dermatologic disorders
Pseudofolliculitis Barbae
Treatment of Pseudofolliculitis Barbae
Cessation of shaving Warm compresses and retraction and release of ingrown hair tips Topical or oral drugs as needed for inflammation and secondary infection Sometimes hair follicle removal Sometimesprednisone Shaving should be discontinued until all inflammatory lesions have cleared. Acute manifestations of pseudofolliculitis barbae (eg, papules and pustules) can be treated with warm compresses and manual retraction of ingrown hair tips with a toothpick or sterile needle to release embedded hairs. Topicalhydrocortisone1% or topical antibiotics can be used for mild inflammation. Oraldoxycycline(50 to 100 mg 2 times a day) or oralerythromycin(250 mg 4 times a day, 333 mg 3 times a day, 500 mg 2 times a day) can be used for moderate to severe inflammation. Because inflammation, not infection, is being treated, there is no fixed duration for treatment withdoxycyclineorerythromycin. Tretinoin(retinoic acid) gel, liquid, or cream orbenzoyl peroxidecream may also be effective in mild or moderate cases but may irritate the skin. Topicaleflornithinehydrochloride cream may help by slowing hair growth so that shaving can be done less frequently. Alternatively, hairs can be allowed to grow out; grown hairs can then be cut to about 0.5 cm in length. Hair follicles can be permanently removed by electrolysis or laser treatment. Chemical depilatories may also be used because chemical removal of hairs does not trigger the pathology; however, it may irritate the skin. A short course ofprednisonemay be necessary for resistant cases. Once lesions clear and patients resume shaving, shaving techniques must be optimized. 