This post might fit better in another forum, but I felt it might be particularly interesting for those of us who are anti canned goo.
Sorry for the long post, but I just had a dermatologist appointment today, and some odd advice came out of it. Skip to the end if you want the cliff notes. I have been struggling with recurring folliculitis for somewhere around 5 years. I was dealing with this a year or two before I started shaving my head, as I've always kept the sides and back at no-gaurd clipper level. Dealing with Folliculitis is one of the things that attracted me to wet shaving in the first place, as I had read about so many men who had the problems go away completely after they switched to DE or Straight Razor shaving.
I have been wet shaving almost a year, and my folliculitis started getting especially bad somewhere around November. I've been in to see the dermatologist 3 times since then, because it keeps coming back unless I'm on an oral antibiotic. Today's appointment was my first since 2012 with my original dermatologist. He had some interesting suggestions that I hadn't gotten from the other doctor.
-First, he immediately wanted to do a culture to see what exactly we were dealing with. Good so far.
-He definitely believes there is a physical component to the condition...aka pseudofolliculitis barbae. Here's where the discussion got interesting.
Basic Notes on the visit.
-Apparently, I am a Caucasian with hair like an African American or Asian. I knew my hair was coarse and thick, with large, visible follicles, but I never would have assumed it was that bad.
-He's not sure if the ingrowns are getting infected, or if the infection is causing ingrowns. Cultures will help determine that.
-Antibiotics could be treating the problem not by killing off the bacteria, but by relieving the inflammation. I had never heard that before, but apparently that's a big reason why antibiotics are used to treat acne.
Shaving Discussion during the visit.
-The doctor recommended I use a razor with lubricating strips... I promptly explained that I use a traditional double-edge safety razor, which uses a single cutting edge. He relented on the lubricating strips.
-Brush and Soap - While not likely, he said it's possible that the brush and soap could be holding onto the bacteria, helping to fuel the infections.
-He suggests using a Shave Gel. He specifically recommended Edge or Aveeno, and also mentioned Shave Magic as an option. I told him I would give it a try following my antibiotics, but that I was switching back to my soap and brush if it didn't work. As a compromise, maybe I'll pick up a quick-drying synthetic so I can bowl lather and then use my hands to apply the lather so the brush never makes contact with my skin to pick up the bacteria in the first place.
-Here's the truly shocking item. He recommended that I try shaving ATG (against the grain) for a while, since staying away from it didn't seem to be working for me. He said the growth pattern for some people can lead to sharp edges when shaving WTG, and those sharp edges can cause more ingrowns than shaving ATG, particularly when you are dealing with a single blade shave.
So, to summarize
-Cultures should help determine a better long-term treatment
-The Bad News - Stop using soap and brush and try a shaving gel for a while
-The Good News - Dermatologist recommendation to shave ATG for a while
