the irritation. Others may use a razor
Razor
A razor is a bladed tool primarily used in the removal of unwanted body hair through the act of shaving. Kinds of razors include straight razors, disposable razors and electric razors....
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
Electrology
Electrology is the practice of electrical epilation to permanently remove human hair. The actual process of removing the hair is referred to as electrolysis.-Overview:...
or laser hair removal
Laser hair removal
Laser hair removal was performed experimentally for about 20 years before it became commercially available in the mid 1990s. One of the first published articles describing laser hair removal was authored by the group at Massachusetts General Hospital in 1998...
, or use exfoliating products
Exfoliation (cosmetology)
Exfoliation involves the removal of the oldest dead skin cells on the skin's outermost surface, and has been used for many years to help maintain skin. Exfoliation is involved in the process of all facials, during microdermabrasion or chemical peels at medical spas...
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, because they are expensive and take repeated visits. There is a risk of skin discoloration and very small risk of scarring.
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
Glycolic acid
Glycolic acid is the smallest α-hydroxy acid . This colorless, odorless, and hygroscopic crystalline solid is highly soluble in water. It is used in various skin-care products. Glycolic acid is found in some sugar-crops...
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 tweezersTweezers
Tweezers are tools used for picking up and manipulating objects too small to be easily handled with the human hands. They are probably derived from tongs, pincers, or scissors-like pliers used to grab or hold hot objects since the dawn of recorded history...
. 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
Folliculitis
Folliculitis is the inflammation of one or more hair follicles. The condition may occur anywhere on the skin with the exception of the palms of the hands and soles of the feet.- Causes :...
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
Keloid
A keloid is a type of scar, which depending on its maturity, is composed mainly of either type III or type I collagen. It is a result of an overgrowth of granulation tissue at the site of a healed skin injury which is then slowly replaced by collagen type 1...
-like bumps form on the neck.
Legal issues
The Eighth Circuit Court of AppealsUnited States Court of Appeals for the Eighth Circuit
The United States Court of Appeals for the Eighth Circuit is a federal court with appellate jurisdiction over the district courts in the following districts:* Eastern District of Arkansas* Western District of Arkansas...
found that, because African American males suffer from pseudofolliculitis barbae more than Caucasian males, Domino's Pizza
Domino's Pizza
Domino's Pizza, Inc. is an international pizza delivery corporation headquartered in Ann Arbor, Michigan, United States of America. Founded in 1960, Domino's is the second-largest pizza chain in the United States and has over 9,000 corporate and franchised stores in 60 countries and all 50 U.S....
's no-beard policy violated the 1991 Civil Rights Act, Title VII.