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Last Updated On: Jul 9, 2024
Between shaving, waxing, sugaring, threading, tweezing, creams and laser hair removal, it seems like the methods for removing unwanted body hair are endless. However, those options can look very different for people with eczema. Hair removal can be difficult since people with eczema are prone to easy triggers, potentially causing eczema flares or discomfort.
“Hair removal is common and there are many approaches from cutting, shaving, plucking and beyond,” said Dr. Peter Lio, dermatologist and clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine. “However, the hair follicle is an integral part of the skin and almost any approach to removing it can cause irritation, discomfort and the potential to aggravate eczema. While the easiest answer would be simply to avoid trying to remove hair for those with eczema or sensitive skin, that is simply not feasible for many patients who have unwanted hair. However, there are clearly more irritating treatments that should generally be avoided, and each patient must seek to find the least uncomfortable approach for their skin.”
Amanda Lopez, 42, from Corpus Christi, Texas, whose eczema ranges from mild to moderate, points out that hair removal is tough for people with eczema since many experience fluctuations in flares, including herself. “It changes all the time; it’s so tricky,” she said. “You have to navigate whatever symptoms you have, and so everything — your dressing, your grooming — is based on the current symptoms. It can be for a season, a year, a couple of weeks or months; it just depends on how quickly the flare will subside.”
Weighing your options
To determine which hair removal method is best for you, go on a case-by-case basis. “There are a number of considerations, from the type of removal, to the cost, to the potential side effects and even the frequency that it will be required,” said Dr. Lio, who is also the co-founder and co-director of the Chicago Integrative Eczema Center. “In general, patients with eczema and sensitive skin should talk to their dermatologist about what might be a good fit, taking into account their skin, their hair, the areas that have unwanted hair and other factors.”
If you’re experiencing an active flare, it’s best to avoid any type of hair removal. “It just depends on the type of symptoms that I have, which vary,” Lopez said. “The question is to shave or not to shave.”
Keep in mind that different hair removal methods can be used on different body hair areas. “It’s important to consider one’s skin sensitivity, hair density, amount and the areas that have unwanted hair — all of these can have a big impact on which method is used,” Dr. Lio said. “I think that most patients do use a combination of approaches: many people pluck eyebrow hairs, shave the axillae [underarm] and get laser hair removal on their legs, for example.”
No matter which option you choose, it’s always imperative to seek out an experienced practitioner. “Waxing is done in many spas, but there is — like any procedure — a range of skill and expertise that a practitioner may have,” Dr. Lio said. “It’s extremely important to find high-quality, experienced practitioners who will also help guide someone through the process and, of course, any potential adverse events that may occur. This is not a place to skimp or look for ‘deals’ for those who are sensitive.”
Pros and cons of each method
These are the most common hair removal methods and how they affect those with eczema:
Laser hair removal
“Laser hair removal is, in my opinion, one of the most well-tolerated when done properly,” Dr. Lio said. “Generally, I find that this is the least disruptive approach and — for many [eczema] patients — represents a great balance of safety and long-term efficacy, even given the higher initial costs. However, again, cutting corners can result in disastrous outcomes, from serious burns to very unpleasant post-inflammatory pigmentary change, so caution is key!”
Keep in mind that although laser hair removal can be “permanent,” it’s generally much more transparent to say that it is semi-permanent: even in the best cases, over time some hair can return.
Dr. Lio recommends seeing an experienced practitioner for laser hair removal and starting with a small test area first to make sure there isn’t a reaction. “This is a rapidly developing area of dermatology and there are multiple lasers and settings that can be used — ideally it is tuned to the individual by an expert,” he said. “It is generally less irritating than other approaches, but can cause pain, redness and even blistering in some cases. It also can be fairly expensive.”
Depilatory creams
Though they might seem gentle, depilatory creams can contain extremely irritating chemicals that can cause an eczema flare. Do a patch test first and try it on a small area of skin to ensure there isn’t an allergic reaction.
“This is another highly variable area, and there are multiple types of depilatory creams on the market,” Dr. Lio said. “It is important to follow the directions carefully in terms of timing — left on too long, it can be very damaging to the skin.”
Shaving
A tried and true favorite, shaving is a popular way to remove hair. “It turns out that the race for more razor blades is good for getting rid of hair, but is — for many — not so good for the skin,” Dr. Lio explained. “There are so many potential pitfalls with shaving: People can react to the shaving cream or gel, they can get an irritating dermatitis from the process of shaving, they can get secondary infections (usually Staph bacteria) from the micro cuts from shaving, given so many eczema patients have colonization with Staphylococcus aureus on the skin.”
To play it safe, Dr. Lio recommends using a single-blade razor, shaving with the grain of the hair (instead of against the grain), using sufficient amounts of a gentle shaving gel or cream preparation and going slowly and gently.
“I’m more of a shaver type of person, because for me, it’s the convenience,” Lopez said. To avoid irritation, she uses soap or shaving cream to protect her skin. As soon as she’s done, she rinses everything off and gently pats herself dry with super soft towels, which are easier on her skin. Next, she applies a body oil while her skin is still damp so that it absorbs it better, waits a few minutes and then tops it off with body cream.
Waxing
“Waxing can be better than shaving for some, but for other [eczema] patients it can be extremely irritating,” Dr. Lio said. “Particularly, for those with high hair density, it can cause both heat trauma as well as the mechanical trauma from pulling the wax and hairs, and that can result in an eczema flare,” he added. “The main tips are aiming to limit it for smaller areas, such as eyebrows, and always working with a seasoned practitioner.”
Sugaring
Considered a gentler alternative to waxing for sensitive skin, those with eczema should still proceed with caution and do a patch test first. “It’s highly variable how people will react [to sugaring] and very practitioner dependent,” Dr. Lio said.
Threading
A popular option for grooming brows, Dr. Lio suggests seeking an experienced threading professional and “starting with a small area first to make sure it is tolerated,” he said. Once again, reactions vary widely.
Tweezing
“A gentle touch here is key, and keeping the areas to a small size,” Dr. Lio said. “Tweezing larger areas can result in lots of irritation and increased blood flow that can trigger a flare.”
Amanda Lopez is a NEA Ambassador. If you’re an adult living with eczema or a caregiver of someone with eczema, join NEA Ambassadors.
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