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Beware of ingrown hairs. Prevention is better than cure.

Ingrown hairs, a.k.a. razor bumps. Very common, almost normal but they can still be problematic.

An ingrown hair is one that’s grown back into your skin instead of rising up from it. It can lead to pseudofolliculitis barbae (PFB), which sounds more serious than it is because it’s in Latin. PFB is a chronic, inflammatory reaction characterized by papules and pustules secondary to ingrown hairs. Even in English, PFB is not that pleasant and can get complicated.

PFB requires a genetic predisposition, plus a traumatic hair-removal practice; sharp-pointed hair shafts curve back into the adjacent epidermis, causing inflammation, and may lead to an abscess. Curly hair is a major risk factor due to the acute angle created with the plane of the skin, the mutation of a gene that codes for keratin may also be involved in causing PFB.

Although most often found in men, PFB can also be seen in women. Women are most commonly affected during the perimenopausal period due to changes in hormone levels, although
those with hirsutism problems may be affected earlier. Shaving or depilation is also a common practice in women for cosmetic/cultural/fashion reasons, and they increase the likelihood of developing PFB.

Possible consequences? Infection, post-inflammatory hyperpigmentation, scarring. These are good reasons to stop the problem before it happens.


If the problem appears in a man that shaves his beard, growing a beard usually solves it, but this option is limited by culture and fashion (once upon a time, growing a beard was banned in some South American countries!).

If you are going to shave, here are some tips.

  • Before shaving, wet your skin with warm water, and use a lubricating formulation like Skin Actives Skin Hydrating Shaving cream.
  • Shave with a sharp single-blade razor in the direction your hair is growing.
  • Use as few strokes of the razor as possible, decrease the stress on the skin
  • Rinse the blade with water after every stroke.
  • Don’t shave too closely to your skin, leave a little bit of stubble if you can.
  • If you’re using an electric razor, hold it slightly above the surface of your skin.


In between shaves, try some mechanical exfoliation. You can also try chemical exfoliation, with salicylic acid or proteases.

You can also try other hair removal methods that are less likely to lead to ingrown hairs. Those include creams that dissolve hair and a laser or electric current (electrolysis) to remove the hair follicle for good. I like the methods that use sanding paper, but they are only suitable for the legs.

Dead skin can clog a hair follicle, forcing the hair to grow sideways under your skin, rather than up and out. Salicylic acid and Vitamin A will help prevent clogged pores (preventing acne at the same time).

See your MD!

The known association with hormonal levels suggests that PFB in women may be unique and may signal underlying problems like increased dehydroepiandrosterone, polycystic ovarian syndrome (PCOS), or hirsutism. A visit to your MD or a good endocrinologist will help.


Sakai R, Higashi K, Ohta M, et al. Creeping hair: an isolated hair burrowing in the uppermost dermis resembling larva migrans. Dermatology 2006; 213:242–244.
Nguyen TA, Patel PS, Viol KV, et al. Pseudofolliculitis barbae in women: a clinical perspective. Br J Dermatol 2015; 173:279–281.
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