By Lisa Rapaport

(Reuters Health) - Barbers may be able to recognize hair follicle problems that are common in men of color and advise them on how to shave to avoid irritation or complications, a small study suggests.

Researchers surveyed 50 barbers from 37 barbershops in Oklahoma City and found nearly four in five could identify a condition that often develops in the beard area of African-America men and other people with curly hair.

Pseudofolliculitis barbae (PFB), also known as razor bumps, “can be a frustrating issue for all men,” said lead study author Dr. Prince Adotama, a dermatology researcher at the University of Oklahoma Health Science Center in Oklahoma City.

“African American men, in particular, are at an increased risk of developing this condition (due) to their curly afro-textured hair,” Adotama said by email. “This type of hair texture has an increased propensity to bend backwards, pierce and re-enter the skin, and develop an inflammatory reaction that eventually results in the development of razor bumps; shaving close to the skin can exacerbate this issue.”

Most barbers also knew that razor use would aggravate PFB and another type of hair follicle problem known as acne keloidalis nuchae (AKN) that develops at the back of the head and neck, researchers report in JAMA Dermatology.

The best way to treat this PFB is to stop shaving altogether, but this isn’t always a realistic option for many men, Adotama said. Using clippers instead of razor blades can help prevent razor bumps from getting worse.

Razor bumps tend to develop when curly hairs grow back into the skin, and then the tissue becomes inflamed in reaction to the foreign object. Scars can develop over time.

For the study, researchers asked barbers to identify PFB and AKN in photographs and then questioned them about how they would handle customers with these problems and what they would advise men to do about these conditions.

In 16 percent of PFB cases and 30 percent of AKN cases, barbers incorrectly thought they were looking at fungal infections, however. This suggests that barbers may need more education on how to spot common hair follicle problems in men of color, the researchers conclude.

Men can often treat razor bumps with topical corticosteroids that reduce inflammation, said Dr. Lawrence Charles Parish, a dermatology researcher at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia who wasn’t involved in the study.

The problem can develop because men must shave daily to prevent the hair from growing enough to grow back into the skin, Parish said by email. Shaving should also be with and against the grain or other directions, too, to stop ingrown hairs, he advised.

“I prefer a four or five bladed razor, and a disposable razor often causes more problems,” Parish said. “The man should not mix a safety razor with an electric razor and/or depilatory because this also contributes to the problem. In summation, either shave appropriately or do not shave.”

Early detection and treatment can keep both types of hair follicle problems from getting worse, and barbers are well positioned to help men catch issues early, said Dr. Andrew Alexis, a dermatology researcher at the Icahn School of Medicine at Mount Sinai in New York City who wasn’t involved in the study.

Severe cases can result in keloids (large elevated scars), severe discoloration, drainage of pus, and other disfiguring features, Alexis said by email. He added, “Early detection can help reduce the risk.”

SOURCE: http://bit.ly/2AgYtx1 JAMA Dermatology, online October 18, 2017.