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Ask a Dermatologist Free: Pseudofolliculitis Barbae

Dear Doctor 

Hello. I am a 23 year old male, and since 2008-2009 I’ve have what looked to be a small pimple/ingrown hair on my right cheek, I have lots of facial hair so every time I shaved my facial hair this bump would enlarge and become very noticeable for tow or three days before shrinking back to a smaller size where is almost Unoticeable and can hardly see it,

well around the summer of 2010 I finally had enough of it and pick it out of frustration thinking it’s just a weird pimple that I’ve had for a few years , well not pulse came out of it , just blood and lots of pain ,

now it’s 2014 and since I picked this bump in 2010 it has never shrunken back to a smaller size, it’s now very large and won’t go away no matter what I try now, I don’t even k ow what it is because it can’t be just a regular pimple or ingrown hair because it’s been almost 6 years since I had it and 4 years since I picked at it, now I wished I didn’t  because it’s easily noticeable on my face, it’s flesh colored (pinkish)  and I’m a African American so with brown skin this bump can easily be spotted on my face ,

If I knew what it was I would know how to treat it a long time ago but I don’t , can anymore give me a clue as to what it could be ? I’ll even send pics if it’s possible to give you a better look close up

client 1

Dear Client

Your picture and symptoms are suggestive of a condition known as Pseudofolliculitis barbae BPF.

PFB, which is also known as shaving bumps, develops when a hair which has been cut reenters the skin and causes inflammation.

The treatment of Pseudofolliculitis Barbae includes:

1. Not shaving. One study found that not shaving for around a month reduced the number of PFB lesions.

 

2. If you must shave because of your job or personal preferences, it is advisable to use an electric shaver since the size of the hair can be set to around 0.5 to 1mm which is a good beard length for reducing the risk of PBF.

 

3. Single blade razors like the Bump Fighter can also be used since they were shown in a study to reduce PBF. However, a study done with a 5 blade razor did not show in increase in the number of PBF lesions.

 

4. Chemical depilatories which contain Barium sulphide like the Magic Red Shaving Powder can also be used. These work by weakening the bonds in the hair so that it breaks and falls off. Before using these compounds always do a patch test by applying them to a small part of the beard since some people develop allergic reactions to them.

 

5. 1% Hydrocortisone cream is also applied to the beard area after shaving to reduce inflammation especially after shaving with chemical depilatories.

 

Complications of Pseudofolliculitis Barbae

One of the complications of pseudofolliculitis barbae is the development of hypertropic scars and keloids which may explain that large bump on your face.

The treatment of facial keloids can be quite challenging. Surgical excision is one way of removing them though it has a high recurrence rate. This rate can be reduced by applying a medication known as imiquimod though they can still recur.

Keloids on the face can also be treated with lasers or injected with a medication known as bleomycin.

For your situation I would advise you to consult a plastic surgeon if it really bothers you and to focus on managing the PFB effectively so that you do not develop other keloids or hypertrophic scars.

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