Razor bumps, also known as "pseudofolliculitis barbae" for face and "pseudofolliculitis pubis" for pubic skin, is an intense inflammation presenting as acne-like pimples and pus-heads on hair-bearing areas that are shaved like face, scalp and neck of men, and bikini areas and sometimes legs of women. It primarily affects curly-haired males who shave but can also affect some white males.
What causes it?
The cause is believed to be intense 'foreign body' reaction to growing curly hair that reenters the skin, a short distance away. Black men are predisposed because of their inherent curly hair. It can also occur when the sharp tip of a growing hair first pierces through the sac of the follicle. Close shaving, pulling skin taut while shaving, shaving against the grain, plucking hairs with tweezers, removing hairs with wax strips or electrolysis, and using multiple-bladed razors can also predispose to this condition. These methods leave sharp tip of hair follicle just below the skin surface, which is then more likely to pierce through the sac or enter the nearby skin, causing the intense inflammatory reaction.
What are the treatment options?
Behavior Modification – switch to alternate methods of hair removal like chemical depilatories, avoiding regular shaving, close shaving and multiple blades in razors
Medications – Retinols like tretinoin and tazarotene applied nightly remove the thin top layer of skin that the growing hair becomes trapped in. Topical corticosteroid creams can help reduce inflammation. Topical eflornithine HCL 13.9% cream (Vaniqa) has been used for excessive facial hair and in patients with pseudofolliculitis barbae. For severe cases of presenting with pustules and abscess formation, topical and oral antibiotics may be prescribed.
Treatment is important to prevent scarring, hyperpigmentation, secondary infection, and keloid formation. Talk to your dermatologist if you have this condition and are subject to the requirement of clean-shaven face for military or any other employment, so you can be exempt until your condition improves or resolves.