Common terms for this condition includerazor bumps, shaving bumps, oringrown hairs.
This condition develops after hair has been removed by either shaving (most commonly) or waxing.
Symptoms of pseudofolliculitis barbae include:
These symptoms may develop or worsen within a day or two after shaving.
Photo: LaylaBird / Getty Images
Pseudofolliculitis also causes darkening of the skin in affected areas, a condition calledpost-inflammatory hyperpigmentation.
Hypertrophic (raised scars)orkeloid scarscan also develop in people who are prone to them.
Pseudofolliculitis barbae is incredibly common in Black men and men who have curly facial hair.
It’s estimated that up to 83% of all Black men develop pseudofolliculitis barbae.
Hair stretches, just a bit, when shaving, especially if the skin is pulled taut.
As the razor cuts, the hair pulls back and retracts into the follicle.
It is also more common in perimenopausal and menopausal women.
Other risk factors for pseudofolliculitis include taking cyclosporine or and corticosteroids (in renal transplant patients).
Diagnosis
PFB is diagnosed based on a review of symptoms and a visual inspection of the skin.
There is no specific test for diagnosing pseudofolliculitis barbae.
They look like dark grey or black lines or spots under the skin.
In some cases, your healthcare provider may swab your skin to check for a bacterial infection.
Sometimes these conditions can occur at the same time as PFB.
Over time, though, the skin improves because the grown-out hair stays above the skin’s surface.
Hence, it is much less likely for ingrown hairs to develop.
When you completely stop shaving, marked improvement is typically seen in about three months' time.
In many cases, stopping shaving will completely clear up pseudofolliculitis barbae.
At this point, any treatment for post-inflammatory hyperpigmentation or scars can be started.
However, letting hair grow out isn’t an option for everyone.
You may have a job that requires you to be clean-shaven, for example.
If that’s true for you, there are other treatment options that can be used.
This isn’t a permanent means of getting rid of hair; it will grow back.
But when it does, the hair itself has a softer, finer tip.
The downside is depilatories are messy and smelly.
They can also be irritating for some people, causing burning and stinging during use.
If you’re particularly sensitive, they may also causecontact dermatitis.
Always use depilatories with care and follow all directions on the package.
They are typically applied once or twice daily over all affected areas.
Topical Steroids
Your healthcare provider may recommendtopical steroidsfor short-term treatment to alleviate moderate to severe inflammation.
Over-the-counter hydrocortisone creamcan reduce itching and inflammation.
If OTC options aren’t enough, you may be prescribed a stronger medication.
Side effects includethinning of the skinand hypopigmentation, which is much more common in dark skin.
Procedures
These aren’t used as a first-line defense against PFB.
Instead, these procedures may be tried if pseudofolliculitis is severe and not responding well to other treatments.
The drawback of these procedures is the expense.
In many cases, they are not covered by medical insurance.
The out-of-pocket cost can make these treatments out of reach for some.
Your healthcare provider can tell you if these procedures are appropriate for you.
Instead, they are used in conjunction with other treatments.
There is no cure for pseudofolliculitis, so you will always be prone to developing ingrown hairs.
It requires lifelong management to keep this skin condition at bay.
Coping
Having pseudofolliculitis barbae can be embarrassing as well as uncomfortable.
Because it most often appears on the face, it feels so “front and center.”
Many people with PFB say they often feel embarrassed or ashamed because of the condition.
It can affect self-esteem and self-confidence.
The most important thing you’re free to do if you have this condition is to start treatment.
PFB can cause stinging and burning, especially while shaving.
Avoiding shaving altogether is the best way to prevent PFB.
When this is not feasible, however, various drug treatments and procedures may be effective.
Gray J, McMichael AJ.Pseudofolliculitis barbae: understanding the condition and the role of facial grooming.Int J Cosmet Sci.
2016 Jun;38 Suppl 1:24-7. doi:10.1111/ics.12331
Ogunbiyi A.Pseudofolliculitis barbae; current treatment options.Clin Cosmet Investig Dermatol.
2013;3(2):53-4. doi:10.5826/dpc.0302a07
