What is the role of surgery 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

Newer hair removal lasers may have a role in the treatment of pseudofolliculitis barbae. The problem with most laser and high-intensity light source hair removal modalities is that the natural skin pigment may be damaged by the laser because melanin in the hair shaft is the target chromophore. Devices being studied at this time may avoid this depigmenting complication. Diode laser treatments have been proven safe and effective in patients with skin phototypes I-IV. [19, 20, 21, 22]

The use of long-pulsed Nd:Yag laser in the treatment of pseudofolliculitis barbae demonstrated a decrease in papule formation, miniaturization, and reduction of hair counts in skin types IV, V and VI. [23] Most subjects had a return of normal hair growth after 6 months; however, 2 of 10 individuals had areas of permanent hair loss after 12-month follow-up. Adverse effects of long-standing hypopigmentation in this study were isolated, signifying that this particular laser is an encouraging modality of therapy. [24]

Reportedly, excellent results can be obtained with the use of an 800-nm diode laser technique with low power and high pulse duration (5-15 J/cm2, 2 Hz, 100–400 ms), especially in darker-skinned individuals. [25]


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