PFD and AKN primarily seen in men of African Ancestry

Pseudofolliculitis barbae (PFB) and acne keloidalis nuchae (AKN) are both conditions that are primarily seen in men of African ancestry and can be a therapeutic challenge, according to a New York City-based dermatologist who presented during a morning session at the second annual Skin Spectrum Summit in Toronto.

"Thankfully through behavioural modification, topical and oral therapies, and newer in office procedures including laser hair removal, if done safely, can really transform patients lives and improve the bumps and disfigurement from both of these conditions," says Dr. Andrew F. Alexis, the chair of the Department of Dermatology and the director of Skin of Color Center at Mount Sinai St. Luke'-Roosevelt Hospital and an associate professor at the Icahn School of Medicine at Mount Sinai.

Dr. Alexis says PFB can be managed through total discontinuation of shaving and growing a beard, chemical depilatory (barium sulfide and calcium thioglycolate), and modifying shaving practices.

Shaving recommendations:


  • Wash with mild cleanser using face cloth in a circular motion to gently release embedded hairs

  • Apply moisturizing shaving cream or gel


  • Use clean, sharp razor

  • Shave in direction of growth

  • Avoid stretching or pulling the skin


  • Topical prescriptions (e.g., low potency corticosteroids in cases of moderate to severe inflammation)

First-line therapy for AKN includes prevention (avoidance of mechanical irritation, low hair cuts, tight fitting caps etc), topical corticosteroids, topical antibiotics, topical retinoids, intralesional corticosteroids, and oral antibiotics, says Dr. Alexis.