What is the treatment for ingrown hair?

Treatment for Ingrown Hair

The most effective treatment for ingrown hair includes gentle exfoliation with glycolic acid products, proper shaving techniques, and topical treatments such as benzoyl peroxide/clindamycin for inflammatory lesions. 1, 2, 3

Understanding Ingrown Hair

Ingrown hair (pseudofolliculitis) is a condition where hair curls back or grows sideways into the skin, causing inflammation, papules, and pustules. It commonly affects individuals with curly or coarse hair, particularly after shaving or hair removal.

First-Line Treatment Options

1. Chemical Exfoliation

• Glycolic acid (10%): Apply daily to affected areas
  • Reduces ingrown hairs by over 60% in controlled studies 2
  • Helps exfoliate dead skin cells that trap hairs
  • Available in pre-moistened pads for easy application 1
  • Allows resumption of daily shaving with minimal irritation

2. Proper Hair Removal Techniques

• Shaving recommendations:
  • Use a sharp, clean razor
  • Shave in the direction of hair growth
  • Avoid stretching the skin while shaving
  • Rinse with warm water after shaving
  • Apply moisturizer after shaving

3. For Inflammatory Lesions

• Benzoyl peroxide 5%/clindamycin 1% gel:
  • Apply twice daily to affected areas
  • Significantly reduces papules and pustules (38.2% reduction at 2 weeks, 63.9% at 10 weeks in black patients) 3
  • Particularly effective for inflammatory ingrown hairs

Second-Line Treatment Options

1. Topical Corticosteroids

• For significant inflammation and irritation
• Use low to medium potency preparations
• Apply thinly twice daily for no more than 2 weeks
• Monitor for skin atrophy with prolonged use

2. Chemical Depilatories

• Alternative to shaving for some patients
• Test on small area first to check for irritation
• Follow manufacturer's instructions carefully

Prevention Strategies

1. Let hair grow longer: Allows hair to exit follicle without curling back
2. Use electric clippers: Set to leave 0.5-1mm of hair above skin surface
3. Exfoliate regularly: Use gentle physical or chemical exfoliants
4. Moisturize: Keep skin hydrated to prevent dry, dead skin buildup
5. Avoid tight clothing: Reduces friction against hair follicles

Special Considerations

• For severe cases: Consider temporary cessation of shaving to allow healing
• For recurrent cases: Evaluate for bacterial infection and consider topical antibiotics
• For persistent cases: Consider laser hair removal for long-term management 4

Treatment Algorithm

1. Start with proper hair removal techniques + daily glycolic acid application
2. If inflammatory lesions present, add benzoyl peroxide/clindamycin gel
3. If minimal improvement after 2-4 weeks, consider short course of topical corticosteroid
4. For persistent cases despite above measures, consider laser hair removal

Common Pitfalls to Avoid

• Aggressive scrubbing or physical exfoliation can worsen inflammation
• Picking or attempting to "dig out" ingrown hairs increases infection risk
• Continuing to shave closely when active inflammation is present
• Using dull razors which increase the risk of ingrown hairs
• Neglecting post-shave care (moisturizing, exfoliating)

Ingrown hairs, while not medically serious, can cause significant discomfort and cosmetic concerns. With proper treatment and prevention strategies, most cases can be effectively managed.