Pseudofolliculitis barbae
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| ICD-10 | L73.1 |
|---|---|
| ICD-9 | 704.8 |
| DiseasesDB | 31373 |
| MedlinePlus | 000823 |
| eMedicine | derm/354 |
Pseudofolliculitis barbae (pronounced /'suː.dɒ.fɒ.lɪk.kjuːˌliː.tɪs 'bɑː.beɪ/) is a medical term for persistent inflammation caused by shaving. The etymology comes from "pseudo" (false) "follicle" (hair) "itis" (inflammation) "barbae" (of the beard). It is also known by the initials PFB or colloquial terms such as "razor burn" or razor rash.
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[edit] 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.
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. 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 descent and other people with curly hair. If left untreated over time, this can cause keloid scarring in the beard area.
[edit] Prevention and treatment
Prevention and treatment varies by person. Some males 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 or in occupations where shaving is a requirement (such as the military), some men get electrolysis, laser hair removal, or use exfoliating products to minimize PFB.
A 100% effective detreatment 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 3 to 4 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 5 minutes.
Electrolysis and laser hair removal should be considered when all else fails, but these are expensive and take repeated visits. There is a very small risk of scarring. A few insurance companies will cover some or all of the cost.
Medications are also prescribed to speed healing of the skin. Glycolic acid lotion 8% is effective (Alpha-hydrox, Neo-Strata, others). 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, as it is somewhat irritating.
[edit] Related conditions
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.
