Shaving Education
Pseudofolliculitis Barbae (PFB) is a disease involving either the embarbment of a growing hair back into the skin, or, a hair, which, while growing, does not clear the opening of the hair follicle, but instead, penetrates the follicle wall into the surrounding skin. This results in an inflammatory response and the potential for a scar and even a keloid; a growth made of scar tissue. It takes approximately 3-5 days for the hair to grow long enough to embarb into the skin. Penetration from within the follicle occurs if the follicle is damaged, or, if the hair is clipped too short, as many electric shavers and multiple track razors can do. This condition occurs primarily in the beard hair area, and, while usually seen in male patients of African American descent, can potentially be seen in any ethnic/racial population, and in either gender. It frequently flares when shaving is required, such as when a Soldier enters active-duty in military service. Pustules can also form when the bump becomes infected. Scarring, dimpling or pitted scars and skin-color changes may occur as a result of the condition.
Identification of PFB
An examination of the facial skin should reveal in-growing hairs, often associated with a
raised bump, and rarely a scar or early keloid. Gently lifting the in-growing hair with a clean needle or sharp toothpick should release the end of the hair that is embarbing into the skin.
Initial steps after Identification of PFB
If bumps are present, the hair should be allowed to grow and be maintained at 1/8 to 1/4 inches in length for 2-4 weeks. This allows the beard to grow, assisting with releasing the embarbed hairs. Hair release treatment is probably the single-most important treatment for this disorder – if there is no ingrowing hair, there is no inflammation. Hairs can be released with a clean needle or a sharp toothpick. This should be performed regularly (daily-every other day), in a systematic way. It should not hurt to perform this procedure. Do not pluck the hair out with a tweezers – this damages the follicular wall, which may lead to a hair follicle infection, or the inability for the hair to track correctly as it grows back along the hair follicle. The Soldier may gently clean the skin with mild soap, and gently scrub using a washcloth, or surgical hand scrub brush, gently swirling the skin. These methods should continue for the rest of the Soldier’s time on active duty, or when a
clean-shaven appearance is needed.
Ways to Reduce PFB
Pre-Shave Preparation:
- Soften the hair: Take a warm shower or apply a warm, wet washcloth to the area for a several minutes to soften the hair and open the pores.
- Hydrate and Lubricate: Use a generous amount of shaving cream or gel to lubricate the skin and hair, preventing friction and allowing the razor to glide smoothly.
Shaving Technique:
- Single-blade razor: Opt for a single-blade razor, or a specialized razor designed to cut hairs at a tolerable length.
- Shave with the grain: Shave in the direction of hair growth to minimize ingrown hairs.
- Short, gentle strokes: Use short, even strokes with minimal pressure.
- Avoid stretching the skin: Avoid stretching the skin while shaving, as this can cause hairs to retract beneath the surface and lead to ingrown hairs.
- Avoid multiple passes: Do not shave the same area multiple times to prevent irritation.
- Consider electric clippers: If you prefer a closer shave, use electric clippers with a guard to leave a small amount of stubble (1-3mm).
Post-Shave Care:
- Rinse with cold water: This helps to close the pores and reduce inflammation.
- Apply a soothing lotion: Use a gentle, alcohol-free moisturizer to hydrate and soothe the skin after shaving.
Additional Tips:
- Don't press hard: Avoid pressing the razor too hard against the skin.
- Replace razors frequently: Use a sharp razor to minimize irritation.
- Consider professional help: If you have severe PFB, consult a dermatologist or healthcare provider for personalized advice and treatment options, including laser hair removal or other therapies.
Issues that come with PFB
- Skin Discoloration: Post-inflammatory hyperpigmentation can occur, leading to dark spots on the skin after the bumps heal.
- Scarring: Severe cases can lead to keloid scarring, particularly in individuals prone to such scars.
- Bumps And Pustules: The condition manifests as firm, skin-colored to red bumps, often filled with pus, centered around hair follicles.
- Itching and Burning: Affected individuals may experience itching or a burning sensation within 24-48 hours after shaving.
To learn more about treatment of PFB speak with your Medical Provider.
Click here to view the Army Directive 2025-13 (Facial Hair Grooming Standards)