Ingrown hair: treatment, causes and how to prevent them

The NHS says there are things you can do to treat and prevent ingrown hairs and help them get better quicker. Use an exfoliating scrub to help release trapped hairs, hold a cool wet cloth to the skin after shaving to reduce irritation, and do not scratch, pick or squeeze them. A pharmacist can advise on creams and lotions to help itching, shaving and hair removal products to reduce irritation, exfoliating products and a mild antiseptic to help prevent infection.

BAD says ingrown hairs can be lifted out using a sterile needle, although this is not practical for widespread ingrown hairs, and brushing the skin gently with an abrasive sponge or toothbrush to release the hair is less effective but quicker. PCDS says to carefully release visibly embedded hairs with a sterile needle or by brushing with a soft toothbrush and not to pluck them.

If a GP is needed, the NHS says a GP may remove the hair using a sterile needle or blade (scalpel), give a steroid cream to help swelling and irritation, or give antibiotic cream or tablets to treat an infection. The PCDS adds a low-strength steroid cream such as 1% hydrocortisone, benzoyl peroxide with or without a topical antibiotic, a topical retinoid, or oral antibiotics, often for 6 to 12 weeks, in persistent cases.

Ingrown hairs can look like raised, itchy bumps on the skin. The NHS says on white skin the bumps may look red, while on black or brown skin redness may be harder to see but the bumps may look a different colour from the surrounding skin. Sometimes you can see a hair trapped under the skin, and infected ingrown hairs can be painful with pus in the bumps.

PCDS describes multiple firm, skin-coloured to red or dark bumps and pus-filled spots centred on hair follicles, with itching or burning within 24 to 48 hours of shaving. BAD says that once healed, larger spots may leave dark discolouration (post-inflammatory hyperpigmentation) and scarring, including keloid scarring.

BAD says hair removal, particularly shaving, leads to ingrown hairs. Usually the hair has been cut too short and the shaft retracts back into the follicle. As it grows it can break into the wall of the follicle and enter the surrounding skin, causing inflammation. This is more likely in curly hair, and skin folds or scarred skin may allow in-growth of straight hairs.

The condition, also known as pseudofolliculitis or razor bumps, is typically seen on the face and neck of men who shave, but can affect men and women of all ethnicities in any body area where hairs are coarse, abundant and subject to shaving, waxing and tweezing. The NHS notes waxing, plucking and threading can also lead to ingrown hairs.

The NHS says the best way to prevent them is not shaving. If you do shave, wet your skin with warm water and use shaving gel, shave in the direction the hairs are growing, use as few strokes of the razor as possible, rinse the razor after every stroke, and try an electric razor, hair removal cream or a long-term method such as laser treatment.

Do not shave too close (leaving at least 1mm of stubble can help), do not use a blunt razor, and do not shave every day if possible. BAD suggests not stretching the skin tight, using single blades and shaving every second day. PCDS suggests aiming for a hair length of 0.5 to 1mm using an electric razor or adjustable clippers.

BAD notes lasers and intense pulsed light can reduce hair growth for prolonged periods but in dark skin there is a high risk of increased or decreased pigmentation.

The NHS says you usually do not need medical help for ingrown hairs, but to see a GP if you have signs of an infection: an ingrown hair or the area around it is very painful, hot or swollen, or you have a high temperature or feel hot, cold or shivery or very unwell.

PCDS lists possible complications including darker skin where inflamed, raised scars and keloids, temporary or permanent hair loss and, rarely, deep sinuses and abscesses needing antibiotics. It says pseudofolliculitis can have a significant psychological impact, and a GP letter may be needed if there is a requirement to be clean shaven and shaving causes problems.

Most ingrown hairs are managed with self-care and pharmacy advice. A GP can treat infected or persistent ones. PCDS says one of the most common reasons for referral to a dermatologist is thick scarring, which can be injected with a steroid, and that long-term hair removal treatments such as laser or eflornithine cream are not available on the NHS in most areas of the UK.

Private laser hair removal and dermatology services exist. BAD and PCDS both advise caution in darker skin, where laser can cause pigmentation change, so choose an experienced operator.