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Ingrown Beard Hairs

(Pseudofolliculitis Barbae)

By

Wendy S. Levinbook

, MD, Hartford Dermatology Associates

Last full review/revision Nov 2020| Content last modified Nov 2020
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Pseudofolliculitis barbae is caused by ingrown hairs, usually in the beard, that 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, and anywhere hair is shaved or plucked. 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

  • Proper shaving technique and warm compresses

  • For inflammation, creams (corticosteroids, antibiotics, benzoyl peroxide, or retinoids) or drugs by mouth

Treatment of the pimples involves initial discontinuation of shaving, and the application of warm compresses several times a day to soothe the area. Ingrown hairs may be released with a sterile needle or toothpick.

If inflammation is present but mild, doctors sometimes give low-potency corticosteroid or antibiotic creams that are applied directly to the inflamed area. Benzoyl peroxide creams and retinoid gels, liquids, or creams can be helpful for people with mild or moderate cases but may irritate the skin.

If inflammation is moderate to severe, doctors may give antibiotics taken by mouth.

Some people may need a short course of treatment with corticosteroids taken by mouth.

Proper shaving technique should be followed once shaving is resumed.

Prevention

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.

Hair can be removed with a depilatory (a liquid or cream preparation that removes unwanted hair) because removing hairs chemically does not trigger the problem the way shaving does, although the chemicals often irritate the skin. Also, hair can be permanently removed with electrolysis or with laser treatment.

People who must shave should wet the area 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 so that shaving can be done less frequently.

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