Methods of close shaving that predispose to the development of pseudofolliculitis barbae include using razors with multiple blades, plucking hairs with tweezers, shaving against the grain of hair growth, and pulling the skin taut while shaving. Pseudofolliculitis barbae is primarily a cosmetic concern, but it can lead to scarring, infection, hyperpigmentation, and keloid formation.
Pseudofolliculitis pubis is a similar condition that occurs in the genital area after pubic hair is shaved. Shaving of the axillae may cause a similar condition.
L73.1 – Pseudofolliculitis barbae
399205006 – Pseudofolliculitis barbae
Differential Diagnosis & Pitfalls
- Bacterial folliculitis is rarely chronic and is usually not scarring. The pustules of pseudofolliculitis barbae are intraepidermal, whereas those of folliculitis are intra-infundibular.
- Tinea barbae presents with more confluent lesions rather than isolated papules and improves with shaving.
- Acne vulgaris usually presents with open and closed comedones.
- Herpes folliculitis – Follicular extension of herpes simplex virus infection. This would be acute and appear focal and unilaterally.
- Sarcoidosis usually develops into larger papules and plaques. Dermal lesions are not follicularly centered.
- Majocchi granuloma
- Immunosuppression-related eosinophilic pustular folliculitis
- Fox-Fordyce disease should be considered in the differential diagnosis of axillary or pubic papules.