Hair Removal

What is hair removal?

Hair is composed of protein and can be a sign of one's age and health. Hair protects the skin and head against trauma and ultraviolet light. It also insulates the skin against temperature changes and is a barrier to foreign objects.

Removing hair is almost always done for perceived cosmetic or social reasons. Certain hair removal techniques can damage the skin and produce dark spots that may last a long time.

  • Depilation is hair removal above the level of the pore (follicular opening).
  • Epilation is the damaging of both the hair and the hair bulb below the level of the skin surface.

What are the different types of hair?

All hair is dead protein. Hair's superficial appearance depends upon its anatomical location.

  • Fine poorly pigmented hair tends to grow on certain parts of the face like the upper cheeks and forehead.
  • Thick darker hairs grow on the edges of the eyelids and brows, the male jaw-line, the scalp, nostrils, and pubic areas.

These characteristics often change as one ages. The palms, soles, and the red portion of the lips do not have hair or hair follicles.

What are the pros and cons of electrolysis?

Electrolysis

What are the pros and cons of laser hair removal?

Laser light is absorbed by pigment in the hair causing the production of heat that can be used to destroy both the hair and adjacent tissues. When done correctly in the appropriate patient, only the follicular tissues are damaged resulting in local hairlessness for an extended period. The process may have to be repeated several times before there is any permanent result. Those with contrasting light skin color and dark hair are the easiest to treat whereas those in whom there is little color difference between skin and hair can be challenging. Those with darker skin often require lasers that generate longer wavelength light. Occasionally, it may be necessary to add an exogenous pigment to the hair if the hair is naturally uncolored. Laser hair removal is relatively expensive and should only be performed by an experienced operator. Laser hair removal can be painful. Poor results are frequently due to darkening of the treated skin and actual thermal burns. There are laser and light systems (Tria, E-ONE, Silk'n, and No!No! are trade names for use-at-home devices.) available for use at home by the untrained consumer. Whether this is a safe and effective approach to hair removal remains to be seen.

What are the pros and cons of shaving?

Depilation is hair removal above the level of the pore (follicular opening). Shaving is the most popular and cheapest type of depilation, and if performed safely, it results in a satisfactory appearance. To minimize follicular irritation (folliculitis), one should move the razor in the same direction that the hairs seem to be growing and pull the razor blade over the skin smoothly and evenly for only a single pass. It is important to use a good lubricant to reduce friction between the blade and the skin. It is also important to use a very sharp blade. Electric razors seem to be somewhat less likely to produce irritation, but repeated passes can produce folliculitis. The safe shaving technique does not produce perfectly smooth skin. There should be a short fragment of hair that remains, extending above the surface of the skin. Shaving must be repeated frequently. There are devices (No!No!) available for home use that "shave" hair by burning it close to the skin surface. This is probably no more effective than shaving.

SLIDESHOW

What are the pros and cons of depilatory creams?

Depilatory creams (Nair, Veet) rely on chemical means to destroy the hair shaft by breaking the disulfide bonds of the hair proteins. They require a three- to five-minute application to be effective. They produce a softer feel to the severed shaft than does shaving. Chemical depilatories may produce irritation or dermatitis in certain sensitive individuals.

What are the pros and cons of sugaring and waxing?

These are two ancient techniques used to remove hair over larger body surfaces. These methods involve applying a molten solution of sugar-impregnated cloth or wax. After these solutions solidify, they are abruptly yanked away from the skin, pulling out the adherent hairs. The hairs must be long enough to be "grabbed" by the material. These types of procedures can be quite painful. If the solutions are too hot, skin burns can occur.

What are the pros and cons of plucking and tweezing?

Plucking or pulling hairs out one at a time is a very effective but tedious method of depilation. This can result in sufficient inflammation to produce dark spots around plucked follicles. Permanent hair loss can ensue if plucking is performed repeatedly over long periods.

What are the pros and cons of twist-threading?

This is an ancient method of depilation popular in the Middle East. A skilled practitioner holds a twisted length of thread in one hand while the other end is held in the mouth or the other hand. Then hairs are trapped in the twisted thread and pulled out. Although this can be performed by oneself, it probably is more easily accomplished by a technician. It is reasonably costly and must be repeated frequently.

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Do any prescription medications or products stop hair growth?

There is a prescription medication, eflornithine cream (Vaniqa), that inhibits hair growth by inhibiting an enzyme in the hair follicle that is required for hair growth. This does not result in permanent hair removal since after the medication is no longer applied the enzyme reestablishes hair growth. Of note, many prescription medications for illnesses and conditions can affect the growth of hair as side effects.

Which hair-removal method provides the longest lasting results?

Epilating methodselectrolysis and laser hair treatment

References

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