Ingrown Hairs and Folliculitis: Causes, Treatment and Long-Term Solutions

Ingrown hairs are one of those concerns that patients often manage for years before asking whether there’s a better answer. They’re treated as an inevitable consequence of hair removal, a minor irritation to be managed with tweezers and skincare, rather than a solvable problem. In most cases, they are solvable, and the solution is more definitive than a better post-wax serum.

This article separates out ingrown hairs and folliculitis, which are related but not the same thing, sets out the home management that genuinely helps, and explains when laser hair removal is the appropriate long-term answer and for whom.

What Ingrown Hairs Actually Are

An ingrown hair occurs when a hair fails to exit the follicle normally and either curls back into the skin or grows sideways along the surface rather than out. The skin’s immune response treats the trapped hair as a foreign body, producing a red, sometimes painful papule or pustule at the site. In some cases the hair is visible beneath the skin surface; in others it isn’t.

Ingrown hairs aren’t caused by hair removal itself, but hair removal practices make them significantly more likely. Shaving cuts the hair at the skin surface with a flat, sharp edge. As the hair grows back, that sharp tip can pierce the follicle wall or re-enter the skin rather than growing out cleanly. Waxing and threading remove the hair from the follicle entirely, but as the new hair grows back through a sometimes narrowed follicle opening, it can fail to emerge correctly. Threading on curved areas like the bikini line or chin is particularly prone to this.

The structural factor that makes some patients much more prone to ingrown hairs than others is hair texture. Curly, coarse hair is significantly more likely to curl back into the skin than straight, fine hair. This is why pseudofolliculitis barbae, a specific and often significant form of ingrown hair on the beard and neck area, disproportionately affects people with naturally curly hair, particularly those with Fitzpatrick skin types IV to VI. The combination of curly hair and razor shaving is almost guaranteed to produce ingrown hairs in susceptible skin.

Common areas:

• Bikini line and pubic area
• Underarms
• Legs, particularly inner thigh
• Beard area, jaw, neck (pseudofolliculitis barbae)
• Chest and back in men

What Folliculitis Is

Folliculitis is an infection or inflammation of the hair follicle, and it looks similar to ingrown hairs, which is why the two are often confused. The distinction matters because folliculitis may need medical treatment, while ingrown hairs generally don’t.

Bacterial folliculitis is the most common type and is usually caused by Staphylococcus aureus. It presents as red, sometimes pustular spots around the follicle opening, often with surrounding redness. Mild cases resolve on their own or with topical antiseptics. Persistent or spreading bacterial folliculitis may need a short course of topical or oral antibiotics from your GP.

Hot tub folliculitis is caused by Pseudomonas aeruginosa in poorly maintained water. It typically appears on the trunk and limbs 12 to 48 hours after exposure to a contaminated hot tub or swimming pool and usually resolves without treatment. Better pool maintenance is the preventive measure.

Fungal folliculitis (Malassezia folliculitis) is often mistaken for acne because it presents as itchy papules and pustules on the trunk and upper arms. Unlike acne, it doesn’t respond to antibiotics and may worsen with them because Malassezia thrives when competing skin bacteria are removed. If you’ve been using acne treatments for body spots that won’t clear, this is worth raising with your GP.

Chemical folliculitis is irritation from skincare products, oils, occlusive sunscreens or synthetic fabrics, particularly post-waxing when the follicle is open. Using non-comedogenic, post-wax products and wearing breathable fabrics for 24 hours after hair removal helps.

How Ingrown Hairs Lead to Other Concerns

Left unmanaged, recurrent ingrown hairs produce two secondary concerns that patients often raise separately.

Post-inflammatory hyperpigmentation. The inflammation around each ingrown hair triggers melanin production, leaving a dark mark long after the hair has resolved. In patients with Fitzpatrick skin types III to VI, this hyperpigmentation can be persistent and distressing. The hyperpigmentation guide covers the treatment options, and the dark spots on the body guide covers PIH specifically in body areas.

Scarring. Repeatedly picked or deeply infected ingrown hairs can produce atrophic or occasionally raised scars, particularly in the bikini area or beard. Acne keloidalis nuchae, a specific form of folliculitis at the posterior neck and occiput, can cause significant scarring and hair loss and warrants dermatological assessment.

What Helps at Home

For patients managing ingrown hairs without laser treatment, the following are clinically useful:

Chemical exfoliation. Salicylic acid (BHA) is the most helpful exfoliant for ingrown hairs because it’s oil-soluble and penetrates the follicle, dissolving sebum and debris that can block the hair’s exit. Applied every other day to prone areas, particularly between waxing or laser sessions, it significantly reduces the frequency of ingrown hairs. Glycolic acid (AHA) also helps by accelerating surface cell turnover.

Post-wax and post-shave care. Applying a BHA serum or appropriate post-wax lotion within 24 hours of hair removal, once the initial skin sensitivity has settled, gives the hair a clearer exit path as it regrows. Avoiding tight clothing for 24 hours post-waxing, and avoiding heat (exercise, hot showers, saunas) for the same period, reduces follicular inflammation.

Shaving technique adjustments. Single-blade razors reduce the risk of ingrown hairs compared to multi-blade cartridges, which cut below the skin surface. Shaving with the direction of hair growth rather than against it, using appropriate shaving cream and rinsing with cool water, all reduce the incidence. Replacing razor blades frequently matters: a blunt blade requires more pressure and produces a less clean cut.

Not picking. Picking or squeezing ingrown hairs introduces bacteria, increases inflammation, and is the primary route to scarring and PIH. A warm compress applied to a visible, near-surface ingrown hair can help it emerge without picking.

Avoid the problem area temporarily. For patients with very active folliculitis or significant ingrown hair inflammation, pausing hair removal in that area for a few weeks while using a BHA and allowing the inflammation to settle is sometimes the right first step before considering longer-term solutions.

When Laser Hair Removal Is the Answer

For patients with frequent, significant or PIH-producing ingrown hairs, laser hair removal is the most definitive treatment. By permanently reducing the density and coarseness of hair in the target area, laser removes the root cause of the problem.

The Cynosure Elite+ at LRC uses Alexandrite 755nm for lighter skin types and Nd:YAG 1064nm for darker skin types. This matters particularly for pseudofolliculitis barbae patients, where Fitzpatrick skin types IV to VI are most commonly affected and the Nd:YAG wavelength is the safe option. The Cynosure Elite+ patient guide covers the full treatment detail.

Laser hair removal for ingrown hair indications typically follows the same course structure as for cosmetic hair removal: 6 to 8 sessions, spaced by body site. The difference is that the clinical indication is often more urgent, and some patients see a meaningful reduction in ingrown hair frequency even within the first two or three sessions as hair density begins to decline.

For patients with pseudofolliculitis barbae who shave professionally or prefer to maintain some facial hair rather than removing it completely, laser can be used strategically to reduce the hair density in the most problematic areas rather than eliminating all hair growth.

When to See a GP

We recommend a GP consultation when:

• Folliculitis is spreading, recurring or not clearing with simple measures
• There is fever, significant swelling or warmth beyond the immediate follicle, which may indicate developing cellulitis
• There are signs of a deeper abscess requiring incision and drainage
• Fungal folliculitis is suspected and won’t respond to over-the-counter treatments
• Acne keloidalis nuchae or another scarring folliculitis variant is present or developing
• The patient is immunocompromised, where follicular infections can behave differently

Persistent PIH following ingrown hairs that doesn’t respond to topical management may warrant a dermatology referral, particularly in darker skin types.

A Note on Waxing at LRC

We offer professional waxing using Lycon wax, a low-temperature professional wax suitable for sensitive skin and fine to coarse hair types. Professional waxing technique reduces the trauma to the follicle compared to home waxing, which lowers the risk of ingrown hairs post-treatment. For patients who prefer waxing over laser, professional waxing paired with a BHA home routine is the best combination for minimising ingrown hair frequency.

However, for patients with recurrent, significant or PIH-producing ingrown hairs, we’ll always discuss whether laser hair removal is the more appropriate long-term solution at the same time.

Frequently Asked Questions

What’s the difference between ingrown hairs and folliculitis?

An ingrown hair is a mechanical problem: the hair fails to exit the follicle normally and grows back into or along the skin, triggering an immune response at that site. Folliculitis is infective or inflammatory: bacteria, fungi or irritants inflame the follicle, producing redness, papules or pustules around the hair opening. Both look similar and can coexist, but folliculitis may need medical treatment such as antibiotics or antifungals, while ingrown hairs are primarily managed with technique and exfoliation.

Can laser hair removal cure ingrown hairs?

For most patients, yes. By permanently reducing hair density and altering the character of regrowth, laser removes the root cause of recurrent ingrown hairs. The Cynosure Elite+ at LRC treats all skin types, using the Nd:YAG 1064nm wavelength for darker skin types where the risk of Alexandrite is too high. Most patients see meaningful reduction in ingrown hair frequency within the first few sessions. It’s the most definitive solution for patients with frequent or PIH-producing ingrown hairs.

Why do ingrown hairs cause dark marks?

The inflammation around an ingrown hair, like any skin inflammation, triggers melanin production as part of the tissue response. This post-inflammatory hyperpigmentation (PIH) persists at the site long after the ingrown hair has resolved. In patients with Fitzpatrick skin types III to VI, PIH from ingrown hairs can be particularly persistent. Chemical exfoliation and sun protection help fade existing marks. Eliminating the ingrown hairs through laser prevents new marks forming.

Is waxing or shaving better for preventing ingrown hairs?

Neither is definitively better for all patients. Waxing removes the hair from the follicle, which means the regrowth has a finer, tapered tip less likely to penetrate the skin. However, waxing can narrow the follicle opening and lead to ingrown hairs in its own way. Shaving leaves a sharp, flat hair tip that’s more likely to re-enter the skin. For patients with curly or coarse hair, neither is consistently good. Laser hair removal is usually the better long-term answer for patients who are significantly affected by either method.

What exfoliant should I use for ingrown hairs?

Salicylic acid (BHA) is the most targeted choice for ingrown hairs because it’s oil-soluble and penetrates the follicle opening, clearing sebum and debris that block regrowth. A 1 to 2% salicylic acid lotion, serum or toner applied every other day to prone areas is the standard recommendation. Glycolic acid (AHA) supports surface cell turnover and can be used in combination. Avoid physical scrubs, which can irritate inflamed follicles and spread bacteria.

Why are some people more prone to ingrown hairs than others?

The primary factor is hair texture. Curly, coarse hair is significantly more likely to curl back into the skin than straight, fine hair because it wants to follow its natural curve rather than grow straight out. This is why pseudofolliculitis barbae, the clinical term for beard-area ingrown hairs, predominantly affects people with naturally curly hair. Follicle structure, skin thickness, and hair removal method all play a secondary role. If you’re significantly affected regardless of technique, laser hair removal addresses the structural root cause.

When should I see a GP about folliculitis?

If the folliculitis is spreading, recurring despite basic hygiene and skincare, not clearing within 2 to 3 weeks, or is accompanied by fever, significant swelling or warmth, see your GP. Bacterial folliculitis may need topical or oral antibiotics. Fungal folliculitis needs antifungal treatment. Any sign of a deeper abscess, developing cellulitis, or scarring folliculitis warrants prompt medical assessment rather than continuing to self-manage.

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Related reading

• Patient guide: Cynosure Elite+ laser
• Laser vs IPL: a treatment comparison
• Hyperpigmentation: types and treatment
• Dark spots on the body and hands
• Acne scarring: types and treatment
• Sun damage prevention and SPF guide
• Homecare between treatments