Expert Consensus Defines Best Practices for Pseudofolliculitis Barbae

A new expert consensus study published online in JAMA Dermatology outlines best practices for diagnosing and managing pseudofolliculitis barbae (PFB), including hair removal modification, medical therapy, procedural treatment, and occupational considerations.

A 3-round Delphi study of US dermatologists has established 40 expert consensus statements on the diagnosis and management of pseudofolliculitis barbae (PFB), publishing the document in the JAMA Dermatology.

Delphi Consensus Addresses Pseudofolliculitis Barbae Diagnosis and Treatment

Investigators conducted a 3-round Delphi consensus study involving a panel of board-certified US dermatologists with expertise in PFB. The panel evaluated statements covering diagnostic criteria, behavioral modification, topical and systemic treatments, procedural interventions, and occupational considerations using a 9-point Likert scale. Consensus was predefined as at least 75% agreement.

Forty statements reached consensus across PFB diagnosis, medical and procedural management, and occupational considerations. Experts supported modifying hair removal practices as first-line therapy. Consensus also supported targeted topical and systemic treatments and procedural interventions, including laser hair removal.

The panel did not reach consensus on adopting a standardized PFB grading scale, using oral isotretinoin for refractory disease, using superficial chemical peels, or using multiblade razors.

“Using a Delphi consensus study approach, expert consensus guidelines were established for diagnosing and managing PFB,” the authors wrote. “These recommendations provide an evidence-informed framework to support clinical decision-making, guide future research efforts, and help inform policy considerations associated with PFB management.”

Source

JAMA Dermatology. 2026. Doi:10.1001/jamadermatol.2026.3579