From the Guidelines
Pseudofolliculitis barbae is best treated by temporarily stopping shaving to allow inflammation to subside, followed by proper shaving techniques, and using topical treatments such as benzoyl peroxide or retinoids to reduce inflammation and prevent ingrown hairs. When shaving, it is essential to use a single-blade razor or electric razor with guards, prepare the skin with warm water and shaving cream, shave in the direction of hair growth, and apply a moisturizer afterward 1. For established PFB, topical treatments include:
- Benzoyl peroxide (2.5-5% gel applied once daily)
- Retinoids like tretinoin (0.025-0.05% cream applied nightly)
- Glycolic acid (8-15% lotion) Topical antibiotics such as clindamycin 1% solution twice daily can help with inflammation 1. It is crucial to avoid greasy creams for basic care, manipulation of skin, hot blow-drying of the hair, and wearing of tight shoes, as these can exacerbate the condition 1. For severe cases, oral antibiotics like doxycycline 100mg twice daily for 2-4 weeks may be necessary, and long-term management includes considering permanent hair removal methods like laser therapy 1. These treatments work by reducing inflammation, preventing ingrown hairs, and decreasing bacterial colonization that worsens the condition. Consistent adherence to these practices is essential for effective management of this condition. It is also important to note that topical steroid preparations, such as prednicarbate cream, can be used to treat erythema and desquamation, but should be used under the supervision of a dermatologist 1.
From the Research
Treatment Options for Pseudofolliculitis Barbae
The treatment for Pseudofolliculitis Barbae (PFB) requires a multifaceted approach, targeting various aspects of the pathogenesis. Some of the treatment options include:
- Preventive measures
- Antibiotics
- Corticosteroids
- Keratolytics
- Chemical depilatories
- Laser treatments 2 Topical therapies are currently the mainstay treatment for PFB, but laser hair removal has become a potential long-term treatment option 2, 3.
Medical and Surgical Therapies
Medical treatments for PFB include various combinations of topical antibiotics, corticosteroids, and retinoids 3. Surgical therapies, such as laser therapy, have revolutionized the treatment of PFB and have enabled cure for the first time for those plagued by this disorder and for whom a beardless face is acceptable 3.
Current Treatment Options
The most effective treatments for PFB involve a multifaceted approach, including behavioral changes in shaving habits as well as the use of topical therapies 4. A combination of topical eflornithine cream and long-pulsed Nd-YAG laser has been shown to be effective in reducing inflammatory papules and hair density in PFB cases 5.
Diagnosis and Prevention
Diagnosis of PFB is clinical, and cessation of shaving or removal of the involved hair follicles usually terminates the development of PFB 6. Individuals with a single nucleotide substitution in the hair follicle companion layer specific keratin gene (K6hf) have a six-fold increased chance of developing PFB 6.
Treatment Efficacy
The efficacy of different treatment options for PFB has been evaluated in various studies. For example, a study found that the combination of topical eflornithine cream and long-pulsed Nd-YAG laser was more effective than either treatment alone in reducing inflammatory papules and hair density 5.