Pseudofolliculitis (a.k.a. razor bumps)
WHAT IS Pseudofolliculitis (a.k.a. Razor bumps)?
Pseudofolliculitis is also known as razor bumps or shaving bumps. These are red bumps on the face, neck, scalp, or any other area you shave. It can also happen when hair is waxed or plucked. It is most common in black skin with naturally curly hair. Curly hair shaved close to the skin curves back into the skin. Shaving curly hairs very close to the skin makes this condition more likely, and it can heal with scars or dark marks:
Pulling the skin tight during shaving
Shaving with a razor with multiple razor blades
Shaving against the grain of hair growth
Shaving over the same area more than once
Plucking hairs out with tweezers
Waxing to remove hairs
These great pictures show the difference between folliculitis and pseudofolliculitis. To manage folliculitis, see my folliculitis page.
How do I treat pseudofolliculitis?
These are steps to treat the redness of pseudofolliculitis, but this skin condition is really one that you need to prevent (see below for prevention):
Medicated acne wash – I recommend benzoyl peroxide in a wash to use in the shower to simplify your routine. Almost every skincare company makes a benzoyl peroxide product, but remember: higher prices ≠ better results. Also, stay at 5% or less, because 10% dries you out more without extra benefit.
My favorite medicated acne wash is CeraVe Acne Foaming Cream Cleanser (4% benzoyl peroxide). I also like AcneFree’s 2.5% wash.
Switch razors to a new Skinguard blade (or Venus’s version for women) - designed to minimize the “close shave” that causes pseudofolliculitis.
Alcohol hand sanitizer – I love this simple step. Keep a bottle of Purell hand sanitizer in the bathroom. Right after your daily shower, rub hand sanitizer on the areas where you usually get pseudofolliculitis. It dries within seconds and you can still style your hair or apply a good moisturizer over it. And, if you believe the label, it kills 99.99% of bacteria.
Hibiclens (chlorhexidine) wash – This antibacterial wash is used in the operating room. It works best if you leave it on the skin for at least 5-10 minutes before rinsing off.
Use steroid (cortisone) ointments if it is itchy or red and inflamed – Nothing works better to calm down the redness and irritation of pseudofolliculitis than steroids. An over-the-counter hydrocortisone ointment twice daily works best (instead of cream).
WARNING: Overuse of topical steroids like hydrocortisone can cause skin thinning, stretch marks, and easy bleeding or bruising.
Steps for using a medicated acne wash or hibiclens:
First thing in the shower, rinse the areas where you get pseudofolliculitis with water.
Apply benzoyl peroxide wash or Hibiclens wash and leave it on for 5-10+ minutes for the medication to soak into your skin before rinsing off.
Benzoyl peroxide wash or Hibiclens can be used once or twice a day.
NOTE: Benzoyl peroxide will dry you out. Apply lots of moisturizing cream to fight the dryness until your skin gets used to it. Also, benzoyl peroxide can bleach towels and clothing.
How do I prevent pseudofolliculitis?
If you get red bumps and pimples in areas you shave (face, neck, scalp, thighs, groin):
Pre-treat areas you shave with benzoyl peroxide wash or Hibiclens wash as described above before you shave.
Switch razors to one of the following: 1) new Skinguard blade (or Venus’s version for women), 2) single-use disposable razors (for women), or 3) an electric razor (simple or fancy) that doesn’t shave as close to the skin.
Change up your shaving routine to minimize close shaves:
Use your non-dominant hand to shave
Don’t stretch or tighten your skin to shave
Only shave in the direction your hair grows (for example, shave down in the sideburn area)
Keep your razor blades sharp so you only go over each area once
Shave less frequently
Do not pluck out hairs with a tweezer
Apply a good moisturizer after shaving and before bed.
If you are required to be clean-shaven for work, get a “beard card” or medical permission from a dermatologist to grow a well-groomed beard.
What if my pseudofolliculitis isn’t getting better?
The steps above can help most people prevent pseudofolliculitis or make it better when it happens. Sometimes prescription creams or antibiotic pills are needed, especially if it is severe or starts scarring. If over-the-counter options are not working, look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
DISCLAIMER
The statements expressed and content of this website are not intended to be a substitute for professional medical advice. Readers should seek their own professional counsel for any medical condition or before starting or altering any treatment, exercise, or dietary plan. Please see our full disclaimer here.