What Is Pseudofolliculitis Barbae (Razor Bumps)?
Key takeaways:
Pseudofolliculitis barbae (PFB) are razor bumps without an infection.
It’s more common in people with curly or coarse hair.
Not shaving or changing shaving methods can help prevent pseudofolliculitis barbae, and treatments are available if you struggle with it.
If you’ve struggled with red, irritated bumps after shaving, you’re not alone. Pseudofolliculitis barbae (PFB), or razor bumps, is a common condition in which bumps appear on the skin after shaving. These bumps are not dangerous, but they can definitely be frustrating. The good news is that there are ways to treat and prevent them.
This article will focus on why PFB happens and what you can do about it.
What causes pseudofolliculitis barbae?
PFB is caused by inflammation around hair that has grown in the wrong direction.
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Normally, hair grows upward through a special opening. But when hair is cut or shaved very closely, it can disrupt normal growing patterns. Instead of moving straight up, closely cut hair can grow sideways and even upside down. Eventually, this hair can pierce the skin outside of its special opening, causing inflammation, redness, and bumps.
It can happen in any area that is shaved, including the beard, scalp, groin, and legs.
Who’s most at risk of experiencing razor bumps?
People who have curly or coarse hair are at a higher risk for razor bumps. There is a high prevalence of PFB in men of African descent, though it can affect people of all genders and ethnicities.
How is pseudofolliculitis barbae different from folliculitis?
What distinguishes PFB from folliculitis is an infection. Folliculitis means there is an infection around the hair follicle. This infection can be caused by bacteria or a fungus.
PFB only means there is inflammation around the hair, but no infection. That said, PFB can progress to folliculitis if the area gets infected.
Are razor bumps serious?
Razor bumps are not dangerous. They can cause pain, itching, redness, and discomfort. They also have a risk of becoming infected, but it is not serious or life-threatening if they do.
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What treatments can help with pseudofolliculitis barbae?
First, it’s best to avoid shaving while PFB is flaring. This can help prevent it from worsening or getting infected.
There are also a few treatments for PFB, including:
Topical antimicrobial creams: These creams, such as clindamycin, can reduce inflammation and can help PFB resolve more quickly.
Mild topical steroid creams: Creams like hydrocortisone can reduce inflammation and treat active PFB.
Benzoyl peroxide face wash: This can reduce inflammation and bacteria on the skin. It can both treat and prevent PFB.
Sometimes, oral (taken by mouth) antibiotics are needed if PFB is severe or an infection is present. These medications can help treat the infection and also reduce inflammation.
How can you prevent pseudofolliculitis barbae?
Not shaving gives you the best chance of preventing PFB, so consider cutting back or stopping altogether. However, if you must shave, there are a few ways to help keep razor bumps away.
It helps to prepare the skin prior to shaving. But the main goal is to reduce the closeness of the shave. Here are some tips to consider:
Prior to shaving, wash your face with warm water and a gentle cleanser. This softens the hair and makes it easier to cut.
Use plenty of shaving cream to reduce friction between the razor and the skin.
Shave along the direction of the hair, not against it.
Do not stretch the skin when shaving.
Use a sharp new blade every time you shave and a razor with a foil guard.
Consider trying an electric razor.
Use a moisturizing cream after you shave to rehydrate the skin.
Consider using topical exfoliants like retinoids and glycolic or alpha hydroxy acids, which help prepare skin for shaving and help hair grow in the right direction.
When is laser hair removal recommended for razor bumps?
If PFB has not improved with topical or oral treatments, and stopping shaving is not an option, hair removal may be a good option. By removing hair at the source, it’s possible to prevent PFB from ever occurring.
There are a few different options for hair removal, including:
Laser hair removal: This is an effective option, but it only works for dark hair. And it takes time to complete, as it requires many (sometimes over 10) treatments.
Electrolysis: This technique also requires many treatments. It can also be painful and, in some cases, actually cause PFB.
Waxing: While waxing may bring temporary relief, when the hair regrows, it can also trigger PFB.
Chemical hair removal: This treatment breaks the hair at the surface, which makes it less likely for the hair to regrow in the wrong direction and cause PFB. But it should not be done daily, as chemical depilatories, such as calcium thioglycolate or barium sulfide, can be irritating to the skin.
If you’re struggling with razor bumps, it’s a good idea to speak with your primary care provider or dermatologist to determine the best method of hair removal for you.
The bottom line
PFB is a common condition involving red, irritated bumps that appear after shaving. It often occurs in men who shave their faces, but can affect women as well. Generally, people with curly or coarse hair have a higher risk of getting PFB.
The only way to fully prevent PFB is to stop shaving or to have hair permanently removed. Topical treatments are available, but you can reduce your risk of PFB with shaving techniques, by moisturizing the skin before and after shaving, and by using foil-guard or electric razors.
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References
Gray, J., et al. (2016). Pseudofolliculitis barbae: Understanding the condition and the role of facial grooming. International Journal of Cosmetic Science.
Perry, P. K., et al. (2002). Defining pseudofolliculitis barbae in 2001: A review of the literature and current trends. Journal of the American Academy of Dermatology.
