Fast Five Quiz: Annoying Medical Conditions

Richard H. Sinert, DO


April 25, 2022

Pseudofolliculitis barbae, or shaving bumps, is a foreign-body inflammatory reaction involving papules and pustules. Pseudofolliculitis pubis is a similar condition occurring after pubic hair is shaved.

Patients report a painful acneiform eruption that occurs after shaving. The patient's shaving history, including the method and the frequency, may reveal an improper shaving technique. The method for preparation of the beard, the use of medications or depilatories, and the use of hair-releasing procedures should be discussed with the patient. The primary lesion is a flesh-colored or erythematous papule with a hair shaft in its center. If the hair shaft is gently lifted up, the free end of the hair comes out of the papule. These inflammatory papules are seen in shaved areas adjacent to the follicular ostia. Although usually not regarded as a serious medical problem, pseudofolliculitis barbae can cause cosmetic disfigurement. The papules can lead to scarring, postinflammatory hyperpigmentation, secondary infection, and keloid formation.

Pseudofolliculitis barbae is found mostly in Black men, who are genetically predisposed to pseudofolliculitis barbae because of the curvature of their hair follicles. It is particularly common among Black men who shave closely on a regular basis.

Chemical depilatories work by breaking the disulfide bonds in hair, which results in the hair being broken off bluntly at the follicular opening. Chemical depilatories should not be used every day because they cause skin irritation. Every second or third day is an acceptable regimen.

Patients with pseudofolliculitis barbae may use razors if single-edged, foil-guarded, safety razors are used. Double- or triple-bladed razors shave too closely and should not be used.

Learn more about pseudofolliculitis of the beard.

This Fast Five Quiz was excerpted and adapted from the Medscape articles Friction Blisters, Tinnitus, Fast Five Quiz: Tinnitus, Hiccups, Fast Five Quiz: Hiccups, Benign Paroxysmal Positional Vertigo, and Pseudofolliculitis of the Beard.

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