A 100% effective treatment is to let the beard grow. Once the hairs get to be a certain length they will not grow back into the skin. For most cases, totally avoid shaving for 3 to 4 weeks until all lesions have subsided, while applying a mild prescription cortisone cream to the involved skin each morning. Shaving every other day, rather than daily, will improve pseudo-folliculitis barbae. If you must use a blade, water soften the beard first with a hot, wet wash cloth for 5 minutes. A preshave solution (Hydroglyde from Moore skin care 1-800-745-9422) helps soften the hairs. Then use lubricating shaving gel (Edge, Aveeno), a prescription medicated shaving foam (benzashave by Dermik) or British shaving oil and use the Aveeno PFB Bump Fighter Razor or the Flicker razor. Shave with the grain of the beard and do not stretch the skin. Use only one stroke over each area of the beard.

Use of an electric shaver may also help the condition because it does not cut as close as blades do. Use the electric razor on high setting to avoid close shaving and prepare beard with electric razor pre-shave. Do not stretch skin while shaving and shave with the grain of beard growth. Avoid multiple repetition of strokes in the same area. Do not press razor head hard against the skin. Shave every other day. Better still is a barber's clipper (with clipping guard) to prevent shaving closer than 1mm cut of whisker hair

Some doctors recommend chemical "shaving" with products such as Magic Shave, Surgex shaving powder, Nair or Neet (these are brands of Barium sulfide or Calcium thioglycolate depilatories - very mild to strong). These dissolve the hairs but can cause chemical burns on facial skin. It should be left on for less time than the package recommends until you see how your skin reacts to it.

Most patients "cannot tolerate" these because they don't wait for their skin to clear before using them as directed. PFB-involved skin is not "normal," and it should be expected to be more-easily irritated than normal skin. These depilatories should be tried only once the skin is bump free. Use only every 48-72 hours. Use mildest form that works. Apply to small areas at a time (1/4 - 1/2 of the face) and start removal no later than 3 minutes (for Barium sulfide types) or 5 minutes (for calcium thioglycolate types) after application. Remove with spatula, butter knife, tongue blade, or other blunt straight edge. Use short, rapid strokes against the direction of hair growth. Keep shaving instrument moist but wiped clean. If some hairs remain, repeat after 30-60 seconds. Wait if within 3 minutes of original application. Rapid and thorough rinsing should be done two or three times with soap and water. Neutralize depilatory with a diluted vinegar solution (1 tablespoon per pint of water) then rinse again thoroughly with tap water.

Electrolysis and laser hair removal should be considered when all else fails, but these are expensive and take repeated visits. There is a very small risk of scarring. The SoftLight Laser Hair Removal System is the most effective in treating this problem. Since this Laser Hair Removal System targets the "specialized carbon lotion," it is excellent for treating all skin types and colors. Unlike other lasers, it doesn't target the melanin in the skin or hair. A few insurance companies will cover some or all of the cost.

Medications are also prescribed to speed healing of the skin. Glycolic acid lotion 8% is effective (Alpha-hydrox, Neo-Strata, others). Prescription antibiotic gels (Benzamycin, Cleocin-T) or oral antibiotics are also used. Retin-A is a potent treatment that helps even out any scarring after a few months. It is added as a nightly application of Retin-A Cream 0.05 - 0.1% to the beard skin while beard is growing out. Use as tolerated, as it is somewhat irritating.