What are these bumps in my beard?!

photo: emedicine.com

Q: Help! What are these bumps in my beard?! 

A: Pseudofolliculitis barbae (“razor bumps” or “shave bumps”) is a fairly common problem, affecting 50-80% of African-American men and around 3% of Caucasian men who shave their facial hair. The cheeks and neck are the most common areas affected. The bumps can be itchy, painful, or just plain unsightly and scratching them can lead to bacterial infection and scarring.

Many people confuse this condition with acne but this is not the case. Pseudofolliculitis barbae typically occurs when curly facial hairs are shaved off (which makes them sharper and shorter) and then curl back in and pierce the skin, causing an inflammatory reaction.

Stopping shaving and allowing the hairs to grow out usually fixes the problem. For acutely inflamed bumps, it is best to stop shaving for at least one month – you can use an electric trimmer to keep the hairs short, but should let them get no shorter than ¼ inch. You can also relieve the inflammation by applying a warm compress for 10 minutes, 3 times a day and applying hydrocortisone cream (1%) afterwards. 

For men who are unwilling or unable to grow a beard, some tips to minimize symptoms when shaving include:

  • Allow hairs to grow to at least ¼ inch
  • Rinse face and apply warm water compress for a few minutes
  • Use a generous amount of a lubricating shave cream or gel (i.e. Easy Shave) and allow to sit for 5-10 minutes to soften hairs before shaving
  • Use only a very sharp razor and shave in the same direction as hair growth
  • After shaving, rinse face with water and apply cold water compress
  • Look for any embedded hairs and try to dislodge (don’t pluck!) with a sterile needle or tweezers

There are also topical medications that can be used to treat more severe symptoms. Tretinoin (Retin-A), Benzoyl Peroxide and Clindamycin have all been shown to reduce symptoms. The only definitive cure for pseudofolliculitis barbae is permanent removal of the hair follicle or laser hair removal. These can be expensive and painful solutions so may not be for everybody.

If your shaving bumps persist after trying some of the steps listed above, see your doctor to talk about treatment options.  The physicians at Student Health Services are always happy to help.

Angela Walker, Med IV (Ohio State College of Medicine)

Muhammad Khan, MD (Ohio State Student Health Services)