Management of Pili Incarnati (Ingrown Hairs)
The most effective management for pili incarnati (ingrown hairs) involves gentle exfoliation, avoiding hair removal methods that cause trauma, and proper hair care practices to prevent recurrence 1.
Understanding Pili Incarnati
Pili incarnati (ingrown hairs) is a common condition where hair curls back or grows sideways into the skin instead of rising up from the follicle. This condition is particularly common in people with curly or frizzy hair due to the sideways growth and tight coiling of the hair fiber 1.
Key Characteristics
- Occurs when cut hair grows back into the skin
- More common in curly/frizzy hair types
- Can lead to inflammation, infection, and scarring if untreated
- Often secondary to unsuitable grooming practices 1
Management Approach
1. Prevention Strategies
- Avoid tight clothing over commonly affected areas
- Use proper shaving techniques:
- Shave in the direction of hair growth
- Use a sharp, clean razor
- Avoid stretching the skin while shaving
- Consider alternative hair removal methods that are less likely to cause ingrown hairs:
- Depilatory creams (if not irritating to skin)
- Professional waxing with proper technique
2. Active Treatment for Existing Ingrown Hairs
- Gentle exfoliation to remove dead skin cells:
- Use a soft washcloth or gentle exfoliating product
- Apply in circular motions to affected areas
- Perform 1-2 times weekly (not daily to avoid irritation)
- Warm compresses to reduce inflammation and help release trapped hairs
- Gentle extraction of visible ingrown hairs:
- Use sterilized tweezers
- Avoid digging into skin or forcing extraction
- Topical treatments:
- Benzoyl peroxide to reduce bacterial load
- Salicylic acid products to exfoliate and reduce inflammation
- Glycolic acid products to gently exfoliate
3. Management of Complications
- For infected ingrown hairs:
- Topical antibiotics for mild infections
- Oral antibiotics may be necessary for more severe infections
- For persistent inflammation:
- Low-potency topical corticosteroids may help reduce inflammation
- Consider intralesional corticosteroid injection for severe, isolated lesions
Special Considerations for Different Hair Types
People with frizzy or curly hair require special attention as they are more prone to ingrown hairs 1:
- Proper hair care practices are essential
- Avoid hair relaxers and excessive heat styling which can increase hair fragility
- Minimize tight hairstyles that cause chronic traction
- Regular moisturizing of hair to reduce brittleness
When to Seek Medical Attention
Medical consultation is recommended when:
- Ingrown hairs become severely infected
- Home treatment fails after 2-3 weeks
- Ingrown hairs recur frequently despite prevention measures
- Significant scarring develops
Pitfalls to Avoid
- Aggressive picking or digging at ingrown hairs can worsen inflammation and lead to scarring
- Overuse of exfoliants can irritate skin and exacerbate the condition
- Continuing hair removal methods that consistently cause ingrown hairs
- Ignoring signs of infection such as increasing redness, warmth, pain, or pus
By following these management strategies, most cases of pili incarnati can be effectively managed and prevented from recurring. The focus should be on gentle care, proper hair removal techniques, and addressing any complications promptly.