What is the role of antibiotics in the treatment of pseudofolliculitis barbae (PFB)?

Updated: Feb 07, 2019
  • Author: Thomas G Greidanus, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

For severe cases of pseudofolliculitis barbae with pustules and abscess formation, topical and oral antibiotics may be indicated. [14, 15]

Topical antibiotics may successfully reduce skin bacteria and treat secondary infection. These topicals include erythromycin, clindamycin, and combination clindamycin/benzoyl peroxide (Benzaclin, Duac) and erythromycin/benzoyl peroxide (Benzamycin) agents. Applying one of these agents once or twice per day is effective. Benzoyl peroxide applied topically once a day is also effective in reducing bacterial populations. It should be used sparingly and may be irritating to sensitive skin. It is a good first-line topical agent for persons with oily skin. Benzamycin is a combination of erythromycin and benzoyl peroxide. A once daily application has the benefits of both agents.

If pustules or abscess formation is evident, an oral antibiotic is indicated. Tetracycline is a common choice for a systemic antibiotic. Similar to a standard acne regimen, a dose of 500 mg twice a day used initially for 1-3 months is often effective.


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