II. Pathophysiology

  1. As per the name, not a Folliculitis
  2. Tightly curled hair penetrates skin when shaved
    1. Results in local, foreign-body inflammatory response

III. Epidemiology

  1. Most common in black men (45-85% Prevalence) and hispanic men
  2. Women may also be affected in areas of shaving

IV. Signs

  1. Hyperpigmented Papules and Pustules in beard and other areas of shaving
  2. Distribution
    1. Men: Beard area
    2. Women: Face, axilla and suprapubic region

V. Management: General Measures

  1. Most effective treatment and prevetion of recurrence is to stop hair removal
  2. Consider permanent hair reduction
  3. Optimize shaving technique
    1. Avoid a close shave (leave hairs at least 0.5 mm long)
    2. Use hair clippers or a single-blade razor
    3. Depilatories may be used if not irritating
    4. Shave in Hair Growth direction
    5. Avoid pulling hair taught while shaving
    6. Loosen embedded hairs prior to shaving (e.g. brush, apply compresses, or rub with towel)
    7. Avoid plucking hair

VI. Management: Medications

  1. Mild to medium potency Topical Corticosteroids applied immediately after shaving
  2. Topical Benzoyl Peroxide 2.5% applied in morning
  3. Topical Retina A 0.025% applied at night
  4. Antibiotics indicated if secondary infection

VII. Complications

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