Razor burn

I.       Introduction

The skin is one of the body’s largest organs covering up to 1,5 to 2 square meters of the total body surface of an adult (1). Its primary role is to function as a protective barrier against environmental factors such as sun rays, humidity, and microbes, making it prone to external aggressions and diseases (2). Seemingly harmless practices like shaving can cause the skin to produce an immune reaction, and to present symptoms that could be easily mistaken for more serious microbial infections. In the present article, we describe the differences between a simple razor burn and a viral herpes infection.

II.    Definition

A razor burn is a skin irritation caused by shaving. The sharp blades of a razor can, when used improperly on a dry skin, cause an uncomfortable rash. The rash can be complicated bypseudofolliculitis barbae: a skin condition characterized by the inflammation of the hair follicles and commonly known as razor bumps (3). A razor burn can occur on the face, the legs, the pubic area, or on any hairy surface of the body subjected to shaving.

Herpes is an infectious disease caused by two different herpes simplex viruses (HSV) (4).

. Herpes simplex virus type 1 (HSV-1) occurring mostly in the oral cavity.

. Herpes simplex virus type 2 (HSV-2) occurring in the genital area.

Herpes infections are common: it is estimated that two-thirds (67%) of the global

population under the age of 50 are infected with HSV-1(5) and that 11,7% of the population

aged 15 to 49 are infected with HSV-2 (6).

HSVs are highly contagious and are transmitted through mucosal secretions and the direct contact with an active herpetic lesion (4).

They exhibit a two-phase infection pattern (4):

. A primary mostly asymptomatic infection with the virus establishing itself in a nerve ganglion.

. A secondary phase, with the symptomatic disease recurring at the initial site of infection. The rate and the severity of the recurrence vary between HSV-2 and HSV-2: it is, as with any viral infection aggravated with age, and genital recurrences are up to 6 times more frequent than oral ones.

A reactivation of the virus is usually triggered by a local skin trauma like an exposure to ultraviolet light or an abrasion, or by a systemic reason like hormonal changes or fatigue.

While herpes occurs predominantly at the first sites of infection, cases of cutaneous herpes where lesions appear on any skin surface have been described (7).

III.  Clinical manifestations and prognosis

The main symptom of a razor burn is a red tender skin accompanied by stinging, a burning sensation, and itching.

Shortly after shaving, the skin feels sore, sensitive and redness develops. These symptoms are usually benign and disappear without any intervention.

However, in severe cases, a noninfectious inflammatory condition: pseudofolliculitis barbae ensues (8). It is a chronic disorder caused by an immune foreign-body reaction to an ingrown hair. It is characterized by the formation of papules that can be tender or firm, skin colored, erythematous, or hyperpigmented.

In the case of a bacterial secondary infection, pustules may develop. Papules and pustules remain on the skin until the hair is removed (4,8).

A primary herpes infection can be asymptomatic. When symptomatic, similarly to a razor burn, it is associated with a tenderness of the skin and a burning sensation. This is followed by the presence of painful agglomerated vesicles (4).

While a razor burn and a pseudofolliculitis are caused by shaving, a physical aggression, the viral nature of herpes and its activity in the body are the reason behind a number of symptoms that precede the occurrence of the blisters: Most patients complain of headaches, generalized pain, an increase in the size of the lymph nodes, and fever (4).

These symptoms are often associated with the primary phase of HSV, their occurrence with the secondary phase of the viral activity is usually the sign of a new infection (4). Unless there’s a secondary infection, it takes between two and four weeks for herpes lesions to heal, usually without any scarring.

Herpes

IV. Treatment and preventive measures

The treatment of razor burns and pseudofolliculitis barbae depends largely on the severity of the symptoms (8). In mild cases, a regular skin care regimen should suffice to treat and prevent future outbreaks. This includes simple steps:

. Washing the skin with a mild soap and warm water, with the purpose of softening the longer hairs and releasing the ingrown ones.

. Using a shaving foam or cream to reduce the mechanical stress applied by the razor.

. Hydrating the skin after shaving with an adequate moisturizer.

. Regular close shaving, preferably daily.

In the case of severe pseudofolliculitis, topical corticosteroids creams are used to reduce inflammation. Secondarily infected papules require the administration of topical and/or oral antibiotics.

Herpes, on the other side, cannot be cured. Antivirals are administered topically or orally.

They serve to reduce the severity and the frequency of the symptoms (4).

Hydrating creams are prescribed additionally to moisturize the dry skin surrounding the lesions.

The highly contagious herpes viruses can be contained through prevention. Individuals presenting active orolabial, cutaneous or genital lesions should avoid direct oral contact and sexual activities with healthy persons.

HSVs are becoming a global health problem and research is underway for the production of effective preventive measures such as vaccines (9).

Summary

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