Prevention
The most effective prevention is to let the beard grow. For men who are required or prefer to shave, studies show the optimal length to be about 0.5 mm to 1 mm to prevent their hair growing back into the skin. For most cases, totally avoiding shaving for three to four weeks allows all lesions to subside, and most extrafollicular hairs will resolve themselves in about 10 days. Permanent removal of the hair follicle is the only definitive treatment for PFB. Electrolysis is impractical and ineffective because the needle may not reach the hair follicle. Laser-assisted hair removal is effective. There is a risk of skin discoloration and a very small risk of scarring.
Some men use electric razors to control PFB. Those who use a razor, should use a single blade or special wire-wrapped blade to avoid shaving too closely, with a new blade each shave. Shaving in the direction of hair growth every other day, rather than daily, may improve pseudofolliculitis barbae. If one must use a blade, softening the beard first with a hot, wet washcloth for five minutes or shave while showering in hot water can be helpful. Some use shaving powders (a kind of chemical depilatory) to avoid the irritation of using a blade. Barium sulfide-based depilatories are most effective, but produce an unpleasant smell.
Treatment
The easiest cure is to let the beard grow. Existing razor bumps can often be treated by removal of the ingrown hair. Extrafollicular hairs can usually be pulled gently from under the skin, with tweezers. Complete removal of the hair from its follicle is not recommended. Severe or transfollicular hairs may require removal by a dermatologist.
Medications are also prescribed to speed healing of the skin. Clinical trials have shown glycolic acid-based peels to be an effective and well-tolerated therapy which resulted in significantly fewer PFB lesions on the face and neck. The mechanism of action of glycolic acid is unknown, but it is hypothesized that straighter hair growth is caused by the reduction of sulfhydrylbonds in the hair shaft by glycolic acid, which results in reduced re-entry of the hair shaft into the follicular wall or epidermis. Medications containing Allantoin and Azulene have been shown to reduce swelling, redness and itchiness. Allantoin is a natural soothing skin protectant and moisturizer that increases the water content to provide structure support to skin cells. Azulene is a blue colored oil derived from flowers in the Asteraceae family and can be used to moisturize and soothe irritated skin. Salicylic acid peels are also effective. Prescription antibiotic gels (Benzamycin, Cleocin-T) or oral antibiotics are also used. Retin-A is a potent treatment that helps even out any scarring after a few months. It is added as a nightly application of Retin-A Cream 0.05 - 0.1% to the beard skin while beard is growing out.
Exfoliating the skin before and between shaves using an ingrown hair brush or bump brush effectively frees trapped hair out and teases it away from the skin before the hair has a chance to embed itself.
The most effective prevention is to let the beard grow. For men who are required or prefer to shave, studies show the optimal length to be about 0.5 mm to 1 mm to prevent their hair growing back into the skin. For most cases, totally avoiding shaving for three to four weeks allows all lesions to subside, and most extrafollicular hairs will resolve themselves in about 10 days. Permanent removal of the hair follicle is the only definitive treatment for PFB. Electrolysis is impractical and ineffective because the needle may not reach the hair follicle. Laser-assisted hair removal is effective. There is a risk of skin discoloration and a very small risk of scarring.
Some men use electric razors to control PFB. Those who use a razor, should use a single blade or special wire-wrapped blade to avoid shaving too closely, with a new blade each shave. Shaving in the direction of hair growth every other day, rather than daily, may improve pseudofolliculitis barbae. If one must use a blade, softening the beard first with a hot, wet washcloth for five minutes or shave while showering in hot water can be helpful. Some use shaving powders (a kind of chemical depilatory) to avoid the irritation of using a blade. Barium sulfide-based depilatories are most effective, but produce an unpleasant smell.
Treatment
The easiest cure is to let the beard grow. Existing razor bumps can often be treated by removal of the ingrown hair. Extrafollicular hairs can usually be pulled gently from under the skin, with tweezers. Complete removal of the hair from its follicle is not recommended. Severe or transfollicular hairs may require removal by a dermatologist.
Medications are also prescribed to speed healing of the skin. Clinical trials have shown glycolic acid-based peels to be an effective and well-tolerated therapy which resulted in significantly fewer PFB lesions on the face and neck. The mechanism of action of glycolic acid is unknown, but it is hypothesized that straighter hair growth is caused by the reduction of sulfhydrylbonds in the hair shaft by glycolic acid, which results in reduced re-entry of the hair shaft into the follicular wall or epidermis. Medications containing Allantoin and Azulene have been shown to reduce swelling, redness and itchiness. Allantoin is a natural soothing skin protectant and moisturizer that increases the water content to provide structure support to skin cells. Azulene is a blue colored oil derived from flowers in the Asteraceae family and can be used to moisturize and soothe irritated skin. Salicylic acid peels are also effective. Prescription antibiotic gels (Benzamycin, Cleocin-T) or oral antibiotics are also used. Retin-A is a potent treatment that helps even out any scarring after a few months. It is added as a nightly application of Retin-A Cream 0.05 - 0.1% to the beard skin while beard is growing out.
Exfoliating the skin before and between shaves using an ingrown hair brush or bump brush effectively frees trapped hair out and teases it away from the skin before the hair has a chance to embed itself.
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