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Ingrown Beard Hairs

(Pseudofolliculitis Barbae)

by Wendy S. Levinbook, MD

Ingrown beard hairs become inflamed when the hairs penetrate the skin before they leave the hair follicle or after they leave the follicle and curve back into the skin.

This hair disorder most often occurs in the beard and neck areas of black men with tightly curled hair who shave. It can also occur in women who shave, especially in the groin area. Each ingrown hair results in a tiny, mildly painful pimple with a barely visible hair curling into the center. Scarring can result.

Doctors diagnose the disorder by its typical appearance.

Treatment of the pimples involves following proper shaving technique and applying warm compresses several times a day to soothe the area. If inflammation is present but mild, doctors sometimes give low-potency corticosteroid or antibiotic creams that are applied directly to the inflamed area. If inflammation is moderate to severe, doctors may give antibiotics taken by mouth. Benzoyl peroxide creams and retinoid creams can be helpful for people with mild or moderate cases but may irritate the skin.

The best preventive treatment is to stop shaving and allow the hair to grow. When the hairs are longer, they do not curl back and puncture the skin.

A man who does not want a beard can use a depilatory (a liquid or cream preparation that removes unwanted hair), although it often irritates the skin. Also, hair can be permanently removed with electrolysis or with laser treatment (see Using Lasers to Treat Skin Problems). People who must shave should wet the beard first and should shave in the same direction in which the hair grows. People should avoid shaving closely with multiple razor strokes. Applying eflornithine cream may help by slowing hair growth.

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