Pseudofolliculitis barbae, known as razor bumps, is the number one complaint among black men and women who shave or perform other hair removal methods. Caused by stiff facial hair and a genetically-caused curved follicle, the hair tips reverse their course and literally penetrate and grow back into the skin, like a horseshoe, before they would normally exit. Similar to hundreds of splinters, these trapped hairs incite an inflammatory response, causing soreness, redness and swelling. This reaction, called “bumping up” creates perifollicular papules best described as swollen, pus-filled lesions blanketing the beard and/or other shaving areas.
Similar problems can affect women on the chin, sideburns, neck, chest, abdomen, legs and in the bikini area from tweezing, threading, sugaring, waxing, shaving, and even depilatories. The sensations experienced by the razor bump (ingrown hair) sufferer are constant itching, tingling, burning, soreness, swelling and often pain. Symptoms can be mildly annoying and localized for some, and severe and extensive for others.
Razor Bumps and Ingrown Hair Tend To Be Chronic
Pseudofolliculitis barbae can persist as long as the individual shaves, waxes, sugars, threads, and/or tweezes. Obviously, the problem can be dealt with by just allowing the hair to grow out. As the hair grows longer, it simply pops out the follicular opening and new “bumping up” ceases because the individual has stopped shaving, waxing, tweezing, etc. Not shaving is not always practical due to the pressure of one’s employer, lifestyle, and beauty and grooming customs.
Strict grooming regulations have been historically imposed by law enforcement agencies, fire departments, parcel delivery services, and the military. These and other industries have traditionally insisted on the clean-shaven look, and this has caused suffering and disfigurement to hundreds of thousands of black and bump-prone men. In recent years, consciousness has gradually increased and some rules are slowly changing. Some branches of the military, most notably the Navy, are allowing extremely bump-prone men to sport a short, neatly-groomed beard.
For decades, viable solutions to this universal problem eluded the medical, esthetic and drug store markets, and continue to do so on a wide-scale basis. Most physicians have relied unsuccessfully on topical steroids, retinoid creams, and systemic antibiotics.
Over-the-counter, mailorder, and online shaving systems have utilized single edge blades, weak hydrocortisone creams, bromelain enzymes, abrasive scrubs, and alcohol-based salicylic acid solutions. While these methods can help improve the condition, they rarely offer total clearing or longterm relief. As a result, this all-too-common skin disorder presents a wide-open arena for knowledgeable esthetic practitioners. Clinical skin care pros can dispense exfoliating, calming and antibacterial professional products (exfoliating masks and scrubs, AHA exfoliants, BPO, skin brighteners, acetylsalicylate solutions, and hydrocortisone) and have the skill to release ingrown hairs correctly in a safe setting.
We instruct our clients to shave in the direction of hair growth with a single-edge disposable blade like the PFB Bump Fighter or Bic for Sensitive Skin, which is used once or twice and then discarded. Examine the shaving area and determine which areas are less “bumped up” than others. Carefully imitate the shaving method and direction you use on the clearest areas, and repeat the same process on the entire shaving area.
Shave more often and way less close. Don’t stretch the skin and repeatedly go over the same area in a back-and-forth motion in an effort to get a closer shave. Use fragrance-free shaving creams, mild shaving soaps and gels containing benzoyl peroxide or alpha or beta hydroxy acid, which work well with single-edge disposable blades. Because rust starts to form on wet razors, use the blade more than once or twice.
If the preferred shaving method involves an electric razor, nest practice is to use the traditional barber’s trimmer, called a T-edger or liner, which gives a semi-close, more precise shave that larger clippers. An example of this compact trimmer is the Wahl, designed for black men who shave, but Oster, Andes and other trimmers can work equally well. Professional disinfectant spray (Clippercide or Oster) must be used before and after shaving to disinfect and lubricate the blades.
Avoid rotary shavers because they cut beard hair too close and at too many different angles, which compounds the problem. Recently-shaved hair will be situated (and later trapped) below the skin line. The same principle applies to the use of twin, triple, four and five-blade razors; the first blade stretches the skin, while the second (third, fourth and fifth) blades shave way too close.
Tweezing and Tampering
Tampering with the skin of introduces secondary bacteria and leads to inflammation, delayed healing, scarring, and larger, thickened dark spots. Tweezing, threading, waxing and sugaring trap recently removed hairs deep below the skin line and set them up to become trapped again and again as they re-grow.
We often include wives, mothers, sisters, and girlfriends in the consultation. They are often the ones who wield the sewing needles and tweezers, or they observe the picking, digging, unhooking, tweezing and other types of skin tampering habits at home.
Depilatory Creams and Shaving Powders
We discourage the use of chemical depilatories once one of our anti-bacterial, keratolytic topicals can be applied nightly in the bump prone area without irritation. Use of depilatories, which contain lye, similar to diluted Drano and Liquid Plumber, causes chemical irritation which leads to dark hyperpigmentation of the lower face and neck. This beard ‘shadowing’ is worsened by daily sun exposure. Melanin-suppressing skin brighteners should be introduced gradually in the absence of irritation and allergy. During the day, anti-inflammatory creams and oil-free full-spectrum sunscreens are vital to help correct and discourage beard discoloration.
Those plagued with chronic “trouble spots”, usually on the neck or cheeks where tweezing was performed repeatedly, can explore the “blend method” of electrolysis for small problem areas. The electrologist should be skilled and experienced in the treatment of black, bump-prone clients with curved and often scarred hair follicles. The hereditary curved follicle, healing process, risk of scarring and hyperpigmentation, as well as inflammatory reaction to the temporary “trauma” of electrolysis can differ radically from other races, so chose an experienced electrologist who uses the blend method on a diverse clientele.
Laser Hair Removal
Lasers have become increasingly popular in recent years to gradually and permanently reduce hair on the face and body. It is important that candidates do their homework to steer clear of the risks related to lasers, especially scarring and hyperpigmentation on darker skin tones. Most problems arise because the technician uses the wrong laser, at the wrong wavelength, and lacks training and experience treating ethnic skin.
Your laser technician must take the time to consult with you and go over every point below.
(a) They must have access to and use the safest, most appropriate laser for darker skin tones, like the gentle YAG Q-switched neodymium yttrium aluminum garnet laser that produces a 1064nm wavelength of laser light. This is the only wavelength of light that is safe and also effective for darker skin.
(b) They must be well-trained and very experienced in the use of that laser on darker skin tones. A skilled technician can get rid of the hair in about eight treatments, but you must stick to the timetable, usually every four weeks at first.
(c) They must discuss the cycles of hair growth, exactly how the laser works, and disclose what it can and cannot do for you. For instance, laser hair removal cannot remove or reduce light brown, blond, red, gray or white hair.
(d) They must take the time to discuss pre-laser pain management, care instructions to reduce post-laser inflammation, use of melanin suppressing products to control pigmentation during the entire course of treatment, and the need for diligent sun protection.
(e) To avoid reactions, they must also request that you disclose the exact location of any cosmetic tattoos and direct you to remove all mineral make-up and physical sunscreen thoroughly before each treatment.
Tip: If a laser technician fails to touch on all of these points, it would be wise to find a more experienced technician who will.
©2019 Kathryn Khadija Leverette
The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.