Overview

An ingrown hair occurs when a shaved or tweezed hair grows back into the skin. It can cause inflammation, pain and tiny bumps in the area where the hair was removed.

Ingrown hair is a common condition that results from hair removal. It's most prevalent in black men who shave facial hair. But ingrown hair can affect anyone who removes hair by shaving, tweezing or waxing.

Often, an ingrown hair improves without treatment. You can avoid ingrown hair by not removing hair. If that's not an option, you can use hair removal methods that lessen the risk of developing ingrown hairs.

Symptoms

Ingrown hairs most commonly appear in the beard area, including the chin and cheeks and, especially, the neck. They can appear on the scalp in those who shave their heads. Other common areas for ingrown hairs are the armpits, pubic area and legs.

Signs and symptoms include:

• Small, solid, rounded bumps (papules)
• Small, pus-filled, blister-like lesions (pustules)
• Skin darkening (hyperpigmentation)
• Pain
• Itching
• Embedded hairs

When to see a doctor

An occasional ingrown hair isn't cause for alarm. See your doctor if your ingrown hairs are a chronic condition.

Causes

Hair structure and direction of growth play a role in ingrown hairs. A curved hair follicle, which produces tightly curled hair, is believed to encourage the hair to re-enter the skin once the hair is cut and starts to grow back. Shaving creates sharp edges in this type of hair, especially if the hair is dry when shaved.

You might also get an ingrown hair if you:

• Pull your skin taut during shaving — which allows the cut hair to draw back into the skin and re-enter the skin without first growing out
• Tweeze — which also can leave a hair fragment under the skin surface

When a hair penetrates your skin, your skin reacts as it would to a foreign body — it becomes inflamed.

Risk factors

Having tightly curled hair is the main risk factor for ingrown hairs.

Complications

Chronic ingrown hairs can lead to:

• Bacterial infection (from scratching)
• Skin darkening (hyperpigmentation)
• Permanent scarring (keloids)
• Pseudofolliculitis barbae, also known as razor bumps

Prevention

To help prevent ingrown hairs, avoid shaving, tweezing and waxing. If that's not an option, use these tips to make ingrown hairs less likely:

• Wash your skin with warm water and a mild facial cleanser before shaving.
• Apply lubricating shaving cream or gel a few minutes before shaving to soften the hair. Or apply a warm compress.
• Use a sharp razor every time you shave. Further study is needed to determine whether a single- or multiple-blade razor is best for preventing ingrown hair. See what works best for you.
• Avoid close shaves.
• Don't pull your skin taut while shaving.
• Shave in the direction of hair growth.
• Rinse the blade after each stroke.
• Rinse your skin and apply lotion after you shave.

The following hair removal methods also may help prevent ingrown hairs:

• Electric razor or clipper. With the razor, avoid the closest shave setting and hold the razor or clipper slightly away from your skin.
• Chemical hair remover. The chemicals in hair-removing products (depilatories) may irritate your skin, so test on a small area first.
• A cream to decrease hair growth. A product called eflornithine (Vaniqa) is a prescription cream that decreases hair regrowth when combined with another hair removal method, such as laser therapy. Further study is needed to prove the usefulness of this method.

Diagnosis

Your doctor is likely to diagnose ingrown hairs by looking at your skin and discussing with you your hair removal habits.

Treatment

To treat ingrown hairs, stop shaving, tweezing or waxing until the condition improves — usually one to six months. If that's not possible, consider laser treatment, which removes the hair at a deeper level and inhibits regrowth. Laser treatment may cause blisters, scars and skin darkening.

Medications

Your doctor may prescribe certain medications to help manage your condition. They include:

• Drugs that help remove dead skin cells. Retinoids applied to your skin, such as tretinoin (Renova, Retin-A, others), help with clearing dead cells from your skin (exfoliation).
• Creams to reduce inflammation. Your doctor may suggest a steroid cream.
• Creams or pills to control infection. For mild infections caused by scratching the affected area, your doctor may recommend an antibiotic ointment. For more severe infection, your doctor may prescribe oral antibiotics.

Lifestyle and home remedies

To release ingrown hairs, you can:

• Wash the affected area using a washcloth or soft-bristled toothbrush. Use a circular motion for several minutes. Do this before shaving and at bedtime.
• Use a sterile needle, inserting it under hair loops, to gently lift embedded hair tips.

Preparing for an appointment

You're likely to start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in skin conditions (dermatologist).

To get the most from your appointment, it's good to prepare. Here's some information to help you get ready for your appointment.

What you can do

• List any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• List key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements you're taking.
• List questions to ask your doctor.

For ingrown hairs, some basic questions to ask your doctor include:

• What's the most likely cause of my condition?
• What are other possible causes for my condition?
• Do I need any tests?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach you're suggesting?
• Are there restrictions I need to follow?
• Is there a generic alternative to the medicine you're prescribing?
• Do you have any relevant brochures or other printed material that I can take home with me? What websites do you recommend?

Don't hesitate to ask other questions, as well.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• Does anything seem to improve your symptoms?
• Does anything make your symptoms worse?
• What type of razor do you use?
• How often do you shave?
• What shaving or other hair removal technique do you use?

What you can do in the meantime

In the days before your appointment with your doctor, if possible, stop shaving or using any form of hair removal. Ingrown hairs may worsen at first as they regrow, but eventually they'll improve.