What is the treatment for ingrown hair?

Treatment for Ingrown Hair

The most effective treatment for ingrown hair (pseudofolliculitis barbae) is to stop shaving completely or to use electric clippers that leave hair slightly longer, preventing it from curling back into the skin. 1, 2

Understanding Ingrown Hair

Ingrown hair, also known as pseudofolliculitis barbae (PFB), is a condition where a hair curls back or grows sideways into the skin, causing inflammation, pain, and sometimes infection. It occurs most commonly in individuals with curly or wavy hair, particularly affecting Black men who shave, with an incidence of over 50% in this population 3.

Treatment Options

First-line Approaches:

1. Modify shaving techniques:

   • Use electric clippers that leave hair 2-3mm long instead of a close shave
   • Avoid stretching the skin while shaving
   • Shave in the direction of hair growth
   • Use a sharp, single-blade razor if manual shaving is necessary

2. Topical treatments:

   • Glycolic acid lotion - shown to reduce lesions by over 60% and allows resumption of daily shaving with minimal irritation 3
   • Topical corticosteroids - to reduce inflammation
   • Topical antibiotics - if secondary infection is present

3. Chemical depilatories:

   • Can be effective alternatives to shaving
   • Should be tested on a small area first to check for sensitivity

For Persistent Cases:

• Topical retinoids - may help in severe cases by reducing follicular hyperkeratosis 1
• Oral antibiotics - for cases with significant inflammation or infection 2
• Intralesional steroid injections - for particularly severe or keloidal lesions 2

Special Considerations

For Different Hair Types:

Individuals with naturally curly or frizzy hair are more susceptible to ingrown hairs due to the hair's tendency to curl back toward the skin 4. These individuals should be particularly careful with hair removal techniques.

Military Personnel:

Service members with PFB may face unique challenges due to strict grooming standards. Military branches have specific guidelines for managing PFB while maintaining uniform standards 5.

Prevention Strategies

1. Let hair grow longer - the most effective prevention method
2. Exfoliate regularly - helps remove dead skin cells that can trap hairs
3. Moisturize after shaving - reduces irritation and inflammation
4. Use proper shaving tools - sharp, clean razors and appropriate shaving creams
5. Consider permanent hair removal - laser hair removal or electrolysis for severe recurrent cases

Pitfalls to Avoid

• Aggressive picking or squeezing of ingrown hairs can lead to infection and scarring
• Continuing to shave closely despite recurring PFB will perpetuate the condition
• Ignoring signs of infection (increasing redness, warmth, pain, or pus) which may require antibiotic treatment
• Overuse of chemical depilatories can cause chemical burns and skin irritation
• Failure to recognize that PFB can lead to post-inflammatory hyperpigmentation, especially in darker skin tones

The evidence clearly shows that the most effective approach to treating ingrown hairs is modifying hair removal practices, with topical treatments serving as helpful adjuncts. Glycolic acid has demonstrated particular efficacy in controlled studies 3.