A wise man once said, “A beard is like a pet I don’t want to have – I have to groom it, take care of it, but it would feel wrong to just get rid of it.” And like all pets, beards too can be a bit of a nuisance at times. Pseudofolliculitis barbae goes by a few names; “razor bumps” or “ingrown hairs” and is a common condition in those who remove their facial hair. Though it is more common in males, females are also susceptible to the condition.[1,2] Pseudofolliculitis barbae refers to ingrown hairs of the facial region but can occur in any region of skin in which hair removal is implemented. Those of us who have had experience with ingrown hairs know all too well how uncomfortable they can become, both physically and socially. It is for this reason we’ve complied salient information in hopes to help you learn what causes ingrown hairs and how you can avoid them.
What is an Ingrown Hair and Why Does it Happen?
Quick background on how a hair sits in the skin
To better understand what ingrown hairs are and why they happen, we must first understand the anatomy of our skin and hair follicles. The skin is composed of three layers, the outermost layer is known as the epidermis, then there is the dermis, and the deepest layer of skin is known as the hypodermis or subcutaneous fascia. The hair follicle (the structure responsible for growing and housing hair) originates at the surface of the epidermis and extends down into the deep layers of the dermis.[3,4] It is at this deep layer in the dermis that the hair follicle dilates into the hair bulb – the base where cell proliferation is the highest and pushes the newly formed hair outward towards the epidermis.
Credit: Army Medical Department
Here is what happens after shaving
During shaving, we have a tendency to stretch our skin while passing a razor over it - effectively causing two things to occur. The first is the production of sharp-ended hair, and the second is the retraction of that sharp ended hair back into the hair follicle once the skin is no longer taught. As you can imagine, this sharp ended hair now has the possibility to pierce the skin in several ways to cause an ingrown hair:
Transfollicular penetration: the sharp hair can curl and turn into the side of the hair follicle and pierce into the skin rather than growing out of the skin leading to the bumps seen with ingrown hairs.[1,5]
Extrafollicular penetration: Sharp hair has successfully exited the follicular orifice, but loops back and penetrates into the skin.[1,5]
Though it seems like ingrown hairs are an inevitable outcome of shaving - there are alternative grooming methods that can be utilized to limit the number of ingrown hairs we experience, all while still allowing us to look gorgeous.
Who is At Risk?
Individuals who have coarse and tightly curled hair are more likely to experience pseudofolliculitis barbae. Specifically, the disorder is most commonly seen in individuals with African, Hispanic, and Middle Eastern ancestry, though the condition may occur in any population in which curled hair is common. As mentioned before, pseudofolliculitis barbae tends to occur more frequently in men than women, but any race and any gender has the potential to be affected.[1,6]
1. Stop Shaving, Start Trimming
The title of this section says it all. By discontinuing removal of the hair for a month, it allows hair to grow to a length that is unlikely to penetrate the skin. Letting hair grow has historically been the treatment of choice for pseudofolliculitis barbae. But it is easy to understand why growing out one’s facial hair may not appeal to all of us, so instead, use an electric trimmer that keeps the hair at least 1mm in length (a length longer than razor shaves). By using an electric trimmer and keeping the hair at an appropriate length it reduces the risk of developing ingrown hairs.
2. Shower First, Shave After
It has been recommended that individuals shave after a warm bath. The warm water helps to soften the hair and reduces the number of sharp edges formed during shaving. After a hot shower, a diligent pre-shave regimen is crucial. Incorporating a warm compress and a mild cleanser -followed by generous amounts of shaving cream left on for 10 minutes further softens the hair and also aids in preventing the generation of sharp-ended hairs while shaving. As a final note, it has been suggested that one should rinse the razor blade with warm water after each stroke in order to prevent the traction that occurs from hair build within the razor.[1,6]
3. Shave With the Hair and Not Against the Grain
An additional key point is to shave in a direction that is parallel to how the hair is growing, rather than going against the grain or at an angle, again, effectively limiting the production of sharp-tipped hair is crucial.
4. Sometimes Less is More
Consider using a single blade razor instead of a multi-bladed razor. These days, razor blade companies boast about the number of blades their razors have, yet the first blade actually acts to pull the hair up while the subsequent blades are the ones that do the cutting. This subtle but critical nuance is important because it allows for the cut hair to retract back into the follicle. By using a razor with fewer blades and avoiding stretching of the skin while shaving can potentially aid in limiting ingrown hair formation.[1,9]
Use of a slightly abrasive cloth, antibacterial soap, and warm water while scrubbing in a circular motion to wash the bearded area/ location of ingrown hairs can be an effective method in releasing hairs embedded in the skin. This practice should be done daily in order to gain maximum benefit. On a side note, it is not recommended to pick or pluck ingrown hairs – such actions can lead to potential worsening of inflammation and can even result in scarring.
6. Nothing Wrong With A Little Chemistry
Beyond just physical techniques, use of chemical depilatories is also a recommended method for removing hair for individuals with pseudofolliculitis barbae. Chemical depilatories contain compounds such as barium sulfide or calcium thioglycolate that act to break apart the disulfide bonds in hair (these bonds are what give hair its structural integrity). By destroying these bonds, hair can be easily scrubbed away and also results in hair that is softer, blunt-ended, and feather-tipped. Because chemical depilatories have the potential to irritate the skin, it is advised that individuals apply a small amount of the product on a nonfacial area first in order to determine if irritation occurs.[1,8]
7. If All Else Fails, It’s Time To Laser
Since pseudofolliculitis barbae is caused by hair regrowth, use of lasers to selectively destroy hair follicles has been shown to be an effective treatment option. Of the potential methods to reduce the occurrence of ingrown hairs listed here, laser hair reduction is the only one that is a medical procedure and should only be done by a trained physician. Many different laser hair reduction systems exist, but ultimately they all act to destroy hair follicles, causing a decrease in the thickness and density of hair in the treated area, leading to improvement in individuals suffering from the condition.[1,10]
For further reading on shaving and skin care, click on the article links below:
* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.
Perry PK, Cook-Bolden FE, Rahman Z, et al. Defining pseudofolliculitis barbae in 2001: a review of the literature and current trends. J Am Acad Dermatol.2002;46(2 Suppl Understanding):S113-119; PMID: 11807473 Link to research.
Winter H, Schissel D, Parry DA, et al. An unusual Ala12Thr polymorphism in the 1A alpha-helical segment of the companion layer-specific keratin K6hf: evidence for a risk factor in the etiology of the common hair disorder pseudofolliculitis barbae. J Invest Dermatol.2004;122(3):652-657; PMID: 15086549 Link to research.
Yousef H, Sharma S. Anatomy, Skin (Integument), Epidermis. StatPearls. Treasure Island (FL) Link to research.
Martel JL, Badri T. Anatomy, Head, Hair, Follicle. StatPearls. Treasure Island (FL) Link to research.
Florida DAN, PharmDAssociate Professor of Pharmacy PracticeDovena Michel, PharmD, BCPSAssistant ProfessorNathaniel E. Eraikhuemen, PharmDAssociate Professor of Pharmacy PracticeCollege of Pharmacy and Pharmaceutical SciencesFlorida A&M University-Davie Instructional SiteDavie, FloridaAntonio J. Carrion, PharmD, MPH, AAHIVPAssistant Professor of Pharmacy PracticeCollege of Pharmacy and Pharmaceutical SciencesFlorida A&M University–Tallahassee Instructional SiteTallahassee. Pseudofolliculitis Barbae: Prevention and Treatment. Link to research.
Alexis A, Heath CR, Halder RM. Folliculitis keloidalis nuchae and pseudofolliculitis barbae: are prevention and effective treatment within reach? Dermatol Clin.2014;32(2):183-191; PMID: 24680005 Link to research.
Gray J, McMichael AJ. Pseudofolliculitis barbae: understanding the condition and the role of facial grooming. Int J Cosmet Sci.2016;38 Suppl 1:24-27; PMID: 27212468 Link to research.
Kelly AP. Pseudofolliculitis barbae and acne keloidalis nuchae. Dermatol Clin.2003;21(4):645-653; PMID: 14717405 Link to research.
Alexander AM. Evaluation of a foil-guarded shaver in the management of pseudofolliculitis barbae. Cutis.1981;27(5):534-537, 540-532; PMID: 7238107 Link to research.
Ross EV, Cooke LM, Timko AL, et al. Treatment of pseudofolliculitis barbae in skin types IV, V, and VI with a long-pulsed neodymium:yttrium aluminum garnet laser. J Am Acad Dermatol.2002;47(2):263-270; PMID: 12140474 Link to research.