What is the diagnosis and treatment for an ingrown black hair, also known as pseudofolliculitis (PFB) or ingrown hair follicle?

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Differential Diagnosis for Ingrown Hair that's Black

  • Single most likely diagnosis
    • Pseudofolliculitis barbae: This condition is characterized by ingrown hairs, particularly in individuals with curly or kinky hair. The black color of the ingrown hair is consistent with this diagnosis, as it often affects individuals with darker hair.
  • Other Likely diagnoses
    • Folliculitis: An inflammation of the hair follicle, which can cause ingrown hairs to become infected and appear black due to the presence of dirt, dead skin, or other debris.
    • Trichostasis spinulosa: A condition where multiple hairs are trapped within a single follicle, leading to the appearance of a black, ingrown hair.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Squamous cell carcinoma or other skin cancers: Although rare, it's essential to consider the possibility of skin cancer, especially if the ingrown hair is accompanied by other suspicious symptoms such as bleeding, rapid growth, or changes in color.
    • Infectious diseases (e.g., furuncle or carbuncle): Bacterial infections can cause inflammation and pus around the hair follicle, leading to the appearance of a black, ingrown hair.
  • Rare diagnoses
    • Traction alopecia: A condition where hair loss occurs due to constant pulling or tension on the hair, which can lead to ingrown hairs.
    • Perifolliculitis capitis abscedens et suffodiens: A rare inflammatory condition that affects the scalp, causing ingrown hairs, pus, and scarring.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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