Ingrown hair treatment and prevention will help prevent scars and brown marks that result from this common skin problem. Ingrown hairs can happen anywhere you have hair but it is the biggest problem for men where they shave their facial and neck hair, and for women in their armpits and bikini area.
What is an ingrown hair?
Hairs normally grow in a hair follicle, which is a small canal in the skin lined by cells. Typically, growing hairs make it to the opening of the hair follicle without difficulty. This is actually astounding given how many hair follicles you have!
- You have about 5 million hair follicles on your skin.
- Hair follicles are spread over every part of your skin with the exception of your palms, soles, lips and genitalia.
- Terminal hairs are the robust colored hair that you see on your scalp, a man's facial hair, armpits, groin, legs, forearm etc. Ingrown hair typically occur from terminal hair.
- Not all of your hair follicles contain terminal hair. Some contain fine and wispy uncolored vellus hair and others have no hair.
Most of your hairs grow uneventfully, cycling between growth and rest phases, are shaved, waxed and epilated without difficulty. Some, however, fail to grow without drama and instead grow back into the skin to cause an ingrown hair.
If a hair fails to exit the hair follicle canal to the skin surface it continues to grow trapped within or under the skin.
What are the types of ingrown hairs?
- An ingrown hair can curl back after exiting the hair canal, pierce the skin and grow down into the skin.
- An ingrown hair can pierce the lining of the hair canal and grow into the skin before reaching the top opening of the hair canal.
- An ingrown hair can get trapped at the opening of the skin and become unable to exit, either curling back into the canal or eventually piercing the skin and growing into it.
What are the symptoms of an ingrown hair?
1. An ingrown hair can be asymptomatic and visible hair under the skin with or without a bump.
If the hair is tracking in the very top layers of your skin (called the epidermal layer of your skin made of living squamous and basal cells underneath dead cells of the stratum corneum), you will see it as a dark line or coiled hair. There may be a bump but the ingrown hair is usually asymptomatic, meaning it does not itch or hurt.
2. An ingrown hair can be tender or itch with a red bump (papule) with or without pus (a pustule).
If the hair enters the dermis, there is inflammation and a 'foreign body reaction'. That's because the body does not like hair in the dermal layer of the skin. It sees the hair as foreign and tries to destroy the shaft of hair. The reaction is accompanied by redness, tenderness, swelling and pus, just like with a splinter.
Ingrown hair causes
Normal hair can become ingrown as part of the normal hair cycle
Normally, hairs grow in the hair follicle canal and exit freely to the skin surface where they can be shaved, cut, or allowed to grow. Each hair follicle grows for a predetermined number of months or years, then rests. When the hair follicle resumes producing a shaft of hair, the old hair strand is shed and a new hair starts growing from the bottom of the follicle. Typically, the new hair follows the follicle and exits at the top. Sometimes it doesn't work and the hair in grows.
Shaved hair has a sharp end that increases the risk of it piercing the skin
Shaving hair leads to a sharp cut to the end of each hair shaft. Usually this is at the skin surface and poses little risk of ingrowing. Shaving may put tension on hair shafts, causing them to stretch then retract back into the hair follicle. The hair may also recoil from the stretch of being shaved, causing the hair to curve and ingrow. Dead skin cells may cover the follicle opening and prevent passage of hair and force it to grow into the skin.
Tweezed, waxed and epilated hairs may also in grow.
Tweezing, waxing and epilating hair out of the follicle from its base will restart growth of a new hair that may fail to exit the follicle. Incompletely removed hairs are stretched and may coil back, creating a corkscrew deformity that increases the likelihood of an ingrown hair.
Rubbing and friction of hair baring skin can cause ingrown hairs.
Hairs that are chronically rubbed (think groin hair) will become coiled and deformed, increasing the risk of ingrowing. Consider wearing loose breathable clothing if you think friction is playing a role in causing ingrown hair.
Curly hairs are particularly prone to ingrowing.
Curly hair is naturally coiled and may not always grow straight up and out the hair follicle. People with thick and very curly hair are at particular risk for psuedofolliculitis, which many people call "razor bumps". This is especially a problem in the beard area where it is called psuedofolliculitis barbae.
Ingrown hair treatment and prevention
Physically exfoliate skin to prevent ingrown hair.
Keep the dead cell layer exfoliated to help hairs easily exit the follicle. Do this exfoliation regularly when cleansing your skin using an exfoliating shower cloth or facial sponge with your skin cleanser. Massage your skin in a gentle circular motion to help loosen and tease out any early coiling hairs. Pat skin dry and apply a moisturizer to maintain soft skin.
Use keratolytic skin care ingredients to exfoliate and prevent ingrown hair.
Keratolytic ingredients loosen dead cells to prevent build-up of the dead cell layer called the stratum corneum that can cover the follicle opening.
Good keratolytic ingredients to prevent ingrown hairs include benzoyl peroxide, salicylic acid, glycolic acid, and retinoids (like retinol). - Dr. Bailey
Dermatologist's 2 top skin care kits to help prevent ingrown hair.
I've created kits to combine physical exfoliation with keratolytic ingredients for ingrown hair treatment. These help to reduce the risk of ingrown hair.
Body, leg and bikini line kit for ingrown hair:
My Ultra-Fast Body Smoothing Triple Action Kit gives you a Salux shower cloth, a glycolic and salicylic acid skin cleanser and a glycolic acid body lotion to soften and exfoliate skin. These ingredients also help reduce the risk of skin hyperpigmentation. Use the Glycolic Acid Lotion on the leg skin in the bikini area. Don't put it in the groin folds. Use a gentle moisturizer in that area such as my Natural Body Lotion.
Facial exfoliation kit for ingrown hair:
Ultimate Acne Solutions Kit does more than treat acne. The product bundle includes a glycolic acid and salicylic acid cleanser to exfoliate skin daily. (I recommend adding the exfoliating sponge.) The kit comes with a topical benzoyl peroxide cream to target skin bacteria and exfoliate where you are prone to ingrown hair. I also give you the perfect facial moisturizer to keep your skin soft so that hair can more easily exit the follicle opening. This is powerful ingrown hair treatment for the facial area.
Does retinol help for ingrown hair treatment?
Yes, retinol helps by exfoliating skin to keep the follicle open so hair can exit. It also helps reduce hyperpigmentation and scarring. It's easy to use retinol for face and neck ingrown hair. Retinol is always used at bedtime because it is inactivated by light. My Retinol Night Cream is a medical-grade product formulated with the highest allowed levels of retinol to get results.
Benzoyl peroxide treatment for ingrown hair
Benzoyl peroxide cleanser and cream are great preventative ingrown hair treatments on the face and neck, especially for pseudofolliculitis barbae. I recommend cleansing daily with Foaming Benzoyl Peroxide Acne Treatment Cleanser which contains the highest level of ultra-micronized benzoyl peroxide. Use this medical-grade cleanser with the Exfoliating Facial Sponge and massage skin in gentle circular motion. If you want to use Retinol to help fight ingrown hairs, use the Benzoyl Peroxide Cleanser during the day and the Retinol Cream at night.
Ten important proven shaving tips to prevent ingrown hair
- Wash and rinse your skin well before shaving to remove skin bacteria.
- Don't dry shave; always shave wet skin and use a lubricating gel or soap lather.
- Always use a clean and sharp razor, never use a dull razor and rinse the razor between each stroke.
- Multiple blade razors may been more likely to cause ingrown hairs because the first blade stretches the hair as the second cuts it.
- Shave in the direction of the hair.
- Don't pull the skin tight when you shave.
- Avoid close shaves and consider leaving a stubble of hair to prevent hairs from resting below the opening level of the hair follicles. This is especially important if you have naturally curly hair.
- Rinse skin with cool water after shaving to reduce skin inflammation from shaving.
Apply a soothing moisturizer after shaving to minimize skin irritation and keep skin soft and pliable such as my Daily Moisturizing Face Cream that comes in my Ultimate Acne Kit, or my Natural Body Lotion.
- If you use an electric razor, set it to leave a slight stubble so that hair is not shaved at the skin level.
Ingrown hair complications
Hyperpigmentation brown marks from ingrown hair
The redness and inflammation from an ingrown hair can leave a temporary or permanent mark when it heals. Skin inflammation of any sort always activates the melanin producing cells called melanocytes. If you have dark skin, or if you are in the sun and your skin produces melanin (a tan), that melanin can drop into the deeper skin layer (the dermis) where it can stay for a long time.
Skin infections from ingrown hair
Ingrown hairs can become infected with Staph bacteria. This increases the risk of scarring. If an ingrown hair becomes much redder, more tender and swells quickly, it may be time to see a doctor.
Scarring from ingrown hair
the skin inflammation associated with an ingrown hair can lead to scarring.
Ingrown hair treatment
- Stop shaving, waxing or tweezing the area until the problem improves so that you do not irritate the skin.
- Watch for infection. Be sure the ingrown hair lesion does not become infected. Rubbing alcohol or hydrogen peroxide may help. Topical antibiotics such as bacitracin may help too. You may need to seek medical attention for prescription medicines if you think the ingrown hair has become infected.
- Do not pick at, scratch or try to pop ingrown hairs. This may lead to scarring and increased risk of infection.
- Help the hair exit to the skin surface if possible. Use clean tweezers and lift the end of the hair to the skin surface if it is readily visible. Prep the skin with rubbing alcohol first and disinfect the tweezers with rubbing alcohol too. Do not damage the skin. Again, you may need medical attention to do this aseptically.
- Avoid sun exposure. When ingrown hairs occur, protect the skin from the sun to prevent hyperpigmentation (called post inflammatory hyperpigmentation). Use clothing to cover your skin or apply a non-irritating mineral zinc oxide sunscreens. These give the best broad spectrum sun protection to help prevent tanning of skin prone to ingrown hairs.
Best products for ingrown body and bikini hair:
Two best product options to prevent ingrown facial hair:
Add retinoids to your skin care to help prevent ingrown hair and brighten your complexion.
Retinoids, including retinol and prescription tretinoin (Retin A), help keep hair follicles clear so that hair can exit freely without ingrowing. They also help reduce scarring and brown spots with ingrown hair just like they do for acne. As an added plus, they brighten your complexion, help even skin color tone and help to prevent blackheads and clogged pores.
2. Alternatively, you can wash with Foaming Benzoyl Peroxide Acne Treatment Cleanser and the Exfoliating Facial Sponge and Apply Daily Moisturizing Face Cream during the day and Retinol Night Cream at night.
Use a broad spectrum mineral sunscreen to prevent hyperpigmentation of ingrown hair on body or face.
ISCOTT MJ. Cutaneous Reactions to Embedded Extraneous Hair. AMA Arch Derm. 1957;76(1):39–42. doi:10.1001/archderm.1957.01550190041009
Ogunbiyi A. Pseudofolliculitis barbae; current treatment options. Clin Cosmet Investig Dermatol. 2019;12:241-247. Published 2019 Apr 16. doi:10.2147/CCID.S149250
Murphrey MB, Agarwal S, Zito PM. Anatomy, Hair. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
Qi J, Garza LA. An overview of alopecias. Cold Spring Harb Perspect Med. 2014;4(3):a013615. Published 2014 Mar 1. doi:10.1101/cshperspect.a013615
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is the structure of hair and how does it grow? 2019 Aug 29.
Author: Dr. Cynthia Bailey M.D. is a Board Certified dermatologist practicing dermatology since 1987. She has done well over 200,000 skin exams during her career and authors the longest running physician written skin health blog in the world.