Prince Adotama, MD, is a board-certified dermatologist and an assistant professor at the Ronald O. Perelman Department of Dermatology at New York University Grossman School of Medicine.

Prince Adotama, MD

Skin of Color Savvy: The Art and Science of Treating Patients of Color

 podcast, guest host Prince Adotama, MD, of NYU Grossman School of Medicine, spoke with Yoseph Dalia, MD, MBA, a dual board-certified dermatologist and dermatopathologist affiliated with Johns Hopkins Medicine and a committee member of the 

During this conversation, Dalia explained PFB is a chronic inflammatory condition that develops when a hair fails to exit the skin, called a transfollicular pathway, or exits and curls back into it, called an extrafollicular pathway. In both cases, the body mounts a foreign body reaction against the hair shaft.

Skin of Color Savvy: Razor Bumps—Treating Pseudofolliculitis Barbae in Skin of Color

While PFB can affect anyone who shaves, Dalia said it occurs more often and more severely in people with tightly coiled hair, particularly those of African descent, since that hair type tends to grow more parallel to the skin surface and is more likely to reenter it. He noted a possible genetic contributor involving the keratin 6 hf protein, though research remains limited.

What Does PFB Mean for Patients Who Must Shave for Work?

Adotama asked how PFB affects people required to shave for occupational reasons, including military service members, firefighters, and health care workers who need a proper respirator fit. Dalia said stigma around shave waivers persists even where policies exist, and research has linked PFB to reduced promotion opportunities for affected service members. He recommended clinicians keep shave waiver forms pre-printed and use indefinite timelines, given the condition’s chronic nature, and said public education for employers and patients about the risk of permanent scarring and pigment change is essential.

How Is PFB Diagnosed and Differentiated From Other Conditions?

Dalia said diagnosis relies on a history of recurrent, follicular-based bumps that worsen after shaving, often in the beard area, supported by dermoscopy to confirm hairs reentering the skin. PFB lesions tend to form thicker, deeper nodules compared with the more superficial pustules typical of bacterial or fungal folliculitis. Signs of chronicity, including scarring and post-inflammatory hyperpigmentation, further support the diagnosis. Dalia distinguished PFB from folliculitis decalvans and dissecting cellulitis, which typically present on the scalp, and from acne keloidalis nuchae, which occurs at the nape of the neck rather than the beard area.

What Treatment Options Are Available for PFB?

Dalia said treatment begins by establishing whether a patient wants to stop shaving or keep facial hair. Behavioral changes such as shaving cessation or switching to an electric trimmer can help, alongside options like chemical depilatories, tested first on an inconspicuous area, laser hair removal, or electrolysis. Medical management may include topical retinoids and salicylic acid for keratinization, benzoyl peroxide and clindamycin for inflammation, and low-potency topical steroids. Acute flares may warrant oral doxycycline or intralesional steroids, while chronic scarring and pigmentation changes are managed separately with lightening agents or laser therapy. Dalia said a stepwise approach, rather than introducing every treatment at once, improves adherence.

Dalia and Adotama also addressed common misconceptions, noting PFB is not caused by poor hygiene and is not contagious, and that picking or plucking affected areas can worsen the condition. Both emphasized educating barbers and hairstylists, who often have more frequent contact with patients than dermatologists do.¹ They closed by calling for expanded insurance coverage of laser hair removal, noting only a small share of states currently require it, along with continued research and individual patient advocacy.²

To learn more about SOCS’s programs and initiatives, visit the 

Editor's note: Both Adotama and Dalia had no relevant disclosures of note. This episode summary was edited with the help of AI tools.

Rice X, Omar D, Goodwin BP, Adotama P. Barber knowledge and recommendations for pseudofolliculitis barbae. 

. 2024;160(1):111-113. doi:10.1001/jamadermatol.2023.4913.

Ahuja R, Olagun-Samuel C, Rodriguez E, Vasquez R, Adotama P. State-based insurance coverage access to laser hair reduction for the treatment of pseudofolliculitis barbae: an evaluation of public and private policies. 

. 2025;93(2):542-543. doi:10.1016/j.jaad.2025.04.024.

Podcasts

Yoseph Dalia, MD, discusses diagnosing and treating pseudofolliculitis barbae, its occupational impact, and barriers to care in skin of color.

2025 Fall Clinical Dermatology Conference

 in Las Vegas, Nevada, featured a session titled ‘Bullous Pemphigoid: The Time to Treat is Now.’

 spoke with Prince Adotama, MD, assistant professor of dermatology at New York University’s Grossman School of Medicine. Adotama touched on a series of highlights from his talk, including the recent US Food and Drug Administration (FDA) approval of dupilumab.

Clinical Pearls and FDA Approvals in Bullous Pemphigoid, With Prince Adotama, MD

“[Bullous pemphigoid] predominantly impacts patients over the age of 60, usually over the age of 70,” Adotama noted. “Your immune system is going haywire. It's attacking your skin, leading to these intense blisters. It's extremely itchy, extremely pruritic, and patients are very bothered by it…We now have an FDA-approved treatment for bullous pemphigoid, or BP. So it's really an exciting time to be a BP expert treating these conditions. We want to make sure other providers, other dermatologists, are aware and ready to treat this condition.”

, Adotama noted, targets interleukin (IL)-4 and IL-13, which are elevated in affected skin. The medication has a long safety record in atopic dermatitis.

“We have years of data, I think, at least eight or nine years of data on atopic dermatitis that [show it’s] safe,” Adotama said. “It can be used in people as young as six months of age. So I feel very confident trying a treatment like this on a patient. In fact, one of the patients we mentioned was a 96-year-old patient who had this condition, and I felt very confident giving it to that patient, because we know there's a great deal of safety associated with this drug…The hope is that we continue to develop new treatments that target specific cytokines.”

Adotama expressed that patients’ risks of infection are important to remember when looking at new treatments targeting bullous pemphigoid, especially given the advanced age of many patients with this skin condition.

“There are a lot of treatments that are not so suppressive,” Adotama said. “So omalizumab, which is a treatment that's FDA-approved for chronic spontaneous urticaria, has some evidence that it can work for bullous pemphigoid. Now it is used off-label, so it's not FDA-approved yet for bullous pemphigoid, but it can be used off-label, and it has a lot of great results for it.”

For more about the topics highlighted in Adotama’s session, view the interview above. For additional news on recent data in dermatology, view the latest coverage of Fall Clinical Dermatology.

Adotama has reported personal fees from Galderma, Regeneron, and Proctor and Gamble.

Adotama P, Culton D. Seminar-in-Depth: Bullous Pemphigoid: The Time to Treat is Now. Session presentation at the 2025 Fall Clinical Dermatology Conference, Las Vegas, Nevada, Oct 23-26, 2025.

Regeneron Pharmaceuticals Inc. Dupixent® (dupilumab) Approved in the U.S. as the Only Targeted Medicine to Treat Patients with Bullous Pemphigoid (BP). Regeneron Pharmaceuticals Inc. June 20, 2025. Accessed October 25, 2025. 

https://investor.regeneron.com/news-releases/news-release-details/dupixentr-dupilumab-approved-us-only-targeted-medicine-treat

Videos

This interview with Prince Adotama, MD, at Fall Clinical highlights several takeaways from his session on treating bullous pemphigoid.

Prince Adotama, MD

Articles