What is Pseudofolliculitis? 12th April 2018 | By Kesiree Naidoo Pseudofolliculitis is a common chronic skin condition which typically affects the beard area of men who shave. It is then referred to as pseudofolliculitis barbae or more commonly called ‘shavers rash’. It typically occurs in men with tightly curled hair and of African descent. ‘Barbae’ refers to the beard area though pseudofolliculitis can occur in any shaved area and could even affect women and other race groups. It occurs where hair is coarse and abundant and subject to shaving, waxing or plucking In all cases it is a cosmetically disfiguring condition which is difficult to treat and often recurrent. How does it occur? Paeudofolliculitis is caused when hair grows parallel to the skin surface rather than perpendicular to it such that the sharp tip of the newly cut hair curls back and pierces the skin causing trauma, inflammation and ultimately an ingrown hair. A newly cut or plucked hair shaft may pierce the follicular wall to enter the dermis without ever leaving epidermis (upper layer of the skin) once again resulting in an ingrown hair and inflammation While this process occurs mainly in curly hair, skin folds or scarred skin may cause the condition in straight hair. Pseudofolliculitis barbae is essentially a chronic foreign body reaction to an ingrown hair shaft. What does it look like? Pseudofolliculitis barbae typically presents with firm papules and pustules in the beard area. For some reason it does not occur on the moustache area. The appearance of the disorder can be cosmetically distressing for affected patients. Postinflammatory hyperpigmentation, secondary bacterial infection, scarring, and keloid formation are potential complications. How can you prevent it? Use good shaving techniques. Cleanse the skin thoroughly and wet the skin and hair before shaving. Wetting the hair softens the keratin making it easier to cut. Applying a warm wet towel for a few minutes before shaving may also be helpful. Shaving preparations provide additional hydration and cushion the blade against the skin to minimise trauma. Use a clean,sharp blade and shave in the direction of hair growth where possible. This may be difficult as the hair in the beard area tends to grow in different directions. Cleanse the skin thoroughly after shaving, as residual shaving preparation left on the skin surface may cause irritation. How do you treat Pseudofolliculitis? Stop shaving The first step is to stop shaving in the area till all inflammatory lesions and ingrown hairs have cleared. You may trim the hair to a minimum length of 0.5 cm with a scissors or electric clippers Release ingrown hairs on a daily basis Apply a warm water compress to the affected area for 10 min to soften the epidermis ( upper layer of the skin). Then release the ingrown hairs with a sterile needle or toothpick. Topical corticosteroid Apply a mild topical steroid to the area to decrease the inflammation and reduce burning and itching. Systemic antibiotics Some patients may need an oral antibiotic for secondary infection or for anti inflammatory effect. Other treatments Other treatment options include topical retinoids, alphahyroxyacids and benzoyl peroxide. Chemical depilatory creams may be used for hair removal. Laser hair removal is sometimes recommended for those with resistant and recurrent pseudofolliculitis. Once the condition has resolved, adopt good shaving techniques as described above, and invest in a suitable skincare regimen as recurrence is common. Skincare recommendations for Pseudofolliculitis. Neostrata Foaming Glycolic wash – This is a potent, foaming facial cleanser with glycolic acid and lactobionic acid to resurface and hydrate the skin with minimal irritation. The special formulation exfoliates and unclogs congested pores. Obagi Clenziderm pore therapy This liquid treatment contains salicylic acid which helps unclog pores and remove dead surface skin cells. NeoStrata Ultra Smoothing Lotion 10 AHA – Ultra Smoothing Lotion is an antioxidant-rich, exfoliating moisturiser. This is a lightweight formulation which is suitable for use on the face and body and may be preferred by men. The exfoliating action of alphahydroxyacids removes the surface dead skin cells and helps unclog pores.