What is the best treatment for ingrown hair?

Treatment for Ingrown Hair

The most effective treatment for ingrown hairs is topical glycolic acid, which has been shown to reduce lesions by over 60% and allows resumption of daily shaving with minimal irritation. 1

Understanding Ingrown Hair

Ingrown hairs occur when hair grows back into the skin instead of rising up from it, causing inflammation, redness, and sometimes infection. This condition is particularly common in people with curly hair, affecting over 50% of Black men who shave regularly 2.

First-Line Treatment Options

Topical Treatments

• Glycolic Acid (10%):

  • Apply daily to affected areas 3, 1
  • Works by exfoliating the skin, removing dead cells that can trap hairs
  • Significantly more effective than placebo in clinical trials
  • Allows for resumption of daily shaving with minimal irritation

• Benzoyl Peroxide 5%/Clindamycin 1% Gel:

  • Apply twice daily to affected areas
  • Particularly effective in Black patients, with reduction in papule and pustule counts ranging from 38.2% at week 2 to 63.9% at week 10 4
  • Addresses both inflammation and bacterial components

Mechanical Prevention

• Proper Shaving Techniques:
  • Use sharp, clean razors
  • Shave in the direction of hair growth
  • Avoid stretching the skin while shaving
  • Consider using electric clippers that leave a small amount of hair above the skin surface 5

Second-Line Treatment Options

For Persistent or Severe Cases

• Intralesional Corticosteroids:

  • For particularly inflamed or persistent lesions
  • Triamcinolone acetonide (5-10 mg/mL) injected just beneath the dermis 6
  • Multiple small injections (0.05-0.1 mL) can be administered to affected areas

• Antibiotic Therapy:

  • For cases with signs of infection
  • Topical or oral antibiotics may be considered
  • Fusidic acid has shown efficacy in similar follicular conditions 7

Special Considerations

For Different Body Areas

• Facial Area: Use gentler approaches first (glycolic acid) before stronger treatments
• Pubic/Genital Region: Extra caution with chemical treatments; consider trimming instead of shaving
• Neck Area: Often responds well to glycolic acid treatment

Prevention Strategies

• Exfoliate regularly with gentle scrubs
• Consider hair removal methods that don't cut hair at skin level (depilatory creams, laser hair removal)
• Moisturize skin to keep it supple and prevent hair from becoming trapped

Common Pitfalls to Avoid

• Picking or squeezing ingrown hairs can lead to infection and scarring
• Aggressive scrubbing can worsen inflammation
• Continuing to shave over actively inflamed areas can exacerbate the condition
• Ignoring signs of infection (increasing redness, warmth, pus, or spreading inflammation)

Treatment Algorithm

1. Start with daily application of 10% glycolic acid to affected areas
2. If no improvement after 2-4 weeks, add benzoyl peroxide 5%/clindamycin 1% gel twice daily
3. For persistent individual lesions, consider intralesional corticosteroid injection
4. For widespread or recurrent cases, evaluate shaving techniques and consider alternative hair removal methods