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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.

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As with any prescription or over-the-counter (OTC) drug, there may be negative side effects with use of the following drugs, and long-term use is not recommended. Although eradicating the symptoms of PFB through shaving protocols and effective skin care products and regimens is preferable, following are drugs that can be used to help treat severe PFB.

  • Topically applied tretinoin has shown promise. When used nightly, it alleviates hyperkeratosis. It may remove the thin covering of epidermis that the hair becomes embedded in upon emerging from the follicle.4, 5
  • Mild topical corticosteroid creams reduce inflammation of papular lesions.4
  • For severe cases of PFB with pustules and abscess formation, topical and oral antibiotics may be indicated. Tetracycline is a common choice for a systemic antibiotic. Similar to a standard acne regimen, a dose of 500 mg twice a day used initially for 1–3 months is often effective.6, 7

Products, services and home care

Although usually not regarded as a serious medical problem, PFB can be painful, embarrassing and cause cosmetic disfigurement. The papules can lead to scarring, post-inflammatory hyperpigmentation, secondary infection and keloid formation—an overgrowth of fibrous tissue or scars. By offering products and services to help your growing male clientele with PFB, and providing education for home care, you can become the go-to resource for clients suffering from this condition—and their friends.


  1. FN Quarles, H Brody, BA Johnson, et al., Pseudofolliculitis barbae, Dermatol Ther 20 3 133–136 (May/Jun 2007)
  2. C Kindred, CO Oresajo, M Yatskayer, RM Halder, Comparative evaluation of men’s depilatory composition versus razor in black men, Cutis 88 2 98–103 (Aug 2011)
  3. AM Alexander, Evaluation of a foil-guarded shaver in the management of pseudofolliculitis barbae, Cutis 27 5 534–537, 540–542 (May 1981)
  4. ND Childs, Tretinoin, hydrocortisone cream controls PFB, Skin and Allergy News 30 5 20 (1999)
  5. EV Ross, LM Cooke, AL Timko, et al., Treatment of PFB in skin types IV, V, and VI with a long-pulsed neodymium:yttrium aluminum garnet laser, J Am Acad Dermatol 47 2 263–270 (Aug 2002)
  6. AM Kligman and OH Mills, Pseudofolliculitis of the beard and topically applied tretinoin, Arch Dermatol 107 4 551–552 (Apr 1973)
  7. LA Brown, Pathogenesis and treatment of pseudofolliculitis barbe, Cutis 32 4 373–375 (Oct 1983)
  8. JJ Leyden, Topical treatment for the inflamed lesion in acne, rosacea and pseudofolliculitis barbae, Cutis 73 6 Suppl 4–5 (Jun 2004)


IM Freedberg, ed., Fitzpatrick’s Dermatology in General Medicine, 6th ed., McGraw-Hill, New York (2003)