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Dermatology · Hair disorders: pseudofolliculitis barbae
Sample itemA man with tightly curled hair has recurrent inflamed papules and pustules in the beard area after close shaving, with curved hairs re-entering the skin. What is the best advice?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Avoid close shaving, allow the beard to grow, or use a razor guard or laser hair removal
Pseudofolliculitis barbae is a foreign-body inflammatory reaction to curved shaved hairs that re-penetrate the skin, common in men with curly hair. Management is to avoid close shaving, release ingrown hairs, use a guard and consider laser hair reduction. Topical retinoids and eflornithine can help.
Option by option
A. Start long-term oral antibiotics only
Antibiotics alone do not address the mechanism.
B. Start oral terbinafine
Terbinafine would not treat a non-fungal condition.
C. Avoid close shaving, allow the beard to grow, or use a razor guard or laser hair removal (correct)
Correct. Avoiding close shaving or reducing the hair is the main strategy.
D. Pluck all hairs every day
Plucking worsens inflammation and ingrown hairs.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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