For millions of men with coarse, curly hair there is no such thing as a smooth clean shave. For these men, shaving is painful because they develop razor bumps on the face and neck from the closely cut ends of hairs that embed themselves to irritate and scar the skin.
Although they occur among men of other races, the bumps are particularly common among black men. And they are a particular problem for them too, because the skin of blacks tends to form large scars known as keloids more easily than that of whites.
The easiest and most effective treatment is simple: grow a beard or use clippers to leave a stubble and a permanent 5 o’clock shadow.
Yet the prescription is often difficult, if not impossible, to fill because of social pressures to be clean shaven. Some organizations, like police departments or airlines, demand that men be clean shaven. Many other employers informally make it clear that the corporate image requires a smooth shave. Some have been criticized as harassing bearded workers.
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Ruling Finds Discrimination
The condition, pseudofolliculitis barbae, ”is a disorder that is really generated by societal pressures to force individuals with coarse, curly hair to shave,” said Dr. Stanford I. Lamberg, a dermatologist at Johns Hopkins Medical School in Baltimore.
Dr. Lamberg testified in a recent civil rights case in Maryland that has cast doubt on the legality of on-the-job grooming rules that require men with the condition to shave. A Maryland hearing examiner ruled that a ban on beards that allowed no exceptions for medical reasons was discriminatory under Maryland’s civil rights laws.
But the issue remains unclear. Courts in other states have held that there is no constitutional right to grow a beard and that companies can require employees to be clean shaven.
Because accurate surveys have not been conducted, it is not known how many men with the problem have been forced to shave to get or keep a job.
Dermatologists interviewed said that the overwhelming majority of blacks suffer at least a few razor bumps at some time and that about 25 percent of black men suffer continuing irritation unless they stop shaving.
The issue often arises among uniformed personnel who deal with the public, including police officers, waiters, fast-food handlers, airline flight attendants and bus drivers. Fire departments that ban beards say they interfere with the use of breathing devices. Critics say organizations like these often shunt bearded men behind a desk or to an office out of the sight of clients.
Yet others with highly visible jobs believe it is more important to shave, even if an employer does not explicitly require a clean shave.
Dr. Bernard S. Goffe, a dermatologist in Seattle, said he had cared for workers with shaving bumps at large multinational organizations who felt compelled to shave because of the corporate culture. Other dermatologists said they had found the same attitude expressed by investment bankers and executives.
The Marine Corps requires close shaves and will discharge men who cannot find an effective way to cope with the condition after eight weeks.
Chief Warrant Officer Randy Gaddo, a Marine Corps spokesman, said, ”Marines do not wear beards, period.”
But the Army, Navy and Air Force have eased their policies to permit beards not exceeding one-quarter of an inch, largely in response to complaints during the Vietnam War. But critics say many susceptible servicemen shave anyway because of pressure from superior officers and other servicemen or because those who grow beards are often denied promotion.
Dr. Richard B. Odom, chief dermatologist at the University of California at San Francisco, said that as a white physician who was part of an Army committee that developed new guidelines concerning the condition, he often felt that blacks were discriminated against because they were not allowed to grow beards when medically warranted.
Many blacks have complained that most whites know little about the condition and that shaving requirements are set by people who have no idea how uncomfortable the ingrown hairs can be.
”If you are part of a decision-making group and you don’t have the problem, you don’t understand how it makes you uncomfortable,” said Dr. Lucius C. Earles 3d, a black dermatologist in Chicago who wore a beard for many years until the condition wore off as it sometimes does.
Dr. A. Melvin Alexander Jr., a black dermatologist in Columbia, Md., said that in testifying in razor-bump cases he had not met judges who knew about the condition and its prevalence among blacks. ”Many take the attitude that if they haven’t heard of the problem, or don’t have it themselves, how can it really exist,” Dr. Alexander said. Dermatologists say that razor bumps are found only in those who shave, the condition gets worse for those who continue to shave and remission invariably occurs after people affected by the condition stop shaving for about a month.
The condition comes about because shaving puts the skin under tension and cuts hair at an angle, leaving a sharp tip. When the tension is relaxed, some hairs retract beneath the surface, provoking the type of inflammatory response that follows injection of a foreign substance. Sometimes large cysts form and fluid can drain from the skin.
Next to growing a beard, dermatologists say, the best treatment is to meticulously uncurl the hairs by first wetting the face to soften the skin. Periodic application of hair-removing products can help but may leave an unpleasant odor and may be irritating.
Many bumps on the face represent ingrown hairs that will remain buried until the caught hairs are freed. Dermatologists therefore say that freeing up the tips of caught hairs is more helpful than letting the hairs work themselves free. But dermatologists advise against plucking a hair because it could possibly cause a severe, deep reaction when it regrows.
Shaving with a two-track razor, against the grain or with a dull blade aggravates the condition. Electric razors are of little help because they are designed for shaving straight hair.
In a new development, women who use a mechanical hair-removing device to shave their legs have developed razor bumps, said Dr. Charles J. McDonald, the chief of dermatology at Brown University Medical School in Providence, R.I. ”Over the last several months we have seen a number of young white women with ingrown hairs and pustules on their legs that looks exactly like pseudofolliculitis barbae,” he said.