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Hair Follicle Conditions (Hair Bumps)

Hair follicles can become ingrown, infected, inflamed, or irritated, resulting in a variety of bumps. These may include “shaving or razor bumps”, a skin condition known as keratosis pilaris (KP), or a more troublesome ingrown hair condition called Pseudofolliculitis Barbae. These different kinds of  hair follicle bumps may be unnoticeable for some people or considered unsightly and embarrassing for others. Some become inflamed, thickened and discolored. Many of the patients that visit Dermatology Specialists of Atlanta  are experiencing  symptoms of hair follicle conditions. A board-certified dermatologist such as Dr. Smith at Dermatology Specialists of Atlanta can help manage or reduce these irritations with a variety of treatment options.

Keratosis Pilaris (KP)

Typically, the condition consists of a scattered, patchy rash made of very small red or light colored bumps.  The buildup of keratin, the protein that protects skin, hardens and forms a plug that blocks the opening of a hair follicle, causing small raised bumps. The affected area may have as little as 10 or up to hundreds of scattered, very small slightly rough bumps, resulting in a fine, sandpaper-like texture. Sometimes, a small, coiled hair is trapped beneath the rough bump. The bumps usually appear on upper arms, thighs, and buttocks. Although it can also show up on the cheeks as pink, red, flushed, very small (pinpoint) bumps, it is less common.


source: kpessentials.com

Keratosis pilaris is benign and isn’t usually painful, though dry skin may make it itchy and uncomfortable. It also often affects people with certain skin conditions, including eczema. Many children and teens get it, and it usually disappears as they get older. A family history of keratosis pilaris is also very helpful since there is a strong genetic component to the condition.

Treatment Options

Various treatments are available to reduce the irritation and keratin bumps associated with KP. These include:

  • Keeping skin moist with moisturizing creams,
  • Regulation of environmental conditions such as using warm water and a gentle cleanser to wash, using a humidifier, and limiting time in baths or showers,
  • Prescription strength topical medicines containing active ingredients such as retinoids, salicylic acid, or alpha-hydroxy help to exfoliate the skin and assist in controlling skin cell turnover to lower the incidence of KP bumps.
  • Limited use of  products containing hydrocortisone to reduce inflammation.
  • Specially mixed compound creams with multiple different combined ingredients prescribed by Dr. Scott.

Pseudofolliculitis Barbae (PFB)

Pseudofolliculitis barbae (razor or shaving bumps) is a common condition of the beard area occurring in men of ethnic descent and other people with coarse and curly hair who shave or tweeze the hair on the neck and face. In fact, statistics indicate that up to 60% of African American men suffer from this unsightly condition.  PFB is not to be confused with Pseudofolliculitis pubis – a similar condition experienced from shaving, waxing or use of other depilitories in the bikini and pubic hair area.

source: emedicine.medscape.com

source: emedicine.medscape.com

PFB is a foreign body inflammatory reaction involving papules and pustules, especially if patients’ hairs are coarse, curly and plentiful, and skin is sensitive. The problem results when highly curved hairs grow back into the skin causing inflammation and a foreign body reaction. Shaving sharpens the ends of the hairs like a spear. The hairs then curve back into the skin, causing keloid type scarring which looks like hard bumps. The bumps may also also be discolored or darker than the patient’s normal skin color, making them even more noticeable.


Although the most effective treatment is to let the beard grow after Dr. Smith’s prescribed treatment program has eradicated the ingrown hair lesions, this is not always an option. However, Dr. Smith recommends the following treatment plan for eradicating this concern: a daily regimen using a facial cleanser for acne prone skin and a topical application of 30% salicylic acid peel solution to exfoliate the outer layers of irritated, thickened skin; in combination with laser hair removal.  Unlike temporary treatment options, laser hair removal can make curly, coarse, dark hairs a thing of the past.

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