Patient information · Dermatology
Shaving rash and ingrown hairs
a hair-shape problem, not a hygiene problem
Razor bumps happen when a shaved hair curls back and re-enters the skin, provoking inflammation. It affects people with tightly curled hair disproportionately — up to eight in ten Black men who shave — and left untreated it causes lasting dark marks and, in some, keloid scarring.
Seek assessment if there is
- spreading redness, swelling or pus, with fever
- painful lumps on the back of the neck that are enlarging or hardening
- rapidly growing raised scars extending beyond the original spots
- boils recurring in the armpits or groin as well — this may be hidradenitis
- lesions that are ulcerating or not healing
Acne keloidalis nuchae — firm papules and keloid scarring at the nape of the neck — is a related condition that scars permanently and should be treated early rather than shaved over. Hidradenitis suppurativa can present similarly in flexural sites.
Why it happens
Tightly curled hair grows in a curved follicle. Shaved close, the cut end is sharp and angled, and as it grows it either curves back into the skin surface or never fully exits the follicle. The body treats the hair as foreign material, producing a red inflamed bump, sometimes with pus. Repeated cycles leave post-inflammatory hyperpigmentation — dark marks that take months to fade — and in some people raised keloid scars.
Shaving technique
- Do not shave too close. This is the single most important change — the closer the shave, the more likely the hair retracts below the surface. Leave slight stubble.
- Prepare properly — wash with warm water for two to three minutes, or shave after a shower, and use a lubricating gel or cream rather than soap.
- Shave with the grain, in the direction of hair growth. Never against it, and avoid stretching the skin taut.
- One pass only, and rinse the blade constantly. Do not go over the same area repeatedly.
- Use a single-blade razor, an electric clipper with a guard, or a foil shaver — multi-blade cartridges cut below the skin surface, which is exactly the problem.
- Afterwards, rinse with cool water and apply a fragrance-free moisturiser. Avoid alcohol-based aftershaves.
Do not dig hairs out with a needle or tweezers
It is extremely tempting when you can see the loop of hair under the skin. It introduces infection, worsens the inflammation and substantially increases scarring and dark marks. If a hair is clearly looped over the surface, it can be gently lifted with a sterile needle without digging — but picking, squeezing and excavating make the outcome worse every time.
Treatment
- Stop shaving for two to four weeks if you possibly can — this alone allows most lesions to settle, and is the fastest route to clear skin.
- Topical treatments — a retinoid at night to reduce follicular plugging, benzoyl peroxide or a topical antibiotic for inflamed lesions, and azelaic acid, which treats both the inflammation and the dark marks.
- Chemical exfoliants containing glycolic or salicylic acid, used a few times a week.
- Oral antibiotics at anti-inflammatory dose for widespread or persistent inflammation.
- Short-term topical steroid for severe inflammation only — not long term on the face.
- Treat the dark marks separately, with azelaic acid, and daily SPF 50, which prevents them darkening further.
Laser hair reduction
Laser is the most effective long-term solution, reducing hair density so there is far less to grow back in. The device matters: a long-pulsed Nd:YAG laser is the appropriate choice for darker skin, as other wavelengths risk burns and pigment change. Several sessions are needed, and it is worth asking specifically which laser will be used and what experience the practitioner has with your skin type.
If shaving is required at work
Some employers, and some roles requiring respirator masks, expect a clean shave. Pseudofolliculitis barbae is a recognised medical condition, and it disproportionately affects Black men, so a blanket shaving policy can amount to indirect discrimination. A medical letter supporting a shaving waiver or an alternative arrangement is entirely reasonable to request, and we can provide one.
Why come to us. This is frequently dismissed as a shaving habit rather than treated as the skin condition it is. Our dermatology team can prescribe the retinoids, antibiotics and azelaic acid that are not available over the counter, treat the dark marks and any early keloid scarring, and provide a medical letter for a workplace shaving waiver where one is needed. We offer laser hair reduction on site with appropriate devices for darker skin. Seven days a week, no referral needed.
Prescription treatment, laser, and a letter for work
Dermatology and laser on site, appropriate devices for darker skin.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.