Pseudofolliculitis barbae is irritation of the skin due to beard hairs that penetrate the skin before leaving the hair follicle or that leave the follicle and curve back into the skin, causing a foreign-body reaction.

Pseudofolliculitis barbae predominantly affects black men. It is most noticeable around the beard and neck. It causes small papules and pustules that can be confused with bacterial folliculitis. Scarring can eventually result.

Diagnosis is by physical examination.

Pseudofolliculitis Barbae

Treatment

Acute manifestations of pseudofolliculitis barbae (eg, papules and pustules) can be treated with warm compresses and manual removal of ingrown hairs with a needle or tweezers. Topical hydrocortisoneSome Trade Names
CORTEF
SOLU-CORTEF
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1% or topical antibiotics can be used for mild inflammation. Oral doxycyclineSome Trade Names
PERIOSTAT
VIBRAMYCIN
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(50 to 100 mg bid) or oral erythromycinSome Trade Names
ERY-TAB
ERYTHROCIN
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(250 to 500 mg qid, 333 mg tid, 500 mg bid) can be used for moderate to severe inflammation. TretinoinSome Trade Names
RETIN-A
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(retinoic acid) liquid or cream or benzoyl peroxideSome Trade Names
BENZAC AC
BENZAGEL
NEUTROGENA ACNE MASK
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cream may also be effective in mild or moderate cases but may irritate the skin. Topical eflornithineSome Trade Names
VANIQA
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hydrochloride cream may help by slowing hair growth. Hairs should be allowed to grow out; grown hairs can then be cut to about 0.5 cm in length. Depilatories are an alternative but may irritate the skin. Hair follicles can be permanently removed by electrolysis or laser treatment.

Last full review/revision September 2012 by Wendy S. Levinbook, MD

Content last modified November 2012