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Home > Skin & Beauty > Hair & Scalp > Ingrown Hair: Causes, Symptoms, and Treatment

Ingrown Hair: Causes, Symptoms, and Treatment

February 9, 2021 - Updated on August 20, 2021
5 min read
By Akanksha Shah Sanghvi, MD, Clinical Dermatology

In this article:

  • Where Does Ingrown Hair Appear?
  • Causes of Ingrown Hair
  • Symptoms of Ingrown Hair
  • Ingrown Hair Treatment
  • Diagnosing Ingrown Hair
  • Complications Associated With Ingrown Hair
  • When to See a Doctor
  • Final Word

Ingrown hair, razor bumps, or pseudofolliculitis barbae is a common problem among people with curly hair, especially African Americans. (1)(2) Ingrown hair refers to a strand of hair that grows back or curls into the skin surface, often penetrating the skin with the tip.

ingrown hair

As the hair reenters the skin, the body treats it as a foreign body and generates an immune reaction, leading to inflammation. This can cause tiny bumps on the skin surface and can become a source of pain.

It is common to develop ingrown hair after shaving, waxing, tweezing, or other forms of hair removal. The inflamed spots are commonly known as razor bumps. 

Where Does Ingrown Hair Appear?

Ingrown hair is usually found in areas of the body that have been recently shaved, including:

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  • Legs
  • Chest
  • Chin and cheeks
  • Neck
  • Scalp (3)
  • Armpits
  • Pubic area

Causes of Ingrown Hair

factors that can cause ingrown hair growth

Ingrown hair generally develops after shaving or cutting, as the cut hair can sometimes curl back into the skin. This property of hair is determined by various factors, including the direction of the hair growth and hair structure.

The following may also contribute to the development of ingrown hair:

  • Tweezing. Tweezing your hair strands can leave a fragment of the hair under the skin, which may curl and grow within the skin.
  • Shaving incorrectly. Shaving your hair in the direction opposite to the growth or holding your skin taut while shaving can increase the chances of ingrown hair.
  • Wearing tight clothes. Tight clothes can rub against your shaved hair, causing friction.
  • High testosterone levels. High levels of testosterone stimulate excessive hair growth, increasing the chances of ingrown hair.

Symptoms of Ingrown Hair

Ingrown hair can be characterized by the following signs and symptoms:

  • Small round bumps known as papules (4)
  • Pus-filled lesions known as pustules (4)
  • Boil-like sores
  • Visible hair under the skin surface
  • Discomfort
  • Itching
  • Hyperpigmentation (4)

Ingrown Hair Treatment

medical treatment options for ingrown hair

It is best to take self-care measures to avoid ingrown hair in the first place. However, if you have multiple ingrown hairs, it is best to consult a dermatologist, as removing ingrown hair at home can lead to infections.

The doctor may recommend the following:

1. Avoid hair removal

Refrain from shaving, waxing, or tweezing until the problem is resolved, which can usually take up to 6 months.

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2. Laser treatment

Lasers are used to remove the hair from deeper levels and inhibit its regrowth. (5) Studies showed that the use of Q-switched Nd:YAG laser is an effective treatment for ingrown hair. (6)(7) However, if you have sensitive skin, opt for other treatments, as laser may cause scars, blisters, and hyperpigmentation.

3. Depilatory creams

You can use depilatory creams, which dissolve the hair to remove facial hair. (8)(9) Always conduct a patch test before using any cream on your face to check for irritation or allergy.

4. Incision

The doctor may make a small cut to release the hair if it is troublesome or infectious.

5. Retinoid

Retinoid-containing creams may be prescribed to help thin out the surface skin layer and prevent dead skin cell buildup, both of which can block the hair follicles and cause ingrown hair. Moreover, retinoid improves discoloration, if any.

6. Steroid

Steroid creams can help control the inflammation on your skin.

7. Antibiotics

If the ingrown hair is infected, you may be prescribed a short antibiotic course. This may be replaced with stronger antibiotics with anti-inflammatory effects if the infection is severe.

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Diagnosing Ingrown Hair

Ingrown hair can be easily identified with a simple physical examination.

The doctor may also inquire about your skin care routine to know your shaving and other hair-removal habits, through which he can determine the reason behind your ingrown hair problem.

In rare cases, the doctor may order blood tests to determine your testosterone levels.

Complications Associated With Ingrown Hair

ingrown hair complications

A severe, prolonged problem of ingrown hair can result in:

  • Bacterial infection
  • Skin darkening
  • Scars or keloids
  • Razor bumps, known as pseudofolliculitis barbae (10)

When to See a Doctor

It is suggested to consult a doctor if:

  • The ingrown hair is causing pain, swelling, or redness.
  • You have fever or are feeling ill.
  • A pimple or boil develops around the ingrown hair.
What you may ask your doctor
  • What can be the reason behind my problem?
  • Do I need to undergo any tests?
  • What treatment do you recommend?
  • Do I need to change my skin care habits?
What your doctor may ask you
  • When did you first notice the ingrown hair?
  • What treatments have you tried?
  • What hair removal methods do you use and how often?
  • Have you noticed anything that aggravates or improves your symptoms?

Final Word

Ingrown hair is a common problem that can occur due to multiple reasons, including shaving, irritation, or even the curly nature of hair.

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It is vital to refrain from plucking ingrown hair as this can lead to infections and abscesses. Instead, consult a doctor and get appropriate treatment. Consult your doctor on different self-care measures that can help prevent and manage the problem of ingrown hair.

Continue Reading Continue ReadingHome Remedies for Ingrown Hair and Self-Care Tips
References
  1. Puhan MR, Sahu B. Pseudofolliculitis corporis: a new entity diagnosed by dermoscopy. International journal of trichology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387696/. Published 2015.
  2. CE; C. The causes and treatment of pseudofolliculitis barbae. Cutis. https://pubmed.ncbi.nlm.nih.gov/9640558/.
  3. Tavares IR, Weffort F, Duque-Estrada B, Quintella DC, Cuzzi T, Pirmez R. Ingrown Hairs: A Recurrent Trichoscopic Feature in Scarring Alopecias. Skin appendage disorders. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120390/. Published August 2018.
  4. Ladizinski B, Ramirez-Fort MK, Cohen YK, Rosendahl C, Elpern DJ. Pseudofolliculitis barbae: a dermatoscopic correlate. Dermatology practical & conceptual. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663401/. Published April 30, 2013.
  5. RA; JTJS. Pseudofolliculitis cutis: a vexing disorder of hair growth. The British journal of dermatology. https://pubmed.ncbi.nlm.nih.gov/25255890/.
  6. DA; RCJG. Treatment of pseudofolliculitis barbae using the Q-switched Nd:YAG laser with topical carbon suspension. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al.]. https://pubmed.ncbi.nlm.nih.gov/10940059/.
  7. Schuler A, Veenstra J, Tisack A. Folliculitis Induced by Laser Hair Removal: Proposed Mechanism and Treatment. The Journal of clinical and aesthetic dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380697/. Published May 2020.
  8. LA; B. Pathogenesis and treatment of pseudofolliculitis barbae. Cutis. https://pubmed.ncbi.nlm.nih.gov/6354618/.
  9. Pany A; Klang V; Brunner M; Ruthofer J; Schwarz E; Valenta C; Effect of Physical and Chemical Hair Removal Methods on Skin Barrier Function in vitro: Consequences for a Hydrophilic Model Permeant. Skin pharmacology and physiology. https://pubmed.ncbi.nlm.nih.gov/30343288/.
  10. Ogunbiyi A. Pseudofolliculitis barbae; current treatment options. Clinical, cosmetic and investigational dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6585396/. Published April 16, 2019.
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