Pseudofolliculitis of the Beard

Updated: Feb 10, 2016
  • Author: Thomas G Greidanus, MD; Chief Editor: Dirk M Elston, MD  more...
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Overview

Background

Pseudofolliculitis barbae (PFB) or shaving bumps is a foreign body inflammatory reaction involving papules and pustules. It primarily affects curly haired males who shave. [1] Pseudofolliculitis barbae can also affect some white men and hirsute black women. Pseudofolliculitis pubis is a similar condition occurring after pubic hair is shaved.

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Pathophysiology

Two mechanisms are involved in the pathogenesis of pseudofolliculitis barbae: (1) extrafollicular penetration occurs when a curly hair reenters the skin, and (2) transfollicular penetration occurs when the sharp tip of a growing hair pierces the follicle wall.

Black men who shave are predisposed to this condition because of their tightly curved hair. The sharp pointed hair from a recent shave briefly surfaces from the skin and reenters a short distance away. Several methods of close shaving result in a hair cut below the surface. These methods include pulling the skin taut while shaving, shaving against the grain, plucking hairs with tweezers, removing hairs with electrolysis, and using double- or triple-bladed razors. The close shave results in a sharp tip below the skin surface, which is then more likely to pierce the follicular wall, causing pseudofolliculitis barbae with transfollicular penetration. [2, 3]

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Epidemiology

US frequency

About 10-80% of adult black men have pseudofolliculitis barbae, particularly those who shave closely on a regular basis. It is a significant problem in black men in the military where regulations require a clean-shaven face. [4]

Race

Pseudofolliculitis barbae is found mostly in black men.

Sex

Men with facial hair comprise most patients, although hirsute women can also develop pseudofolliculitis barbae. Both sexes can develop pseudofolliculitis pubis. Common sites in black women and those of ethnic backgrounds characterized by darker skin include the pubic and axillary areas because these are more frequent sites of hair removal in this population.

Age

Pseudofolliculitis barbae affects men with facial hair (postpuberty).

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