Pseudofolliculitis / folliculitis barbae

What it is

Pseudofolliculitis barbae is a common condition affecting the face and the neck in people with tightly curled hair. It occurs when hairs are cut at an angle and curl in on themselves, creating a foreign body reaction.

So the lesion is not, in the first place, an infection. It is a reaction to the patient's own hair, cut at an angle and curled back into the skin, and everything in the management follows from that.

Causes and risk

Shorter hair makes it worse, and every habit that shortens the hair is a risk. Multi-blade razors, pulling the skin taut and plucking hairs all result in shorter hair and are likely to exacerbate the problem. Clippers generally result in a less close shave and contribute less to pseudofolliculitis barbae.

Shaving advice

Cessation of hair removal improves the condition. That is the first thing offered, and it is offered as the thing that works.

If this is not desired, less aggressive hair trimming is recommended. That means the clippers rather than the close shave, since the clippers leave the hair longer, and it means leaving out the three that shorten it: the multi-blade razor, pulling the skin taut, and plucking.