Mostly affecting men in their 20s, pseudofolliculitis barbae is the ingrowing of hairs mainly on the beard area of the neck. A change in shaving technique or laser hair removal is often required to manage the condition.
A 29-year-old man had a five-year history of papules and a few pustules on the beard area of his neck. Some of the thicker hairs were ingrowing (Figure). He had tried to manually extract these hairs and thought that this had helped some of the papules settle more quickly. He had been unable to find a blade shaver that did not seem to worsen the irritation.
On examination, there were multiple red papules on the beard area of the patient’s neck. Occasional, small pustules were seen on the anterior and lateral neck in the beard area and on the jawline. A moderate number of hairs grew more horizontally and some of these could be seen to be growing back into the skin. There were also a few small scars from previously inflamed lesions.