Skincare Case 127

Discussion:

A 27-year-old female with Fitzpatrick skin type 6 and combination skin type presents with a persistent issue of ingrown hair, particularly following Brazilian or bikini waxing hair removal. Physical findings include raised, hard hair follicles, suggestive of underlying cysts or nodules.

Causes:

Ingrown hairs occur when hair grows back into the skin instead of rising up from it. This could be due to several reasons, including:

1. Curly or coarse hair: People with curly or coarse hair are more prone to developing ingrown hairs, particularly after hair removal.
2. Hair removal methods: Certain hair removal methods, like shaving, waxing, or plucking, can lead to a sharp tip on the hair, which can increase the likelihood of the hair curling back into the skin.
3. Clogged hair follicles: Dead skin can clog up a hair follicle, forcing the hair inside it to grow sideways under the skin, rather than upward and outward.

In this particular case, the client’s skin type (Fitzpatrick skin type 6) makes her more prone to developing post-inflammatory hyperpigmentation (PIH) from ingrown hairs and subsequent inflammation.

What’s Done Wrong:

1. Waxing: Waxing is a common cause of ingrown hairs because it can cause hair to grow back unevenly with a sharper edge. This sharper edge can easily re-enter the skin, leading to an ingrown hair.
2. Inadequate exfoliation: Regular exfoliation can help prevent ingrown hairs by removing dead skin cells that can clog hair follicles. If the client is not exfoliating regularly or effectively, this may contribute to the development of ingrown hairs.
3. Inadequate aftercare: After waxing, the skin needs to be treated gently to avoid inflammation and irritation that can lead to ingrown hairs. The use of a black tea bag for significantly inflamed spots might not be enough to reduce inflammation and soothe the skin.

Treatment Options:

1. Topical treatments: Over-the-counter creams, lotions, or serums containing salicylic acid, glycolic acid, or other hydroxy acids can help to exfoliate the skin and reduce inflammation.
2. Retinoids: Topical retinoids can help to speed up the skin’s natural exfoliation process and decrease the likelihood of pores becoming clogged.
3. Professional extraction: In some cases, a dermatologist or esthetician may need to extract the ingrown hair.
4. Laser hair removal: For persistent and severe cases of ingrown hairs, laser hair removal could be a viable option. This treatment destroys the hair follicle, preventing the hair from growing back.
5. Corticosteroid treatment: If the ingrown hair has caused inflammation and possible scarring, a topical corticosteroid may be prescribed to reduce inflammation and prevent further damage.

Office and Home Care:

1. Exfoliate regularly: Use a gentle exfoliating scrub or a brush to exfoliate the skin regularly, preferably a few days before waxing and continue regular exfoliation after waxing.
2. Moisturize: Keep the skin moisturized to prevent dryness and irritation. Look for non-comedogenic moisturizers that won’t clog pores.
3. Avoid tight clothing: Tight clothing can cause friction and exacerbate ingrown hairs, particularly in the bikini area. Try to wear loose, breathable clothing.
4. Warm compress: Apply a warm compress to the area before waxing to open up the pores and make hair removal easier.
5. Proper aftercare: Following hair removal, apply a soothing, anti-inflammatory product like aloe vera or witch hazel. Avoid using heavy creams or lotions immediately after hair removal that can clog the pores.
6. Over-the-counter treatments: Use over-the-counter products containing salicylic acid or glycolic acid to help prevent and treat ingrown hairs.

Prevention:

1. Change hair removal method: Consider switching to a hair removal method less likely to cause ingrown hairs. Laser hair removal, for example, can provide a more permanent solution.
2. Proper shaving technique: If shaving is preferred, use a sharp, single-blade razor. Wet the skin and hair with warm water before applying a shaving cream, and shave in the direction of hair growth.
3. Regular exfoliation and moisturizing: Regularly exfoliating the skin can help to remove dead skin cells that can clog pores. Keeping the skin moisturized can also help to prevent ingrown hairs.
4. Loose clothing: Wear loose clothing around the waxed area, especially around the bikini line, to reduce friction and irritation.

Detailed Home Care Daily Routine:

1. Morning routine: Cleanse the skin with a gentle, non-comedogenic cleanser. Follow up with a moisturizer suitable for combination skin. Apply sunscreen with an SPF of at least 30 to protect the skin, especially if using products containing exfoliating acids.
2. Evening routine: Cleanse the skin and apply an over-the-counter topical product containing salicylic acid or glycolic acid. These ingredients help to exfoliate the skin and can help to prevent and treat ingrown hairs.
3. Weekly routine: Exfoliate the skin 2-3 times per week. You can use a gentle scrub, a brush, or a product containing an exfoliating acid. Make sure to moisturize after exfoliating to keep the skin hydrated.
4. Before waxing: Prep the skin by applying a warm compress to open the pores. After waxing, apply a soothing, anti-inflammatory product and avoid heavy lotions or creams that could clog the pores.
5. Post-waxing care: For the next 24-48 hours, avoid hot baths, saunas, and intense physical activity that could cause sweating and potentially irritate the waxed area. Continue to apply soothing products and exfoliate the skin regularly to prevent ingrown hairs.

Remember that everyone’s skin is different, and what works for one person might not work for another. It might be necessary to adjust this routine to suit the individual’s skin response and comfort. Regular check-ins with a dermatologist or skincare professional can help ensure the routine is working and make necessary adjustments.