Dr. Andrew Alexis experiences men coming into his office struggling with redness, burning and bumps due to shaving. He’s discovered the main challenges with shaving are due to complications of mechanical irritation, redness, burning and hair that re-enters into the skin, producing a foreign body which can produce pseudofolliculitis barbae.
What’s the best solution physicians can give their male patients in order to minimize irritation and enjoy shaving again? Dr. Alexis shares the studies, science and best practices for before, after and during the shave.
Cleansing the skin before shaving removes debris, excess sebum and carenum sites. Scrubbing the skin gently dislodges embedded hairs and minimizes ingrown hair. A cleaner surface will allow the blade to easily glide along the skin.
Hydration is key. Dr. Alexis says exposing the facial hair to water for 2 minutes significantly reduces in cutting force of beard hair. Hydration gives swelling in hair shafts, making it easier to cut the hydrated hair at a 90 degree angle.
The two important things to keep in mind during the shaving period is the type of razor and the way it’s used.
The razors typically used for shaving consist of multiple blades enclosed by lubrication strips. Dr. Alexis shares a study that compared five blade razors with lubrication strips vs. no strips. Strips with lubrication compared to lower tier disposable strips show much less manifestations of vasodilatation and irritation.
The three forces of shaving are the key force, which is a perpendicular force also known as “the load,” the 180 degree force called the “drag” and the hair cutting force. If all three forces are minimized, there’s a substantial reduction of irritation in the skin.
If the patient’s shaving technique is poor and the equipment use is not optimal, it’s likely the patient is pulling the hair shaft, triggering sensory nerves (in close association with perifollicular skin), which then release neuropeptides, massive cell degranulation, resulting in manifestations of razor burn and irritation.
Historically, it was thought too close of a shave with multiple blades would worsen Pseudofolliculitis barbae. Studies done with multiple (three to five) blade razors show the PFB does not worsen in men and the trend towards reduction in papules, pustules and ingrown hair counts and overall severity.
Understandably, there is disruption to the skin barrier after you’ve shaved, so moisture is important! A small study compared skin that was moisturized post-shave vs. no post-shave moisturizer. The results showed rapid reduction in transepidermal water loss when using a moisturizer compared to the no moisturizer control.
Dr. Alexis encourages men to use moisturizers with ingredients such as glycerin, niacinamide, shea butter, aloe and other hydrating ingredients to restore the skin’s barrier. Avoid any aftershave with alcohol in it.
How often should patients shave?
Many patients claim they can’t shave more than once a week because it’s too irritating to their skin. Dr. Alexis recommends shaving daily or twice a week if your patient wants to commit to a clean shaven face. Frequent shaving does not cause irritation if the patient uses the correct technique and equipment.
If patients with PFB and other complications with shaving are coming into your office, Dr. Alexis advises creating a handout that gives them guidance post, during and after shaving.
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