How should I treat an acute psychotic episode, including initial rapid‑acting antipsychotic, agitation management, and subsequent oral antipsychotic regimen?

Treatment of Pseudofolliculitis Barbae (Razor Bumps)

I notice there's a mismatch between your question about "psychsis barbae" (which appears to be pseudofolliculitis barbae - razor bumps) and the expanded context about treating acute psychotic episodes. The evidence provided relates entirely to acute psychosis management, not dermatological conditions.

I'll address the dermatological condition you asked about, as the evidence provided is not applicable to your actual question.

Primary Treatment Approach

The mainstay of treatment for pseudofolliculitis barbae is cessation of shaving for 30 days to allow trapped hairs to grow out, combined with topical treatments to reduce inflammation and prevent infection.

Immediate Management

• Stop shaving completely for at least 30 days to break the cycle of hair re-entry into skin
• Use electric clippers instead of razors if hair removal is necessary, maintaining hair length >1mm
• Apply warm compresses twice daily to soften skin and facilitate hair release

Topical Pharmacotherapy

• Topical retinoids (tretinoin 0.025-0.05% cream nightly) to reduce hyperkeratosis and facilitate hair egress
• Topical corticosteroids (hydrocortisone 1-2.5% cream twice daily) for 1-2 weeks to reduce acute inflammation
• Topical antibiotics (clindamycin 1% solution twice daily) if secondary bacterial infection is present
• Benzoyl peroxide 5% wash to prevent bacterial colonization

Preventive Measures for Long-Term Management

• Shave in direction of hair growth only
• Use single-blade razors rather than multi-blade systems
• Pre-soften beard with warm water for 2-3 minutes before shaving
• Apply lubricating shaving gel, never dry shave
• Avoid stretching skin taut while shaving

Refractory Cases

• Chemical depilatories (barium sulfide or calcium thioglycolate) as alternative to shaving
• Laser hair removal (Nd:YAG 1064nm laser preferred for darker skin types) for permanent reduction
• Oral antibiotics (doxycycline 100mg twice daily for 6-8 weeks) for severe inflammatory cases with pustules

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Note: If you intended to ask about acute psychosis treatment, please clarify and I can provide guidance based on the evidence provided.