The removal of excess facial, leg, underarm, chest and back hair has become increasingly more popular with both men and women as part of the standard grooming and hygiene process. This demand for proven methods of hair removal has brought about many new advances and improvements in effective hair removal.
Sometimes, though, hair can be an esthetic embarrassment because there is too much of it, or too much of it in the wrong place. For example:
- Visible hair above the upper lip or on the chin may be welcomed by a man, but be definitely unwelcome for a woman.
- Shaggy eyebrows may reinforce “character” for a man, but detract from the feminine character of a woman.
- Underarm (axillary) hair may be an esthetic negative for both men and women, depending on cultural and social circumstances.
- Sleek, hairless legs may be a necessity for a man or a woman whose social milieu demands the appearance influenced by cultural circumstance, advertising and mass media entertainment role modeling.
Hair in excessive amount or in an esthetically inappropriate site may be an indication of genetic inheritance (See Genes and Hair Growth and Hair Loss), or of a medical condition:
Defining Excessive Hair
- Hypertrichosis is a medical term for hair density and hair length that are abnormal for a person’s age, sex and genetic heritage-for example, long, dense, shaggy hair on the body, face or limbs. Hypertrichosis is usually due to an underlying disease or other cause such as the effect of anti-cancer or other medications. It is distinct from hirsutism because hair growth is at sites not influenced by androgenic (male) hormones.
- Hirsutism is a condition of excess hair growth in women at sites where women typically have little or no hair (chin, above the upper lip, chest). Hirsutism is caused by a disease process such as polycystic ovaries or adrenal gland tumor that influences production of androgenic (male) hormones.
Hypertrichosis and hirsutism are conditions requiring medical diagnosis and treatment. Both conditions cause hair growth that may be removed by any of the hair removal techniques.
Neither hypertrichosis nor hirsutism is the cause of most esthetically embarrassing “misplaced” hair. Genetic heritage is the controlling factor in amount and placement of hair in the majority of adult men and women.
Hair Removal Methods
Laser Hair Removal
Laser hair removal can be performed on any part of the body.
How It Works
Laser hair removal is based on the principle that wavelengths of laser light are selectively absorbed by a target material. For hair removal, laser wavelengths are absorbed by melanin, the coloring pigment of hair (see Hair Color: Biology, Mythology and Chemistry). When the intense laser energy beam is absorbed by melanin, the melanin transmutes laser energy into heat energy. The heat energy destroys all (or most) melanin-containing cells in the hair and hair follicle.
Lasers currently used for hair removal use light wavelengths that target eumelanin, the coloring pigment of brown and black hair. Dark hair of large cross-section (“coarse hair”) has rendered the best results from laser removal. Because pheomelanin, the relatively colorless coloring pigment of blond and red hair is not affected, red and blond hair cannot be removed by laser treatment. Newer technology used in Intense Pulsed Light (IPL) instruments creates a range of wavelengths rather than a coordinate beam of a single wavelength; IPL technology offers the possibility of targeting a variety of melanin hues.
How It Is Done
The hair removal laser or IPL generator is contained in a box-shaped instrument. The instrument is pressed firmly against the skin where hair is to be treated. Pressing the instrument firmly against the skin assures that (1) all of the laser energy is focused upon the treatment site, and (2) prevents accidental leakage of laser light into the environment where it could damage someone’s eyes even in an adjoining room. During laser treatment, the eyes of the treating physician and assistants are protected by goggles and the patient’s eyes are protected by goggles or covered with opaque patches.
How a laser hair removal session is conducted is influenced by characteristics of the individual patient-for example, hair pigmentation, skin color, skin thickness and any previous skin conditions. The number of laser pulses directed at a specific site to assure adequate “kill”, the number of sites treated at one session, and the duration of a session can all be influenced by patient characteristics.
Laser hair removal is a medical procedure. As with preparation for any medical procedure, the patient undergoes a physical examination and is questioned regarding medical history and medications currently being taken.
Side Effects, Outcomes and Cost
Hair removal by laser or IPL treatment usually requires several sessions to realize the optimal result. Sessions are scheduled several weeks apart. The same sites may be treated several times to assure maximum “kill” of hair follicles. Some follicles are destroyed by treatment but others may be resistant to laser treatment and require multiple procedures.
Laser hair removal is permanent for some patients; other patients may experience regrowth of hair from treatment-resistant hair follicles, or if the procedure was performed by an operator with inadequate training in laser hair removal.
Side effects of laser hair removal may include:
- Unpleasant warmth at a site being treated, a side effect alleviated by cooling with air or a spray;
- Post-treatment lightening or darkening of skin at treatment sites-usually temporary; and,
- Rarely, post-treatment oozing and crusting at a treatment site.
Cost of laser hair removal varies greatly, depending on variables such as number of sessions required. Cost should be discussed with the physician before treatment is undertaken. The patient should find out, before treatment, whether medical insurance will cover all or part of the treatment cost.
Hair Removal by Electrolysis
Hair removal by electrolysis has been around for a hundred-plus years. When done correctly by a trained professional, it can be a permanent method of hair removal. Done incorrectly, it can be a disappointment, can perhaps cause permanent skin injury, and will be a regretted expense. The permanence of hair removal by electrolysis depends upon the assured destruction of hair follicles. The procedures and instruments of electrolysis evolved over its long history. The basic principle remained the same-to remove hair by destroying the hair follicle with heat or a chemical reaction initiated by an electric current. The basic instrument of electrolysis is a needle or stylus that is placed into a hair follicle and used to deliver an electric current. The electrolysis technique called thermolysis uses alternating current to generate heat in the follicular tissue. The technique called galvanic electrolysis uses direct current to initiate a destructive chemical reaction inside the follicle. The electrolysis technique accomplishes hair removal by destroying hair follicles one at a time. After follicle destruction, the resident hair in the follicle is extracted. Electrolysis hair removal should be performed by a trained professional who has received certification from an accredited school of electrology, and is licensed in a state that requires licensing of electrologists. Although electrolysis instruments (“tweezers”) are sold for home use, the procedure does not destroy hair follicles.
The cost of electrolysis hair removal varies, depending on variables such as number of sessions required for optimal result; the principal side effect of electrolysis is a slight, temporary reddening of skin at treatment sites.
Hair Removal by Shaving & Plucking
Shaving is a very temporary method of hair removal. Hair is cut off at skin level and grows out to visibility within a day or two. Plucking has a somewhat longer lasting effect because it extracts hair from follicles at “root” level. Hair regrowth may not be visible for a week or longer.
Hair Removal by Waxing & Sugaring
The waxing procedure of hair removal should be performed by a trained cosmetologist or under the supervision of a cosmetologist in a professional beauty salon. It is a procedure that could potentially harm a person with medical conditions such as a bleeding disorder, poor blood circulation, varicose veins, skin infection or irritation, or poorly controlled diabetes. Waxing should not be carried out on anyone who uses, or who has recently used an acne medication such as isotretinoin (Accutane). Skin areas with moles, warts, sunburn, and chapping or allergic dermatitis should not be waxed.
Waxing removes hair “by the roots”, extracting it from hair follicles. Because the follicles are not destroyed, they will produce new hair that will become visible in a few weeks. Repeated waxing may eventually damage hair follicles and render them able to produce only wispy, fine hairs.
The waxing procedure is carried out by covering the area to be treated with a thin layer of a wax especially compounded for the waxing procedure. When the wax cools, it is pulled forcefully off the skin, removing loose skin cells and pulling hair out of hair follicles. Side effects of waxing include pain when the wax is pulled off the skin, minor bleeding at hair-removal sites, and misdirected new hair growth after the procedure that may result in ingrown hairs. The cost of waxing varies, but cost is typically substantial.
The hair removal technique called “sugaring” is similar to waxing. It is a home-use technique with a long history as a folk remedy. Sugar and lemon or other fruit juice are mixed with water and boiled down to a thick paste. The paste is applied to the skin like icing to a cake, allowed to cool, then peeled rapidly off the skin to strip hair from hair follicles.
Hair Removal by Chemical Cream
Chemical depilation (hair removal) is almost always a do-it-yourself procedure, done at home with over-the-counter products. Its main advantages are in being inexpensive, convenient and quickly done. Its main disadvantage is that hair removal is temporary and must be frequently repeated.
The typical chemical depilatory contains a thioglycolate as the active ingredient. Thioglycolates attack the proteins (keratins) that provide structure and strength to hair (Click on Hair Science: How and Why Hair Grows and Hair as a Biologic Fiber). The structural proteins are effectively turned into a mush that is scraped off with the depilatory after the depilatory has done its job. Hair follicles are not affected by chemical depilation; they can begin to regrow hair immediately. Thus, chemical depilation is very temporary and must be repeated frequently to maintain its effect. Unless specifically labeled otherwise, chemical depilatories should not be used on facial skin and especially not near the eyes.
Eflornithine (brand name Vaniqa) is a newer medication that retards hair growth but does not remove hair. The U.S. Food and Drug Administration approved it for use in retarding growth of facial hair in women. Eflornithine is available only by prescription after medical examination and diagnosis by a physician.
Hair Lightening By Bleaching
Bleaching body or facial hair is not a method of hair removal, but it can make the hair appear less visible by lightening the color of hair to light blonde. Bleaching is an attractive, inexpensive in-home option to professional hair removal because large areas of hair can be bleached, often with less pain and irritation than other hair removal methods. Results typically last from 2- 6 weeks.