Razor Burn

Pseudo-Folliculitis Barbae (PFB)

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First...What's This?

Pseudo-Folliculitis Barbae (PFB), Razor Burn, or "Razor Bumps," is caused by ingrown facial hair.

It is more common in people with thick, curly hair such as African Americans and Latino populations, but can be seen in anyone.

While this is common in the military where people are required to adhere to strict grooming standards, this can often be dealt with in the civilian world too.

Unfortunately complete symptom reversal is rare, and typically management is considered successful when the condition is improved enough to allow for comfortable shaving. You may have future flares of the condition, and should return to see your

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Mild-Moderate PFB

You may receive a prescription for a cream such as a topical retinoid (like "tretinoin" or "adapalene") to apply to your facial hair every night. You can also get adapalene or "Differin" gel over the counter to try without a prescription. This medicine will soften the hairs and loosen the follicles, making it less likely to become ingrown. At the end of a 30-60 day time period you should return to shaving daily using the gentle shaving techniques as described below.

If the cream is too irritating to your face, you can try a lower concentration through your doctor or you can try using the cream every other night instead of every night. While using this, be careful to avoid too much sun exposure as your body may become more sensitive to sunburn.

Moderate to Severe PFB

Laser Hair Reduction is the most reliable approach to permanent improvement of your symptoms. This procedure uses light energy absorbed by the hairs within the skin. Heat injury to the follicles from the laser energy reduces the number, size, and strength of hairs. Typically at least 3 treatments is usually needed, with 30-45 days between treatments. This is usually only available at special dermatologist or family practice offices, and will typically require a referral.

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If you haven't responded well to more conservative treatments you may be referred to a dermatologist. Be aware ahead of requesting this that facial hair removal may be permanent, but that shaving may still be required after treatment is complete to have fully smooth skin. This method is most effective at treating black hair; white, red, or blonde hair cannot effectively be treated with this approach.

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How to Shave Gently:

Before shaving, soften your hair first with a hot wet washcloth that you leave on for 5 minutes. This will make hair easier to cut, and more blunt-tipped after cutting. Apply a lubricating shaving gel for 5 more minutes after this. Shave with the grain of the beard without stretching the skin or pressing firmly against the skin. Use one stroke over each area of the skin and use a sharp razor, replacing it often.

If you are using an electric razor, set the hair length longer to avoid too close a shave. Soften the beard with electric razor pre-shave products, shave with the grain of the beard, and do not stretch the skin or press too firmly. Avoid multiple strokes in the same area and do not press the razor head too hard against the skin.

A soothing aftershave cream should be applied whether a razor blade or electric razor is used. If this is insufficient, ask your doctor to consider prescribing a gentle hydrocortisone cream for use after shaving.