Treating Pseudofolliculitis Barbae (PFB) with Aerolase | Natasha Mesinkovska, MD | Science of Skin Summit 2026

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At The Science of Skin Summit 2026, Natasha Mesinkovska, MD, dermatologist and Vice Chair for Research at the University of California, Irvine, breaks down pseudofolliculitis barbae (PFB) and how she treats it with Aerolase.

PFB, often called razor bumps, mostly affects men and is especially common in people of color. It’s often dismissed as a shaving problem or an infection. Dr. Mesinkovska points to genetic research showing that some patients carry keratin mutations that predispose them to it. Curved or coiled hairs exit the follicle and re-enter the skin. The body treats the hair as foreign, which triggers inflammation. In Fitzpatrick skin types III and darker, that inflammation can lead to persistent hyperpigmentation, scarring, and fibrosis. Patients with PFB also show higher rates of keloids and acne keloidalis nuchae.

Traditional treatment includes benzoyl peroxide, clindamycin, topical retinoids, doxycycline, salicylic acid washes, azelaic acid, and low-strength topical steroids. Dr. Mesinkovska calls Nd:YAG laser treatment one of the biggest breakthroughs. Even one or two sessions can reduce inflammation, so permanent hair removal isn’t the only goal. Aerolase pairs deep 1064 nm penetration with a very short pulse. It reaches the target quickly and lowers the risk of burns and redness in pigmented skin.

What patients can expect:

• Shave one to two days before treatment.
• Each session uses one to two passes, and up to four depending on the response.
• Treatments are spaced every four to six weeks, for four to six sessions, then as needed.
• Treatment is generally well tolerated, though larger bumps can be tender. Starting with a test spot is an option.
• Aftercare focuses on controlling inflammation and protecting the area from the sun.

Presented by Natasha Mesinkovska, MD, PhD

Natasha Atanaskova Mesinkovska, MD, PhD, is a board-certified dermatologist and dermatopathologist, Vice Chair of Clinical Research at UC Irvine Dermatology, and Director of Integrative Dermatology at the Beckman Laser Institute. A nationally recognized alopecia expert, her research spans inflammatory skin and hair disorders, aging, and light-based devices.