An intradermal growing hair, commonly known as an ingrown hair, is a condition where a hair strand curls back or grows sideways and re-enters the skin instead of growing outward. This occurrence often happens after hair removal methods like shaving, waxing, or tweezing, which can leave a sharp tip on the hair. The body recognizes this embedded hair as a foreign object, triggering an inflammatory response that results in the visible symptoms of small, reddish, and sometimes pus-filled bumps. For chronic or severe outbreaks, particularly in the beard area, this condition is medically termed pseudofolliculitis barbae, or “razor bumps.”
Why Hair Grows Back Under the Skin
The formation of an ingrown hair is primarily a mechanical issue exacerbated by specific hair characteristics and grooming practices. The most significant risk factor is having naturally coarse or tightly curled hair, which tends to curve back toward the skin’s surface after being cut, making it difficult for the hair to exit the follicle opening cleanly.
Two distinct mechanisms describe how the hair re-enters the skin. Extrafollicular penetration occurs when the hair successfully exits the follicle but then curves back and pierces the adjacent skin surface, much like a splinter. Alternatively, transfollicular penetration happens when the hair fails to exit the follicle at all, instead piercing the follicle wall itself and growing sideways into the surrounding dermis. Close shaving methods, such as shaving against the direction of hair growth or pulling the skin taut during shaving, create a sharp, pointed hair tip that is cut below the skin’s surface, increasing the likelihood of this penetration. Wearing tight clothing can also cause friction that pushes the emerging hair back into the skin, contributing to the problem in body areas like the legs or bikini line.
Immediate Relief and At-Home Care
When an ingrown hair appears, the immediate goal is to reduce inflammation and gently encourage the hair to surface. Applying a warm compress to the affected area for 10 to 15 minutes, several times a day, can soften the skin and open the pores, helping to bring the trapped hair closer to the surface.
Gentle exfoliation can also assist in removing the layer of dead skin cells that may be blocking the hair follicle opening. This can involve using a soft washcloth in small, circular motions or applying over-the-counter chemical exfoliants containing salicylic or glycolic acid. These acids dissolve surface debris and keratin plugs, allowing the hair to emerge more easily.
If the loop of the hair is clearly visible and just beneath the skin’s surface, sterile removal may be attempted, but only with caution. The area and the tool, such as a sterile needle or fine-tipped tweezers, must be thoroughly cleaned with rubbing alcohol before use to prevent introducing bacteria. Carefully thread the sterile instrument under the exposed loop of the hair and gently lift the tip out of the skin. It is crucial to avoid digging, picking, or squeezing the bump, as this significantly increases the risk of infection, scarring, and darkening of the skin.
Long-Term Strategies for Prevention
Preventing ingrown hairs requires a consistent and modified approach to hair removal and general skin care. If shaving is the chosen method, changing the technique is the most effective adjustment. Always shave in the direction of hair growth, using a single-blade razor, which is less likely to cut the hair below the skin’s surface compared to multi-blade cartridges.
Prior to shaving, soften the hair and skin with warm water and use a lubricating shave gel or cream, allowing it to sit for a few minutes. Avoid pulling the skin tight while shaving, as this action causes the hair to retract back into the follicle when the skin relaxes, increasing the chance of ingrown growth. Replacing the razor blade frequently ensures a sharp edge that cuts the hair cleanly, rather than tugging or tearing it.
Alternatives to traditional shaving offer viable long-term prevention strategies, especially for chronic cases. Chemical depilatory creams dissolve the hair shaft at the surface, leaving a blunted tip rather than the sharp point created by a razor. Professional methods like laser hair removal or electrolysis can permanently reduce or eliminate the hair follicle. Laser removal uses concentrated light, while electrolysis uses an electrical current to destroy the follicle, offering the most definitive solution for recurring ingrown hairs.
Potential Complications and Professional Intervention
Failing to properly treat an ingrown hair can lead to several complications that affect both the appearance and health of the skin. The most common risk is a secondary bacterial infection, known as folliculitis, which causes the bumps to become more painful, inflamed, and filled with pus. Repeated inflammation can also trigger post-inflammatory hyperpigmentation, resulting in dark spots that may linger on the skin long after the hair has been released.
Chronic or severe inflammation carries the risk of permanent scarring, particularly the development of raised, firm scars called keloids. These complications are more likely if the hair is repeatedly picked at or squeezed, which introduces bacteria and causes deep tissue damage.
A doctor’s visit is necessary if at-home treatments fail to improve the condition after several days or if signs of a serious infection appear. Red flags requiring immediate professional intervention include:
- Severe pain.
- A widespread outbreak of pustules.
- Warmth or swelling around the bump.
- Systemic symptoms like a fever.
In such cases, a dermatologist may prescribe topical or oral antibiotics to clear the infection or safely remove the embedded hair using a sterile surgical technique.