How to deal with an ingrown hair cyst

An ingrown hair cyst can be deep and painful. It involves a hair follicle and occurs when the hair curl and grow downwards. It is sometimes called trichilemmal, pilar, wen or isthmus-catagen cyst. This detailed evidence based guide provides information on medical and home treatment options for ingrown hair cysts, lists the main causes and symptoms of the disease, features pictures of various hair cysts and a video of ingrown hair cyst removal.

Difference between ingrown x sebaceous and pilonidal cysts

Ingrown hair cyst is often confused with sebaceous and pilonidal cyst.

These two cysts might seem similar to ingrown hair cyst but they do differ. Sebaceous cysts occur from the oil secreting glands on the skin. These glands help lubricate the hair on skin.

In sebaceous cysts, hair might be involved but it’s not always true.

Pilonidal cysts occur on the bottom of the tail bone. It is common to find hair follicles in pilonidal cysts but they are different than ingrown hair cysts.    

Causes of ingrown hair cysts

There are various reasons for the formation of an ingrown hair cyst. The main reason is shaving (1). Also, people with curly hair are more likely to suffer from an ingrown hair cyst.

Here are some of the most common causes of ingrown hair cysts: 

• Shaving: Shaving can cause an ingrown hair cyst. The small razor bumps and razor burns that occur after shaving irritate the skin and make the hair end embed into the skin and grow inwards instead of outwards.
• Waxing: An improper waxing technique can also cause ingrown hair cysts as it may alter the direction of hair growth.
• High sex hormone levels: Different hormones in the body are responsible for various functions. An increase in sex hormones leads to increased hair growth. This in turn increases the likelihood of ingrown hair cysts. Because all that excess hair would not have space for proper growth.
• Clogged pores: Clogged pores are one of the main causes of ingrown hair cysts. If the pores are clogged than there is no space for hair growth. The pores can get clogged due to excess oil, dirt or dead skin cells. This can lead to blockage of pathway of hair growth. Which in turn will cause ingrowth of hair.
• Cystic acne: Cystic acne bumps are present deep in the skin. These bumps can be due to blockage of pores. If the pores are clogged, it can hinder the hair growth. This may cause inward growth of the hair. When a hair follicle gets infected, it results in swelling and pus accumulation. Thus, leading to a cystic hair follicle.
• Curly hair: Curly haired people have a higher tendency for ingrown hair cysts. This occurs due to the natural way their hair curl backwards. If the curl occurs within the skin then it can lead to ingrown hair cysts.
• Skin disease: There are certain skin diseases that can cause ingrown hair cysts. Some diseases can cause thickening of the skin. Thus, making it hard for the hair to grow outwards. When the hair do not have a proper path for growth, they may grow inwards. 

Symptoms of ingrown hair cysts

Ingrown hair cysts is usually a minor problem. But it can have some irritating symptoms and if left untreated it may even be dangerous. It is possible for ingrown hair cysts to be completely symptomless and just removing the offending hair once solves the problem for good.

Yet, in most cases, there are certain symptoms associated with ingrown hair cysts (2). The symptoms can arrange from mild irritation to painful. Following are the common symptoms that occur due to an ingrown hair cysts:

• Irritation: Irritation occurs due to the response of the body to an ingrown hair cyst. When the cyst forms, the body releases certain chemicals to speed-up the process a healing. But, these chemicals cause irritation of skin as a side effect.
• Inflammation: Inflammation occurs due to immune response of the body. When an ingrown hair cyst forms, the body sees it as an invader. The blood vessels in the area around the cyst dilate. The blood contains cells and enzymes that want to attack the invaders. Thus, leading to pooling of blood and cellular material under the skin. This accumulation of fluids causes inflammation. The extent of inflammation ranges from a small bump to a large cystic lesion.
• Pus discharge: If the cyst gets infected pus may be formed. The pus is usually a sign of bacterial activity. The pus can be green or yellow. Its consistency is mostly gooey.
• Redness: The redness around the ingrown hair cyst is due to the dilation of the blood vessels. This redness is a sign of skin irritation.
• Pain and tenderness: It is the most bothersome symptom of an ingrown hair cyst.  It occurs due to the stretching of skin due to inflammation. Pain can also occur when there is a breach in the epithelium lining. Thus, sending a signal to the pain receptors. Pain can range from mild to severe.  

Types of ingrown hair cysts

Ingrown hair cysts can occur on any part of your body. Ingrown hair cysts on the face are common in men due to frequent shaving. While pubic ingrown hair cysts are more common in females. Ingrown hair cysts can also affect the eyelashes. This causes an inward growth of the eyelashes and may result in damage to the eyes.

This is how an ingrown hair cyst may look like:

Here are the areas where an ingrown hair cyst appears most frequently: 

• Pubic area: Ingrown pubic hair cysts can occur on the labia and vagina in females. In males, it can occur on the penis and scrotum. In both genders, the thigh area may also be involved. Pubic hair cysts are caused by intrinsic or extrinsic factors. The extrinsic causes include shaving, waxing or others hair removal methods while the intrinsic causes include hormonal imbalance and curly coarse hair type. The ingrown pubic hair cyst can be a small hard bump or a large cystic lesion.
• Face: Ingrown hair cyst can also occur on any part of the face, including cheeks, chin, forehead and even the eyelids. Facial hair cysts are more common in men that shave their face daily. Ingrown eyelashes tend to be a major issue. If left untreated they may lead corneal scaring, which in turn causes blurring or even loss of vision.
• Armpit: Ingrown armpit hair cysts can cause extreme discomfort. These cysts are common after shaving or waxing your underarm. They should resolve by themselves in a few days. But, sometimes, deep ingrown cysts can form. These cysts cause pain and inflammation. They are likely to get infected. Thus, they need to be treated with haste.

Treatment of ingrown hair cysts

Ingrown hair cysts are an annoying and irritating problem. They can occur almost anywhere on the body. If they occur in the pubic or underarm area, they can be painful. The folds in the skin and the sweat aggregates the symptoms. There are many ways to manage ingrown hair and the associating symptoms.

Below we shall discuss home (natural) and medical treatment options for ingrown hair cysts. The course of treatment depends on the size, site, cause and symptoms associated with ingrown hair cyst.

Before we describe medical and home remedies for ingrown hair cyst here is a word of warning. Never attempt to self treat and always go and see your doctor to get a proper medical treatment. While we try to provide you with as accurate treatment information as possible, you should not rely on any of the information found on the web and you should always seek a proper medical attention. This may save your life.

Ingrown hair cyst - medical treatment options

Medical remedies for ingrown hair cyst include (3):

Corticosteroids

Corticosteroids act as anti-inflammatory drugs. They act by altering the mediators responsible for inflammation.

Inflammation is one of the main symptoms of ingrown hair cysts.

For mild to moderate inflammation, topical steroidal creams are enough.

Corticosteroids also helps reduce irritation and itching.

But in severe cases, oral corticosteroids are recommended.

The commonly used corticosteroids are prednisolone and hydrocortisone.

Corticosteroids may have some side effects and should only be used with medical prescription and prior consent of your doctor.

Here are some of the most common adverse effects associated with corticosteroid treatment:

• Skin redness
• Sweating
• Irritation of skin
• Nausea.

Pain killers

Ingrown hair cysts tend to be painful, mainly when the cyst is located on underarms or in pubic area. This is because of skin folds in these areas, which makes the cyst rub with the opposing skin.

You may use some over the counter (OTC) pain killers for treatment of ingrown hair cyst (Tylenol, Ibuprofen, Naproxen sodium, etc.).

However you should know that killing the pain does not treat the cyst itself and you should always seek a medical attention to get a proper treatment for underlying cause of the hair cyst.

If the cyst is really painful your doctor may prescribe you some stronger pain killers, which are not available over the counter.

Also, do not take aspirin if you suffer from blood disorders (aspiring thins the blood) and/or if you are a child under 18 (risk of a serious disease called Reye syndrome).       

Antibiotics

Antibiotic creams can help fight and prevent bacterial activity in an ingrown hair cyst. Secondary infection may cause many complications.

Erythromycin, clindamycin and benzoyl peroxide are topical antibiotic creams, which may prove helpful in treatment of an ingrown hair cyst.

These antibiotic creams should be applied twice daily till the infections clears up. Make sure to clean your skin before applying the cream. In cases of severe infection, oral antibiotics are recommended. These must be prescribed by your doctor.

Tretinoin (Retin A)

Tretinoin is a form of vitamin A. This drug helps renew the skin cells. It helps reduce the skin plugging and hyperkeratosis (increased deposition of skin keratin).

Ingrown hair cysts can occur due to clogged pores and hardened skin.

This cream helps thin out the epidermis and removes the accumulation of dirt and dead skin cells from the pores.

Thus, reducing the chances of hair embedment and ingrown hair cysts.

You should be careful when using treinoin for ingrown hair cyst prevention and treatment as it may have the following side effects:

• Burning sensation of skin
• Skin irritation
• Redness
• Inflammation.  

Anti-acne medication

Acne is one of the causes of ingrown hair cysts. Therefore when you get a proper treatment for acne, you may resolve the ingrown hair cyst as well.

Most anti-acne creams contain salicylic acid and hydrogen peroxide. 

You may purchase anti-acne creams in your local pharmacy. 

Epilation

Epilation means removal of hair from any part of the body. This is commonly done by waxing, shaving or mechanical epilation.

In case of ingrown hair cysts, there are two ways of epilation: manual and surgical.

The manual method includes tweezers and careful removal of the ingrown hair. This is an office procedure or it can be done at home. Surgical epilation is done in case of deep or persistent ingrown hair cysts.

This is done under local anesthesia.

The doctor makes a small incision and then by using an epilation forceps removes the ingrown hair.   

Electrolysis

Electric current is applied to the hair follicle to destroy the roots.

This is done by the means of fine needle shaped electrodes.

Hair has different stages of growth: growing, resting and shedding.

Electrolysis works best on hairs in growing stages.

You may actually need multiple sessions for complete hair removal.

There are three main type of electrolysis: galvanic, thermolysis and blend.

The type used depends on hair and skin type.

On the other hand some experts think that using electrolysis as treatment option for hair cyst is controversial and may not work due to alternation of hair growth direction.     

These are the main benefits of electrolysis:

• Permanent solution
• Versatile
• Works for any skin type.

On the other hand electrolysis has the following drawbacks:

• Costly
• Time consuming
• Technique sensitive
• Skin discoloration
• Often painful

Cryoablation

Cryoablation and cryotherapy are the two names of the same procedure.

It is a relatively new treatment modality.

It is a minimally invasive technique.

In cryoablation, extreme cold is used to freeze and destroy the diseased tissue.

In case of ingrown hair, cryoablation focuses on hair follicles.

In cryoablation, liquid nitrogen or argon gas passes through a fine needle like applicator towards the target tissue (hair follicle).  

Ablation in the follicular cells due to cryotherapy occurs by three mechanisms. First is the formation of ice crystals in the follicular cells. Second is the interruption of blood supply. Thirdly it is the induction of apoptosis (programmed cell death).

The benefits of cryoablation include:

• Less recovery time because it is one of the least traumatic procedures
• Relatively painless procedure
• Few side effect because it provides targeted therapy
• Permanent removal of ingrown hair

The drawbacks of cryoablation are as follows:

• Expensive procedure
• Damage to surrounding normal tissue or nerves can occur
• Technique-sensitive procedure.            

Surgery

In case of large infected ingrown hair cysts, surgical procedure may be done. An incision of the cyst is made under local anesthesia.

This allows the drainage of the cyst. After drainage, the offending hair is removed.

This skin is covered with a dressing to prevent further infection or wound contamination.

Argon laser

It is a relatively new way of hair removal. Argon laser uses ionized argon as an active medium.

It passes as non-divergent beam of blue and green visible light.

The principle of argon laser is photocoagulation.

This means that the laser coagulates the undesired skin and hair.

A specific wavelength and pulsation of light is necessary for optical effect.

The laser targets the hair follicle and destroys the roots.

This is a great way to deal with ingrown hair cysts.   

Pros of using argon laser for removal of ingrown hair cysts:

• Fewer side effects
• High effectiveness
• Less chance of surrounding tissue damage.

Cons of using argon laser for removal of ingrown hair cysts: 

• High cost
• Reoccurrence of ingrown hair
• Hypopigmentation of skin
• Notching of skin. 

Home remedies and treatments for ingrown hair cyst

In this section, we are going to talk about home remedies for ingrown hair cysts.

The best part about home remedies is few to no side effects.

Also, these remedies cost almost nothing.

Because a lot of these items are already available in most households.

The remedies may not be a permeant treatment for ingrown hair cysts (and you are strongly advised to go and see your doctor to ask for a proper medical treatment and examination) but they may help alleviate the symptoms and provide relief.

Home remedies for ingrown hair cyst range from a warm compress to slat massage.

Warm compress

Warm compress is the most common remedy for inflammation.

While warm compress may not remove the ingrown hair it can still help manage and alleviate the symptoms as it increases the blood circulation.

With increased blood flow, there is also an increase in the blood cells. This helps to resolve the inflammation and speeds up the healing process.

Warm compress also helps reduce irritation and itching and softens the skin (which makes removal of ingrown hair much easier).

How to use?

Take a clean soft cloth.

Warm the cloth with an iron or by dipping it in hot water.

Make sure the cloth is not too hot.

Place this cloth on the affected area for 10 minutes.

Repeat this 3 to 4 times till the swelling goes down.

Tweezers

If you have steady hands then removing an ingrown hair with tweezers may be the best option for you.

Using sharp tweezers to pluck out the offending hair is a simple and surefire way to remove it.

How to use?

• Clean the area surrounding ingrown hair cyst
• Place a warm compress on the area of ingrown hair cyst
• Carefully remove the hair with precise movements
• Make sure to remove the hair follicle as well
• Be careful when removing ingrown hair. Because if the hair breaks, it can again cause the formation of ingrown hair cyst.

Sugar scrub

Sugar is available in every kitchen around the world.

It is a natural humectant.

This means that it attracts the moisture from the surroundings. This helps hydrate the skin.

Sugar contains glycolic acid (an alpha hydroxyl acid) that can easily penetrate into the skin.

It encourages the turnover of the skin cells.

Thus, promoting faster skin healing.

The small particles of sugar help exfoliate the skin.

Exfoliation helps prevent ingrown hair cysts and reduces the swelling and irritation associated with them.

Proper and through exfoliation can also help with treatment of ingrown hair.

How to use?

Mix half a cup of white sugar with 1/4th cup of extra virgin olive oil or argon oil.

Add an essential oil you like for fragrance.

Apply this paste on the problem area.

Rub in a circular motion for a few minutes.

Rinse the skin with lukewarm water.

Repeat a few times a week till the ingrown hair cysts resolves. 

Eggs

Eggs are great for health and skin.

Since ancient times they have been used to treat skin conditions.

Eggs are rich in proteins. Albumin has great skin toning abilities. The nutrients in eggs help promote the healing of skin.

Egg helps tighten pores to reduce oil production and prevent their clogging, which may be helpful in treatment of ingrown hair cyst.

How to use?

Carefully remove the egg membrane from inside the egg shell.

Cover the problem area with the egg membrane.

Let this dry and shrink around the ingrown hair cyst.

Now peel of the egg membrane. The ingrown hair will come out along with the membrane.  

Baking soda

Baking soda is sodium bicarbonate- a natural alkaline substance.

It has antimicrobial, anti-sceptic and anti-inflammatory properties.

It helps to prevent infection of ingrown hair and also helps reduce irritation, swelling and redness.

It also has a soothing effect on the skin.

Using baking soda to exfoliate the skin is great for alleviating symptoms of ingrown hair cysts as well as for prevention of their reappearance.

Proper and regular skin exfoliating can also help prevent formation of ingrown hair cysts.

How to use?

Method 1: Mix a tablespoon of baking soda in a cup of water. Now dip a cotton ball in this mixture. Rub this cotton ball on the affected skin.

Method 2: Mix a teaspoon of baking soda in a few drops of coconut oil. Massage this paste on the affected skin. This helps in removing of ingrown hair.  

Sea salt

Sea salts have numerous skin benefits due to its sodium, magnesium, potassium and calcium content.

These minerals help to ensure proper functioning and communication of cells.

Sea salts form a protective barrier on the skin and help prevent infection of ingrown hair cyst.

They also help hydrate the skin and promote faster healing.

Sea salt exfoliation makes removal of ingrown hair easier.

How to use?

Method 1: Add a tablespoon of sea salts in half a cup of water. Dip a cotton ball in it. Rub this cotton ball on your skin in circular motion.

Method 2: Add few drops of jojoba oil in a tablespoon on sea salts. Rub this mixture on your skin in circular motion. Exfoliate your skin for 15 minutes.

Black tea bag compress

Tea bag compress is an effective way to reduce swelling thanks to its tannin content.

Tannin is a great anti-inflammatory and anti-bacterial agent.

Black tea helps alleviate irritation of the affected area.

While tea bag compress cannot treat ingrown hair cysts it can make you feel better.

It can be used before and after removal of ingrown hair cyst to reduce swelling and pain.

The main benefits of using tea bag compress are that it is inexpensive and contains no chemicals. 

How to use?

Take a tea bag of black tea.

Soak the tea bag in warm water for 5 minutes.

Take the tea bag out and put it in the fridge for 10 minutes.

Now take the tea bag and place it on ingrown hair cyst. Keep it there for about 15 minutes.

Remove and throw away the tea bag.

Repeat this every day to reduce the swelling.

Honey

Honey has been used for centuries for its medicinal properties.

It has anti-bacterial properties and using it has no side effects.

Another advantage of honey is that bacteria are not resistant to it. You can use honey directly on the ingrown hair cyst to treat the symptoms.

Or you can use it to prevent infections that might occur due to ingrown hair.

Honey can be used directly on affected skin or as a warm honey compress.

How to make and use a honey compress?

In a bowl take a few table spoons of warm water. Add a tablespoon of honey in to it. Now mix well.

Take a clean cotton cloth.

Dip it in to the mixture for a minute.

Remove excess water.

Now apply it on ingrown hair cyst for 10 minutes.

Repeat twice a day till the symptoms resolve.  

How to prevent ingrown hair cysts?

Prevention is better than treatment.

Below is a list of things that can help prevent ingrown hair cysts:

• Always make sure to remove hair in the direction of hair growth.
• Remove dead skin cells by scrubbing your skin. This will help reduce chances of ingrown hair cyst.
• Always apply a non-irritating lotion to the skin after hair removal.
• Use a sharp single blade razor for shaving.
• Wet your skin with water and lubricating gel before shaving.
• Shave in the direction of hair growth.
• Use as few strokes as possible.
• Rinse the blade after every stroke.
• Apply a cooling after shave lotion.
• Exfoliate the area you shave regularly. This helps prevent ingrowth of hair.   

Things to remember

Ingrown hair cysts are a bothersome problem.

They can be both irritating and painful and may appear on any part of the body, including eyelids, pubic area, arm pits or legs.

Ingrown hair is caused by intrinsic and extrinsic reasons. The intrinsic reasons are hormonal imbalance and curly hair.

The extrinsic reasons are shaving and waxing.

Treatment options for ingrown hair cyst ranges from medical treatments (corticosteroids, antibiotics, pain killers, cryoablation, epilation, laser removal, surgery, etc.) to natural home remedies (sugar, honey, baking soda, black tea, sea salt, eggs, tweezers, warm compress, etc.).

You should always go and see your doctor when suffering from ingrown hair cyst. He or she will examine you and provide you with the best treatment option based on various factors, such as size and site of the ingrown hair cyst, presence of any underlying skin or systemic diseases, etc.

If you want to prevent ingrown hair cysts, you should follow proper waxing and epilation procedures, use proper shaving technique and sharp razor blades. Good hygiene also helps.