Treatment of pseudofolliculitis with a pulsed infrared laser.

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Abstract
PSEUDOFOLLICULITIS BARBAE is a relatively common disorder that occurs in glabrous skin with coarse, curly hairs.1-4 It is a frequent disorder of any hair-bearing skin with thick, curly hairs that are removed repetitively by shaving, waxing, or plucking. Prevalence figures are only available for pseudofolliculitis barbae occurring in the beard area of African Americans who shave, and range from 45% to 83%.1 Shaving is a predisposing factor because it results in a sharp, pointed, short hair that may curl over and reenter the skin. Extrafollicular penetration of the hair shaft is one cause of pseudofolliculitis barbae. Transfollicular penetration of the hair shaft may occur as well. When the skin is held taut during shaving or when a double-edged razor is used, the sharply cut hair may retract under the skin and grow directly into the follicular wall. Incomplete wax epilation and electrolysis can also lead to transfollicular penetration of the growing hair shaft. In both cases, a foreign body inflammatory reaction ensues. The primary lesions of pseudofolliculitis are erythematous papules and pustules. When chronic inflammation is present, hyperpigmentation, hypopigmentation, and fibrotic scarring may accompany the clinical picture. Biopsy results show foreign body giant cells in the dermis with microabscess formation.5 Cultures of the pustules are sterile, and bacteria are therefore not implicated in the pathogenesis of this disorder.6