What are the treatment options for an ingrown hair at the base of the scalp?

Treatment of Ingrown Hair at Base of Scalp

The most effective treatment for an ingrown hair at the base of the scalp is careful extraction of the hair using sterile tools under direct visualization, which can provide immediate resolution of the condition. 1, 2

Diagnosis

• Ingrown hairs present as black linear lesions beneath the skin, often associated with edematous erythema and folliculitis around the affected area 3
• Dermoscopy can be helpful in visualizing the ingrown hair and distinguishing it from other conditions 1
• Differential diagnoses to consider include:
  • Tinea capitis (fungal infection of the scalp) 4
  • Trichotillomania (hair pulling disorder) 4
  • Alopecia areata 4
  • Pseudofolliculitis barbae (particularly in individuals with curly hair) 5

Treatment Options

First-line treatment:

• Extraction of the ingrown hair:
  • Clean the affected area thoroughly 6
  • Use sterile tools to gently extract the hair under direct visualization 1, 2
  • This approach alone can be curative in most cases 1, 2

Supportive measures:

• Topical antibiotics such as bacitracin may be applied 1-3 times daily if there are signs of secondary infection 6
• Warm compresses can help soften the skin and reduce inflammation prior to extraction 7
• Topical corticosteroids may help reduce inflammation in more severe cases 7

For recurrent or persistent cases:

• Destruction of the hair follicle may be necessary in cases of recurrence 2
• Intralesional corticosteroid injections can be considered for severe inflammatory reactions 7
• Oral antibiotics may be required if there is significant secondary infection 7

Prevention of Recurrence

• Proper hair care practices:

  • Avoid tight hairstyles that pull on the hair at the base of the scalp 5
  • Regular gentle exfoliation of the area to prevent hair follicle blockage 5, 7
  • Avoid picking or manipulating the area, which can cause hairs to grow inward 3

• Shaving techniques (if applicable to the area):

  • Use sharp, clean razors 5
  • Shave in the direction of hair growth 5
  • Consider using electric clippers instead of razors to maintain a short length without complete removal 5

Special Considerations

• In cases where fungal infection is suspected as a contributing factor, appropriate antifungal treatment should be initiated 1
• For patients with curly or coarse hair, the risk of recurrence is higher due to the natural tendency of the hair to curve back into the skin 5, 7
• If the condition persists despite appropriate treatment, consider referral to a dermatologist for further evaluation 4

Follow-up

• Most cases resolve completely after successful extraction of the ingrown hair 2, 3
• Monitor for signs of infection or recurrence for 1-2 weeks after treatment 3
• If multiple recurrences occur, more definitive treatment targeting the hair follicle may be necessary 2