Pseudofolliculitis of the Beard Medication

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

Medication Summary

Hydrocortisone cream is effective in reducing inflammation. Topical and oral antibiotics are used when secondary infection is evident. Tretinoin has shown promise in early pseudofolliculitis barbae. Chemical depilatories are preferential to shaving for some patients.

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Chemical depilatories

Class Summary

These agents are effective alternatives to shaving for some patients. They work by breaking disulfide bonds in hair follicles.

Barium sulfide

 

A fast-acting depilatory powder that is mixed with water to form a paste.

Calcium thioglycolate

 

Effective depilatory that is left on for 10-15 min.

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Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting. Topical preparations reduce bacterial populations and secondary infection.

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Tetracycline (Achromycin V, Sumycin)

 

Used orally to treat secondary infection. Treats gram-positive and gram-negative organisms as well as mycoplasmal, chlamydial, and rickettsial infections. Inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunits.

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Erythromycin topical (T-Stat)

 

2% Topical solution. Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. For treatment of staphylococcal and streptococcal infections.

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Retinoids

Class Summary

These agents decrease the cohesiveness of abnormal hyperproliferative keratinocytes, and they may reduce the potential for malignant degeneration. They modulate keratinocyte differentiation. They have been shown to reduce the risk of skin cancer formation in patients who have undergone renal transplantation.

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Tretinoin topical (Retin-A)

 

Inhibits microcomedo formation and eliminates existing lesions. Makes keratinocytes in sebaceous follicles less adherent and easier to remove. Applied topically, reduces outbreaks of mild pseudofolliculitis barbae. Available as 0.025%, 0.05%, and 0.1% creams. Also available as 0.01% and 0.025% gels.

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Corticosteroids

Class Summary

These agents are used to reduce inflammation and irritation. These agents have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body's immune response to diverse stimuli.

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Hydrocortisone topical (Cortaid)

 

1% cream. Adrenocorticosteroid derivative suitable for application to skin or external mucous membranes. Has mineralocorticoid and glucocorticoid effects, resulting in anti-inflammatory activity. Effective when used topically on a short-term basis.

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Eflornithine HCL 13.9% cream (Vaniqa)

 

Oral eflornithine inhibits ornithine decarboxylase, which affects rate of hair growth (anagen phase). Slows hair growth, and some reports indicate miniaturization of hair growth to areas treated. May take 4-8 wk for improvement; however, condition may return to pretreatment levels 8 wk after discontinuance of therapy.

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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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