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Ingrown Hairs and Psoriasis

Posted on March 05, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Sage Salvo

For some people with psoriasis, ingrown hairs can appear on top of normal psoriasis symptoms. Handling itchy, painful ingrown hairs can be frustrating — especially when the skin is already dry, discolored, and irritated from psoriasis.

Psoriasis is a chronic autoimmune disease that causes dead skin cells to accumulate into discolored, itchy, scaly, and sometimes painful patches called plaques. These plaques can appear anywhere on the body but tend to occur in areas such as the knees, elbows, lower back, and scalp. Other symptoms of psoriasis can include ingrown hairs.

Fortunately, ingrown hairs are avoidable and usually only a minor concern. But if an ingrown hair appears, you’ll need to be careful how you address it. Applying the wrong treatment could irritate your skin and potentially worsen your psoriasis symptoms.

What Causes Ingrown Hairs?

Ingrown hairs occur when a hair improperly penetrates the skin. Because this kind of growth is irregular, the skin doesn’t recognize the hair tip as a part of the body. Instead, it treats the hair the same way it would a splinter or other foreign particle and causes inflammation.

While ingrown hairs can occur spontaneously, they usually appear after tweezing, shaving, or waxing. During tweezing or waxing, for example, a person might only remove a portion of a hair and leave the remaining fragments to grow improperly. Similarly, if you pull your skin taut while shaving, the cut hair may draw back into the skin and create punctures before the hair has a chance to grow outward.

Ingrown hairs tend to be more common among people who have tightly curled hair, as the curved structure of their hair follicles can lead hair to bend back towards the skin when cut.

Symptoms of Ingrown Hairs

Ingrown hairs may cause small, solid bumps (papules) or pus-filled spots (pustules) to form on the skin where hair has been removed. These bumps may resemble pimples and are sometimes called razor bumps. The bumps can cause pain and itching and, in some cases, may encompass visible embedded hairs. This condition is referred to as pseudofolliculitis barbae, as it resembles acne and folliculitis. However, it’s just due to the ingrown hairs.

Ingrown hairs most commonly occur in the beard area in men. However, they can occur in other areas where hair is removed, such as the:

  • Neck
  • Legs
  • Armpits
  • Chest
  • Groin
  • Back

As one MyPsoriasisTeam member shared of their experience, “I have noticed that every hair on the bottom of my legs (where I would shave) is ingrown.”

If left untreated, chronic ingrown hairs can lead to:

  • Skin darkening (hyperpigmentation)
  • Scarring
  • Bacterial infection, if a person scratches too much

How Does Psoriasis Affect Ingrown Hairs?

While a person can experience both psoriasis and ingrown hairs at the same time, one is not directly caused by the other. That said, there is an indirect link between the two: skin irritation.

Irritation and skin injury in people with psoriasis can lead to what is known as the Koebner phenomenon — the appearance of new psoriatic skin lesions on previously unaffected areas after skin trauma. A person who exhibits Koebnerization will develop new psoriasis plaques along the sites of skin injury — even a minor injury, such as irritation and ingrown hairs from shaving.

With Koebnerization, a minor scrape, burn, or other skin injury could cause a psoriasis plaque to appear at the same location within a few weeks, months, or even years. Koebnerization can occur anywhere on the body, even in regions not typically affected by psoriasis, such as the face. Roughly 1 in 4 people with psoriasis experience the Koebner phenomenon.

An ingrown hair (or the damage caused by scratching the skin or improperly treating an ingrown hair) is a skin injury that could trigger a psoriasis flare-up in this way.

Treating Ingrown Hairs With Psoriasis

People who have psoriasis need to be careful when treating ingrown hairs, because some options may trigger Koebnerization and worsen flare-ups.

Take laser hair removal as an example. Laser hair removal is sometimes recommended to people who experience chronic ingrown hairs or want a permanent means of removing unwanted hair growth. However, because laser treatments can cause side effects like blistering, scarring, and skin darkening, they are not advisable for people with psoriasis who may be at risk for Koebnerization. If you pursue laser treatments, try a test spot with the laser to see how your skin reacts.

Chemical hair-removal treatments (depilatories), like Nair, pose similar dangers. According to the U.S. Food and Drug Administration, depilatories may cause burning, blisters, stinging, and rashes among people with sensitive skin, which could trigger a psoriasis flare-up in the affected area later. As one MyPsoriasisTeam member shared, “I’ve tried the hair removal creams, but they just irritate me.”

The safest way to address ingrown hairs is to stop shaving, waxing, tweezing, or otherwise removing hair for a few months. You may want to use an electric trimmer for hair control in the meantime. “If you try an electric shaver, it's not so bad,” one MyPsoriasisTeam member recommended. “That's what I use when my legs are really bad.”

The symptoms of ingrown hairs usually fade on their own, though you can use warm-water compresses before bedtime to accelerate healing. If you’re experiencing any persistent symptoms or infections due to scratching, you may want to ask your doctor for medical advice. They may recommend oral or topical antibiotics, similar to what is used to treat acne. They may also recommend over-the-counter steroid creams to help reduce inflammation.

If you need to shave away unwanted hair, there are a few measures you can take to minimize the chances of ingrown hairs and skin irritation. These approaches include:

  • Wetting your skin with warm water before shaving
  • Applying a shaving gel or lotion
  • Using a single-blade razor
  • Shaving in the direction your hair naturally grows
  • Changing your razor blade often
  • Using a tweezer after shaving to remove or free hairs that appear to be growing into your skin

Meet Your Team

Living with psoriasis can be challenging, but you don’t need to face that challenge alone. MyPsoriasisTeam is a social media network designed exclusively for people with psoriasis and their loved ones. Here, members start conversations, ask questions, and share their perspectives with people who know what it’s like living with psoriasis.

How do you handle ingrown hairs during a psoriasis flare? Share your tips in the comments below or by making a new post on MyPsoriasisTeam.

All updates must be accompanied by text or a picture.
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sage Salvo is a content creator who specializes in developing savvy, SEO-aware content strategies and top notch ghostwritten articles for a wide variety of industry niches. Learn more about her here.

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