Unwanted hair is common on the upper lip, the chin, cheeks, on the back, legs, fingers, feet, or toes. It can be caused by a variety of factors, including genetics, certain medications such as hormones or steroids, or even medical abnormalities, such as higher androgen (male hormone) levels or conditions of the endocrine system, such as polycystic ovarian syndrome.
There are many options available to remove unwanted hair, but few options to get rid of hair permanently. The different methods of hair removal from the old stand-by, shaving, to the new treatments, lasers and Vaniqa, are discussed here. Each person should chose a method or combination of methods that works best for them depending on cost, time available, skin type, and the desired hair-free area.
Understanding how hair grows helps us understand how to keep hair from growing. Each hair is contained in a pilosebaceous unit, which consists of a hair shaft, hair follicle, sebaceous gland, and erector pili muscle. Hair growth and shedding is a continuous cycle through 3 phases. The anagen phase is the growth phase, the catagen phase is a transitional state, and the telogen phase is the resting phase. Hairs spend a variable amount of time in each phase determined by genetics, hormones, and area of the body. Hair in the anagen phase is more susceptible to injury than hair in the telogen phase. All of these factors must be considered when choosing a method of hair removal.
Bleaching is actually not a hair removal method, but rather a way to make the hair less noticeable. This is especially useful for areas that already have thin but dark and therefore noticeable hair like the arms, face, or neck. Bleaching is performed by applying a chemical to the desired area, which removes the pigment from the hair.
Shaving is the most temporary method of hair removal because it merely cuts the hair off at the skin surface. Shaving does not make the hair shaft thicker, darker, or grow faster or slower. However, the short hair shaft may be more noticeable as it grows out because it has a blunt tip instead of the normal tapered tip. Shaving should be done after applying some type of moisturizer to the skin to help the razor glide over the skin, not cut or scrape it. Common moisturizers include water, shaving cream, hair conditioner, or body wash.
Physical Hair Removal
Physically pulling the hair out of the follicle is a common and fairly inexpensive method of hair removal. None of these methods changes the color, texture, or density of the hair. The hair takes longer to grow back because it must grow to the surface of the skin before it is noticed. Because hair grows at different rates, some of the hair that has been physically removed may take more time to grow back in. Repeatedly pulling hair out of the follicle may damage the follicle enough over time to keep it from producing more hair.
Plucking hair with tweezers is an effective way to remove hair but can be very time consuming. The hair shaft must be long enough to grasp with tweezers.
Waxing is an effective method of removing large amounts of hair at one time. In this method wax is warmed to allow it to be spread easily over the skin in the direction of hair growth. The hair becomes embedded in the wax, which cools and firms up grasping the hair. The wax is then quickly pulled off in the opposite direction of the hair growth, pulling the hairs out of the follicles. Cold waxes are available usually attached to strips, which are patted onto the skin. Wax that is still left on the skin must be peeled or scratched off. Caution must be used when heating wax so as not to burn the skin.
Sugar waxing is a popular form of hair removal that works in the same way traditional waxing does. A thick sugary substance similar to caramel is spread on the skin in the direction of hair growth. The hair becomes embedded in the caramel. A cloth or paper strip is patted onto the caramel and then pulled off quickly in the opposite direction of the hair growth, pulling the hairs out of the follicles. The advantage of this method over traditional waxing is the clean up. The sugar substance is water-soluble and can be removed easier than wax by rinsing with water.
Depilatories use a chemical called thioglycolate mixed with sodium hydroxide or calcium hydroxide to literally melt the hair away. Thioglycolate disrupts disulfide bonds, which are chemical bonds that hold skin and hair cells together. The disulfide bonds that hold hair together contain more of the protein cystine than do the disulfide bonds that hold skin cells together. Thioglycolate is more effective on disulfide bonds that contain cystine. The major side effect of a depilatory is skin irritation because the chemical can melt away skin cells.
A depilatory is applied to the area with unwanted hair and left on for 3 to 15 minutes. During this time the chemical dissolves the hair and the resulting jelly-like substance is wiped or washed off after the appropriate time. The chemical should be tested first on a small skin area at least 48 hours before applying it to a large area. Applying a hydrocortisone cream after hair removal may help decrease irritation.
Electrolysis involves inserting a fine needle into the hair follicle and applying an electrical current to the follicle root. This procedure actually burns the hair root theoretically preventing it from producing more hair. Each hair follicle must be treated individually and may take several treatments to destroy the follicle. Electrolysis is a permanent form of hair removal but it has several drawbacks.
First, there are no standardized licensing guidelines for electrolysis so finding an experienced, effective technician is difficult requiring talking to clients who have experienced permanent results. Second, this method requires repeated treatments for up to 12 to 18 months. Hair follicles that are in the telogen phase are more difficult to destroy than hair follicles in the anagen phase. Shaving approximately 3 days before an electrolysis treatment ensures that the hairs that are visible are in the anagen phase. Finally, side effects can include pain, infection, keloid formation (for people who are susceptible), hyperpigmentation, or hypopigmentation.
Laser treatment of various skin conditions has blossomed, as laser technology has become more understood. Hair removal is a common application of laser technology, but it is not permanent and not for everyone. Lasers work by emitting light at various wavelengths, energy output, and pulse widths. The wavelength used determines the skin structure it will affect such as veins, melanin, or water.
Most lasers used for hair removal target melanin and are therefore designed to burn structures that contain melanin. The more melanin, the more damage. It makes sense that laser hair removal works best for light-skinned people with dark hair. As with electrolysis, hair follicles in the anagen phase are more easily destroyed than those in the telogen phase. Therefore, laser treatments for hair removal must be repeated. At this time it appears that laser treatment, while not causing permanent destruction of all hair follicles, does retard the regrowth of new hair.
Vaniqa is a prescription-only topical cream that has been FDA-approved for reducing and inhibiting the growth of unwanted facial hair. The active ingredient in Vaniqa is eflornithine hydrochloride, which has been used to treat African sleeping sickness and certain cancers. Vaniqa works by inhibiting an enzyme that is needed for cell reproduction and other cell functions necessary for hair growth. Vaniqa is applied twice a day to areas of unwanted facial hair. Noticeable results are usually observed after 4-8 weeks of therapy. Application must be continued for as long as inhibition of hair growth is desired. Vaniqa continues to reduce facial hair growth for up to 8 weeks after discontinuing.