Pseudofolliculitis barbae: understanding the condition and the role of facial grooming

Pseudofolliculitis barbae (PFB) is an inflammatory condition of the beard area, with a high prevalence in men of subequatorial African ancestry and, to a much lesser extent, Indo-Europeans. But it can affect both men and women of all ethnicities. Invariably reported as being associated with shaving, recent evidence suggests a strong genetic component in patients with persistent PFB. There is a lack of robust clinical evidence to support recommendations to avoid or curtail shaving or to shave with a single-blade razor. There is recent clinical evidence that PFB is not exacerbated by daily shaving with a multiblade razor as part of a regimen. Further, there is preliminary evidence that a daily shaving regimen, which includes pre-shave hydration and post-shave moisturization, may be beneficial. To develop evidence-based initial management strategies for PFB, there is a requirement for more randomized blinded clinical trials comparing the use of multi- and single-edge razors, different shaving techniques, shaving frequencies and pre- and post-shaving cosmetic products.