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Preventing Pseudofolliculitis Barbae in Male Clients

By: Holly Harmon
Posted: June 27, 2014, from the July 2014 issue of Skin Inc. magazine.

Pseudofolliculitis barbae (PFB) is a foreign body inflammatory reaction involving papules and pustules on the beard area—the lower face and neck—of men. Typically, there are groups of small red or pigmented bumps on the beard area that may flare with repeated shaving, and PFB tends to be worse with very curly or kinky hair.

Causes of PFB

There are two primary causes of PFB:

  1. Extrafollicular penetration occurs when the sharply pointed hair from a recent shave briefly surfaces from the skin and re-enters a short distance away (See Extrafollicular Exfoliation); and/or
  2. Transfollicular penetration occurs when methods of very close shaving result in a hair that is cut below the surface. These methods include pulling the skin taut while shaving, shaving against the grain, plucking hairs with tweezers, and using double- or triple-bladed razors. The close shave may result in a sharp tip below the skin surface, which is then more likely to pierce the follicular wall, causing PFB with transfollicular penetration.1, 2

Treatment for PFB

Treatment for this condition depends on its severity. Treatment specifications include shaving protocols, skin care ingredients and regimens, and prescriptive remedies. An effective starting point for treatment is to advise clients to let their beard grow for 30 days to eliminate ingrown hairs, if lifestyle and work environment allow for this. When they are ready to shave again, ask them to follow these specifications.

Shaving protocols for clients.

Skin care ingredients and regimen

PFB creates an inflammatory environment that often includes bacteria, fungi and infection. Therefore, it is important to look for skin care ingredients that soothe, are anti-inflammatory, and include antifungal and antibacterial active ingredients. Identify quality, effective skin care products that achieve these outcomes. Clients’ regimens should include the following four steps.

  1. Clients should cleanse their skin daily in circular motions each morning and evening.
  2. Skin should be exfoliated to dislodge the impacted hair using products with the recommended ingredients; consider selling a gentle exfoliating brush in the retail area for use. Daily exfoliation is ideal for PFB environments. If clients use an exfoliating brush, they should clean the brush with an antibacterial wash or hydrogen peroxide regularly to eliminate bacteria.
  3. Apply a soothing gel immediately after shaving that is anti-inflammatory, and that addresses a wide variety of fungi and bacteria.
  4. Incorporate remedies for hyperpigmentation to avoid immediate and long-term discoloration. A sampling of ingredients to look for in skin care that address the symptoms of PFB include the following:

Drug remedies for severe PFB