At bathing suit time we start to notice ingrown hairs that are typically due to recent shaving and thus are also called "razor bumps" or "shave bumps." The medical term for razor bumps is Pseudofolliculitis barbae and it’s due to the formation of small inflammatory bumps, some of which may actually be filled with the white cells that makes up a local infection (pus) and can be cosmetically distressing. Although often it is merely a bit unsightly it can lead to pigmentation changes, secondary serious bacterial infections, even MRSA, scaring and in those who get keloids it can cause a keloid. The same condition can occur under the arms, but it’s most common for women in the bikini area. Because some of the worst areas of inflammation are actually the hairs penetrating in ways other than just out of the hair follicle, have your gyno check if the hairs are exiting out the skin near the hair follicle instead of the center or if some of the hairs are entrapped at the normally ‘free’ end of the hair. Individuals with tightly curled hairs are more likely to have this defect and there has even been a discovery of a gene that makes this more likely: hair follicle keratin gene (K6hf). Usually no cultures of the skin are necessary, but there are situations when trying to determine if it’s really a bacterial or actually a fungal infection can be helpful for getting effective treatment, again, consult your gyno.
Steps you can take:
· Use a sponge or loofa to gently cleanse before shaving so the hairs are away from the skin and you can be less likely to accidently encourage ends to penetrate
· Try a single blade, some double blades that pull hair up get that close initial shave but the hair may retract back into the gland and thus be encouraged to grow out the skin where it can become infected. This same issue is why electrolysis is not the preferred method of resolving these issues.
· Try using a different shaving cream, or use warm compresses for just a few minutes to calm the areas and to try to reduce the chance of getting very sharp hair ends after the shave
· Don’t shave for a few days, often the bumps will naturally subside; if that is really bothersome use scissors or clippers very gently so as not to disrupt the hair at the skin surface, preferably to about .05 cm length.
· Don’t scratch, the areas shaved may be a bit itchy, but scratching can introduce more bacteria. Try mild hydrocortisone cream (2.5%) and consult your gyno if the itching becomes severe or you notice skin changes or lesions. The hydrocortisone cream also can reduce the actual inflammation
· You may be able to gently dislodge an occasional trapped hair in which the distal end has been entrapped by using a toothpick, but generally a professional aestheticism can unroof these hairs and decompress the worst areas of infection most successfully
· Treat the area with a topical retinoid, a alpha-hydroxyacide, or a mild glycolic acid.
· Consider laser removal of hair in the areas that are bothersome, follicles then do not form hairs and do not get inflamed. Laser removal is extremely effective for dark hairs, blonde hairs are less effectively treated with lasers.
· Lasers, such as fractional 2940 neodymium:yttrium-aluminum-garnet (Nd:YAG) can help treat the scaring, the infection, and the bumps, even if other wave lengths are also needed to effectively destroy the hair follicle
· Be gentle with the skin, and don’t stretch it when trying to shave
· Shave in the direction of the hair growth, less easily accomplished in the bikini area which tends to grow in a less consistent direction.
· Can try hair removal creams, they do soften hairs by breaking down the bonds that makes the hair in strands, but alternatively you may get skin inflammation. If so do not continue the use of that product. Clip the longest hairs prior to using a cream so that you can use the least amount of chemical product necessary.
· Benxol peroxide cleansing of the area
· Topical antibiotics, available by prescription do work, clindamycin or erythromycin gels are typically the best
· Medical therapy with anti-male hormone treatments or medications in creams such as eflornithine which inhibits hair growth
· Pigment changes to the skin should be evaluated and treated by a professional
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