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Electricity and Medicine
Book excerpt
Date: 1910
Source: Plymmon Sanford Hayes. Electricity and the Methods of its Employment in Removing Superfluous Hair and Other Facial Blemishes. Hammond, Ind.: Frank S. Betz Co., 1910.
About the Author: Plymmon Sanford Hayes (1850–1894) was a physician who was particularly interested in dermatology, as well as in gynecology. He wrote fairly extensively on the use of electrosurgical methods in treatment of skin lesions and for removal of excessive facial hair growth. He was a professor of chemistry and toxicology at the Women's Medical College, professor of analytical chemistry at the Chicago College of Pharmacy, and professor of gynecology and of electro-therapeutics at the Chicago Polyclinic.
INTRODUCTION
Since the beginning of recorded history, people have been trying to improve their facial appearance. The ancient Egyptians used arsenic to treat skin cancer, and animal oils, salt, alabaster, and curdled milk to soften and smooth the skin. The Greeks and Romans combined pumice, tree resins, frankincense, and myrrh to lighten skin and to remove blemishes, lesions, and scarring. In Turkey, fire was used to slightly singe the skin, as an exfoliant; and in Indian, women used a mixture of pumice and urine for the same purposes. By the late 1800s, dermatologists had begun to use a variety of chemical compounds to reduce scarring and facial wrinkles.
The ancient Egyptians utilized sandpaper as a mechanical method for removing facial blemishes and eliminating scars. As recently as the early 1900s, dermatologists were using sandpaper in conjunction with motorized dermabrasion to remove scarring and improve skin texture.
The first scholarly mention of the use of electrolysis for hair removal was in 1875. Charles Michel, an ophthalmologist practicing in St. Louis, Missouri, had been searching for a way to treat his patients' ingrown eyelashes, which were both painful and a deterrent to clear vision. Michel tried a new technique in which he attached a surgical needle to a live electrical wire from a dry-cell battery, and inserted the needle down the length of the hair shaft to the follicle, where it remained for a period of several minutes. The follicle was destroyed, the strand came out easily, and the hair did not grow back. Michel coined the term electrolysis for this procedure, a term that remains in use today. The early machinery was crude, and the process was both slow and somewhat painful.
Electrosurgery, as it is more commonly called in modern times, has been used to destroy and to remove benign and malignant skin lesions since the early 1900s. The most common complications of surgery performed with electricity at that time were burns, shocks, and infection.
PRIMARY SOURCE
I cannot close without again emphasizing the fact that too often too strong a current is used, especially by those who are beginning the use of electrolysis in the treatment of facial blemishes. Remember that too strong a current may leave indelible marks behind, and that too weak a current may only necessitate your having to do a part of your work over again.
DON'TS
in Removing Superfluous Hair
Don't use a sharp-pointed needle.
Don't attach the needle to the positive pole.
Don't use too strong a current.
Don't continue the current long enough to leave a visible scar.
Don't remove two hairs in close proximity to each other.
Don't attempt the removal of a hair near an acne pustule.
In Removing Other Facial Blemishes by Means of Electrolysis
Don't use a blunt-pointed needle.
Don't use too weak a current.
Don't attempt the removal by electrolysis of a rapidly growing vascular nævus of more than one-third of an inch in diameter.
SIGNIFICANCE
After Willem Einthoven's (1860–1927) invention of the electrocardiograph in 1906, scientists and others quickly became fascinated with potential uses for electricity in medicine and health maintenance. Galvanic spectacles delivered a current across the bridge of the nose intended to stimulate the optic nerve and improve vision. Galvanic dumbbells delivered an electric current to help muscles contract while exercising, and led to later generations of electric exercise machines intended to accomplish the exercise for the user. "Electrotherapy" was used to treat conditions ranging from hysteria to circulation disorders, often in combination with massage therapy. For the first half of the twentieth century, the public struggled with determining which electric devices were actually therapeutic, and which stemmed from quackery.
In the present day, most significant skin problems are treated by dermatologists and dermatologic surgeons, who specialize in the treatment of diseases and disorders of the skin, hair, nails, veins, and surrounding tissues. Dermatologists are trained in the treatment and management of benign and malignant skin growths and skin cancers; they are able to offer palliative and restorative treatments for aging and sun-damaged skin; and they also are able to implement desired cosmetic improvements of the skin. The two most common forms of treatment for skin diseases, scarring, and lesions are electrosurgery and laser treatment.
Although people use a wide variety of home and other remedies for removing unwanted hair, the most common methods are electrolysis and laser treatment. Of the two, only electrolysis is able to advertise permanent hair removal by destruction and obliteration of the hair follicle.
Electrosurgery is used to destroy benign and malignant lesions, to control or eliminate bleeding, and to cut or excise unwanted tissue. There are four major electrosurgical modalities: electrodessication, fulguration, electrocoagulation, and electrosection. The electrical power used is determined by the desired results—so the general rule is to start out with low power and increase the output power until the desired result is obtained. In electrodessication, a live electrode is placed against, or inserted beneath, the skin in order to destroy the tissue immediately. In fulguration, the tip of the electrode is held just far enough away from the skin to produce a spark that travels to the skin's surface, producing shallow tissue destruction. Electrocoagulation is used to seal blood vessels. This technique is used to treat skin lesions caused by small blood vessels clustering near the surface of the skin. In electrosection, the electrode is used in place of a scalpel; the tip of the electrode is moved through the lesion in order to remove it in its entirety.
The potential complications of electrosurgery remain the same as they were a century ago: burns, shock, and infection. However, the incidence of complications is now very low, since the surgical process is sterile and precise. The equipment is built with redundant warning devices, and surgeons fine tune the current used to the desired outcome and to the physiologic responses of the individual. Wound care is accomplished with suturing, as necessary, and standard antiseptic treatment.
Lasers have been used in medicine since the 1960s, with increasingly more precision and technical advancement over time. Wave 3 lasers, in use since 1979, were first used for the removal of ingrown eyelashes (as a means of unwanted hair removal); they were found to be of some benefit. These lasers are most effective for treatment of some vascular and skin lesions, and for some types of tattoo removal. Lasers are not currently considered effective as a permanent means of hair removal, although laser treatment may reduce or delay the re-growth of unwanted hair. The laser light creates heat as it passes through the outer surface of the skin, and it targets melanin, the darker pigment found in both the follicle and the hair shaft. If the follicle is in an active growth phase when it is heated—even if it is still beneath the surface of the skin—it is no longer able to produce hair. The laser typically targets thousands of shafts of hair at any one time. According to the American Society for Dermatologic Surgery, some laser-treated areas have remained free of new hair growth for up to two years. Laser treatment is non-invasive and has minimal side effects if properly administered.
Electrolysis continues to be popular as a means of permanently removing unwanted hair. Invasive electrolysis involves the insertion of a sterile probe along the hair shaft to the base of the dermal papilla (the "root" of the hair). A low level electrical current is applied, the dermal papilla and its surrounding regenerative cells are destroyed, and the hair follicle is loosened and removed with a forceps. The hair is permanently destroyed. Although a considerable number of hairs can be destroyed during the course of a single session (depending on the patient's tolerance), multiple sessions are generally needed in order to remove a significant amount of hair. In addition, an electrologist can only remove visible hairs, so the treatment needs to occur over a period of time because of differing hair growth cycles and alternating periods of activity and dormancy within any single hair follicle.
FURTHER RESOURCES
Web sites
American Family Physician
American Society for Dermatologic Surgery. "Laser Applications." 〈http://www.asds-net.org/Patients/FactSheets/patients-Fact_Sheet-lasers.html〉 (accessed November 27, 2005).
American Society for Dermatologic Surgery. "Laser Hair Removal." 〈http://www.asds-net.org/Patients/FactSheets/patients-Fact_Sheet-laser_hair_removal.html〉 (accessed November 27, 2005).
ValleyLab. "Principles of Electrosurgery." 〈http://www.valleylab.com/education/poes/poes_02.html〉 (accessed November 25, 2005).
Medicine, Health, and Bioethics: Essential Primary Sources
