As the summer months are upon us in the U.S., more people are shaving bikini lines, legs and chests to get ready for swimsuit season. Increased shaving activity, friction and curly hair are all factors increasing the risk of pseudofolliculitis barbae, commonly known as razor bumps, ingrown hairs or shaving bumps.1
This common skin condition usually happens with shaving and is an inflammatory response triggered by hair being trapped beneath the skin. The condition is most noticeable around the beard and neck area but may occur anywhere hair is shaved or tweezed, including the underarms, pubic area, face and legs.
There are two conditions that may inflame the hair follicles, pseudofolliculitis barbae and folliculitis barbae. The difference is in the trigger of the inflammation. While folliculitis barbae is triggered by a viral or bacterial infection, pseudofolliculitis is an irritation from shaving and ingrown hairs. Both conditions will be aggravated when you also have another type of dermatitis.2
Anatomy of a hair follicle
Hair is made of keratin, a fibrous structural protein. While it has a simple structure, it plays an important function. Beneath the skin is a hair follicle that anchors each individual hair into the skin. At the base of the hair is a bulb where living cells divide and build the hair shaft.
Blood vessels deliver oxygen and nutrients to the bulb and hormones responsible to modify growth rate and structure. Although the rate is different in different people, and sometimes in different phases of life, the average growth rate is one-half inch each month. There are three cycles of hair growth explaining why you may have different lengths of hair even though you cut your hair to one length.3,4
- Anagen — This is the growth phase when the matrix cells of the hair follicle are fully pigmented and undergoing vigorous growth activity. The three phases do not happen at the same time throughout your scalp. The length of each phase varies with the site on your body and your age. On your scalp, the average length of this phase is 1,000 days and of all the hairs on the average person's head, approximately 90% of them are in the anagen phase at any time.5
- Catagen — During this transitional phase, the amount of pigment at the base of the follicle and growth activity decreases. During normal growth only 1% of hair is found in the catagen phase.6
- Telogen — In this resting phase, the hair detaches from the hair follicle and falls out. The root may lose or keep pigmentation.7 A new hair growing in the follicle will force the growing hair out and the cycle begins again.
What is an ingrown hair?
In the active phase of growth, when hair is cut it continues to grow back. An ingrown hair curls back into the skin rather than of growing straight out of the skin surface. This happens most commonly in those who have coarse or curly hair and are shaving close to the skin.8
The medical term for inflammation from an ingrown hair is pseudofolliculitis barbae. While this may occur anywhere on the body, it's most common in areas where the hair is shaved short or there is a lot of friction.
Shaving with a standard razor gets closer to the skin than an electric razor, increasing the possibility the hair will grow back into the skin as it's growing out. These ingrown hairs show up as tan or red colored bumps that are not exactly pimples but may appear to have pus like a pimple.9
In some cases, dead skin may force the hair to grow sideways under the skin, rather than up and out. Often, you'll be able to see part of the hair just under the skin.10 The irritation caused by an ingrown hair produces a red raised bump, or even a group of bumps looking like small pimples.
They may be itchy, uncomfortable and irritating. Ingrown hairs are more common in men with thick, coarse, curly beards, but overall are more common in women who experience them in the armpit and pubic area.11
Since they occur in areas where there is friction or the hair is dense and curly, ongoing maintenance may be required to reduce the number of ingrown hairs.12 They occur more frequently during puberty and rarely happen on the eyelid or thighs. While medically harmless, they may be cosmetically disfiguring and even lead to scarring and skin discoloration.
When hair is cut close to or below the opening of the skin, the sharp tip may then pierce the skin as it starts to grow out. Waxing, wearing tight clothing and removing hair aggressively may increase your risk of ingrown hair.13
Treat an ingrown hair at home
It is important to treat your ingrown hairs as they occur since chronic occurrence may lead to bacterial infections, skin darkening and permanent scarring.14 Razor bumps range in size and while nothing makes them go away immediately, there are several strategies to help the skin heal more quickly. These may also help prevent them from coming back.15,16
Stop the irritation — Your first step is to stop doing anything to irritate an ingrown hair. This includes shaving, waxing and plucking.17 If you are not able to wait for the hair to grow out, or you don’t have a job where a beard is acceptable, you may have to use other strategies. Avoid scratching the area and be sure to wear loose clothing around the hair to avoid friction.
A warm washcloth and soft toothbrush — Hairs that grow into the skin may be brought back to the surface by applying a warm, wet washcloth to the area to relax the follicle.18 Rub the washcloth in a circular motion to help uncurl the hair. If this is not successful, use a soft toothbrush to release the trapped hair after preparing the skin with a warm, wet washcloth.
Tweezers — Once the hair appears above the skin line you may use a set of tweezers to pull it straight. However, do not dig into the skin as this introduces bacteria and may trigger an infection. Do not pluck it out as this increases the chance the ingrown hair will repeat.19
Salicylic acid — This is a beta hydroxy acid to help exfoliate the skin cells around the ingrown hair. The acid also penetrates the oil glands to unclog your pores and fight inflammation. Salicylic acid is a common ingredient used in acne creams and may be found in cleansers, toners and lotions available in drug stores and online.20
Glycolic acid — This exfoliant may help remove excess skin cells clogging your pores, trapping the hair under the skin. It speeds the natural process of removing dead skin cells and may help razor bumps clear more quickly. Glycolic acid creams and lotions are available online and in some cosmetic shops.
Scrubs — You might consider a mechanical scrub to remove dead skin cells. However, while they remove debris and may physically free ingrown hairs, some people have skin reactions to the rough scrubs that may irritate sensitive skin.21 You can make your own skin scrub at home with raw sugar and coconut oil.22
Brushing — A soft brush may help remove dead skin cells, such as a soft toothbrush or skin care brush. Brushing not only helps remove current bumps but may also help prevent new ones from forming.
Tea tree oil — The anti-inflammatory and antibacterial properties of tea tree oil may help reduce swelling, discomfort and potential for infection, without the side effects of medications. Do not use undiluted oil directly on your skin as it may increase the irritation. Instead, mix 12 drops in 1 ounce of a carrier oil, such as coconut oil or olive oil.23
Recognize an infection for early treatment
For the most part, ingrown hairs will resolve themselves without issue. However, they sometimes become infected, pus-filled sores. When this happens, it is called folliculitis. The hair follicle will become filled with pus, although pus does not necessarily mean there is an infection.24
Mild cases will clear without treatment. Try not shaving for a few days and using a mild antiseptic on the affected area with a warm washcloth to open your pores. Rarely, ingrown hairs turn into cysts, which may present as large or small, soft or hard, and develop deep beneath the skin.25 A cyst will not hurt unless it becomes infected, which then may be red and tender.
In many cases an ingrown hair cyst may be treated at home by avoiding shaving and applying warm compresses for 10 minutes several times a day. This may help the cyst to drain and the hair to grow out. An antiseptic solution, such as tea tree oil, may be applied to the area to help prevent infection.26 Since coconut oil also has antibiotic properties,27 it may be the best carrier oil in this case.
Avoid picking or popping a cyst, as this may release the liquid but will not get rid of the sac where the liquid has accumulated, and the cyst will grow back. Popping a cyst also opens the area to bacteria, which may trigger an infection.
Seek medical attention if the cyst does not clear on its own or if you develop a fever. You should also see a doctor if you believe a foreign object is in the cyst, such as a splinter or piece of glass or if you have a condition or are taking a medication affecting your immune system.28
Simple techniques may help prevent ingrown hairs
There are several simple and effective ways to reduce the number of razor bumps you may experience. The most effective treatment is just to let the hair grow. But, in some cases this may not be possible.29,30,31
• Prepare your skin — Before shaving or tweezing, cleanse the skin with a product containing salicylic acid or glycolic acid to help clear and remove excess dead skin. Ensure your skin is wet if you're going to use a blade or place a warm, wet towel on the area for five minutes before shaving.
Use a lubricating lotion or gel while shaving to reduce irritation. Avoid using irritating skin products that may make inflammation worse. After shaving, use a cool washcloth to reduce irritation and then apply lotion.
• Shaving — Try shaving every other day rather than daily, as this may help improve the condition. Using an electric blade rather than a razor reduces the potential for pseudofolliculitis barbae as an electric razor will not shave as close.
Shave with the grain of the beard and not against it. Do not stretch the skin and be sure to use the fewest number of strokes as possible. Rinse your razor blade with water after every stroke.
Distinguish razor bumps from razor burn
While they sometimes look the same, razor bumps and razor burn are two different conditions. Razor burn is a skin irritation caused by friction from the razor. You'll notice areas of redness and irritation immediately after shaving, while razor bumps take a day or two to form.32
Razor burn may develop into a rash. It is often itchy and you may experience swelling, tenderness and a burning sensation. Although annoying and uncomfortable, razor burn usually resolves on its own. The skin will need time to heal and you may reduce further irritation, inflammation or the potential for infection by not scratching it and by leaving the skin alone.
Cold compresses may help reduce itching and inflammation. The application of naturally astringent liquids, such as apple cider vinegar, chilled brewed black tea or witch hazel extract, may also help reduce inflammation.33 Moisturizing the skin with natural oils, such as coconut oil, sweet almond oil or olive oil may help reduce itching and tenderness from razor burn.
Although razor burn does not often get infected, moisturizing with coconut oil may help reduce the potential. Avoid scented lotions and products with alcohol as they are known irritants. A paste of baking soda and water applied to the skin with a cotton pad that is then allowed to dry may help reduce inflammation and speed healing.34
Source: mercola rss