Medical Term for Post-Shaving Bumps
The medical term for bumps that occur after shaving is pseudofolliculitis barbae (PFB), commonly known as "razor bumps" or "ingrown hairs." 1, 2
What Is Pseudofolliculitis Barbae?
PFB is a chronic inflammatory disorder of the hair follicles and surrounding skin that develops when shaved hair re-enters the skin, triggering a foreign body reaction. 1 The condition presents with:
- Papules (small raised bumps) 1
- Pustules (pus-filled lesions) 1, 3
- Post-inflammatory hyperpigmentation (dark spots after healing) 1, 3
- Pruritus (itching) 4
- Potential keloid formation and scarring in severe cases 1
Who Gets This Condition?
PFB occurs most frequently in individuals with curly hair, particularly men of African and Asian descent. 1 However, it can affect anyone who shaves, including women who shave or wax axillary (underarm) and pubic areas. 2, 4 Individuals with a specific genetic variant (single nucleotide substitution in the K6hf gene) have a six-fold increased risk of developing PFB. 1
Why Does This Happen?
The pathophysiology involves several factors: 1, 4
- The curved shape of hair follicles allows growing hair tips to curve downward and penetrate adjacent skin 1
- Shaving creates sharp hair tips that more easily pierce the skin 1
- This penetration triggers a foreign body inflammatory reaction 1, 5
- The result is the characteristic papules, pustules, and hyperpigmentation 1
Important Clinical Distinction
Do not confuse PFB with folliculitis (bacterial infection of hair follicles). 6 While both can present with pustules:
- Folliculitis presents as tender papules and pustules primarily in hair-bearing regions, often smaller than hidradenitis suppurativa lesions, and is particularly common with shaving pubic hair 6
- PFB is specifically caused by hair re-entering the skin after shaving, not by bacterial infection 1, 2
Folliculitis requires different management, including potential incision and drainage for larger lesions, moist heat application, and systemic antibiotics only when systemic signs are present (fever >38°C, tachycardia >90 bpm, or extensive cellulitis). 7
Treatment Approach for PFB
The most effective strategy combines behavioral modifications with topical therapies: 3
- Cessation of shaving is the most definitive treatment and usually terminates PFB development 1
- Medical treatments include topical antibiotics, corticosteroids, and retinoids 2
- Laser hair removal has revolutionized treatment and can provide cure for those accepting permanent hair reduction 2
- Proper shaving technique with adequate lubrication minimizes trauma when shaving cannot be avoided 6
Key Clinical Pitfall
Patients should be counseled that shaving should be performed carefully with adequate lubrication to minimize trauma, as improper technique significantly increases risk of both folliculitis and PFB. 6