Pseudofolliculitis of the Beard Clinical Presentation

  • Author: Thomas G Greidanus, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 17, 2012
 

History

  • Patients complain of a painful acneiform eruption that occurs after shaving.
  • The patient's shaving history, including the method and the frequency, may reveal an improper shaving technique.
  • The method for preparation of the beard, the use of medications or depilatories, and the use of hair-releasing procedures should be discussed with the patient.
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Physical

  • The primary lesion is a flesh-colored or erythematous papule with a hair shaft in its center. If the hair shaft is gently lifted up, the free end of the hair comes out of the papule.
  • These inflammatory papules are seen in shaved areas adjacent to the follicular ostia.Pseudofolliculitis barbae on the neck of a black mPseudofolliculitis barbae on the neck of a black man.
  • Pustules and abscess formation can occur from secondary infection.
  • Postinflammatory hyperpigmentation, scarring, and keloid formation may occur in chronic or improperly treated cases.
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Causes

  • African Americans are genetically predisposed to pseudofolliculitis barbae because of the curvature of their hair follicles. Improper shaving techniques and the desire for a clean-shaven appearance can result in ingrown hairs via extrafollicular or transfollicular penetration.
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Contributor Information and Disclosures
Author

Thomas G Greidanus, MD  Chair, Department of Emergency Medicine, Parkview Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Beth Honl, MD  Dermatology Associates, PC; Private Practice

Beth Honl, MD is a member of the following medical societies: American Academy of Dermatology and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Leonard Sperling, MD  Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  11. Callender V, Young CM. Combination Laser and Eflornithine HCL 13.9% Cream: A First-line Therapy for Fitzpatrick Type IV-VI Patients With Excessive Facial Hair. J Am Acad Dermatol. Mar 2005;52(3) suppl:P209.

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  16. Robins P, Battle EF Jr, Alexis AF, Cook-Bolden F, Alqubaisy Y, McLeod MP, et al. Unique laser techniques in patients with skin of color. J Drugs Dermatol. Dec 1 2011;10(12):4-26. [Medline].

  17. Schulze R, Meehan KJ, Lopez A, et al. Low-fluence 1,064-nm laser hair reduction for pseudofolliculitis barbae in skin types IV, V, and VI. Dermatol Surg. Jan 2009;35(1):98-107. [Medline].

  18. Ross EV, Cooke LM, Timko AL, Overstreet KA, Graham BS, Barnette DJ. Treatment of pseudofolliculitis barbae in skin types IV, V, and VI with a long-pulsed neodymium:yttrium aluminum garnet laser. J Am Acad Dermatol. Aug 2002;47(2):263-70. [Medline].

  19. Alexander AM. Evaluation of a foil-guarded shaver in the management of pseudofolliculitis barbae. Cutis. May 1981;27(5):534-7, 540-2. [Medline].

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Pseudofolliculitis barbae on the neck of a black man.
 
 
 
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