Archive for the ‘Hair Removal’ Category
Throughout my career in medical aesthetics, Pseudofolliculitis and ingrown hair has been a common concern. Often times it’s men who mistake the condition for acne, other times it’s someone who has had an infection and a doctor recommended they get laser hair removal. The bad news is, that it can be more serious than you might think. The good news is, it can be treated!
What is Pseudofolliculitis?
Pseudofolliculitis commonly known as “razor bumps” or “ingrown hair” is an inflammatory condition in the skin and hair follicle caused by shaving, waxing and ingrown hairs. Pseudofolliculitis can occur anywhere on the body hair grows, however it most commonly occurs on a mans beard and for women on the bikini and underarm area. It tends to be more common in those with curly or coarse hair.
There are two types of Pseudofolliculitis, extrafollicular and transfollicular. Extrafollicular pseudofolliculitis or “razor bumps” occur when curly hair grows back into a hair follicle. Transfollicular pseudofolliculitis or “ingrown hairs” occur when the hair never leaves the follicle, this can happen if the hair grows at an angle. The hair keratin causes inflammation in the skin, usually seen as pustules that look similar to acne.
Concerns and complications associated with Pseudofolliculitis?
Pseudofolliculitis can be painful, embarrassing but more concerning is that it can lead to scars, secondary infection or become abscessed. You may not think that an ingrown hair is a big deal, but it has been associated with serious secondary infections such as MRSA. When there is damage to the skin, it becomes more susceptible to bacteria such as Staphylococcus. It is not unusual for an ingrown hair to become infected with “staph” or become abscessed. In extreme cases, if left untreated staph can lead to a very serious blood infection known as sepsis. These infections can spread and be contagious. If you suspect an infection, you need to seek immediate medical attention.
Laser hair removal remains the best treatment option for Pseudofolliculitis. A series of treatments will be needed, generally spaced 4-6 weeks apart. Another option is to quit shaving, waxing or tweezing and let the hair grow, but if that doesn’t work for you there are some things you can try. When shaving, start with cleansing the area with an exfoliating cleanser that has glycolic acid or some type of an AHA. I also recommend the Clarisonic cleansing brush, which will help to lift the hair. Before you shave place a steamed towel over the area, being careful not to burn your self. For sanitary reasons, I prefer a new razor. Avoid shaving too close, do not stretch the skin or shave against the direction of growth. If you have pustules, you may also be prescribed a topical antibiotic.
Chemical peels and skin care products that contain chemical exfoliant can help with skin discolorations and help to prevent hair from becoming ingrown. - ” the reducing properties of glycolic acid may reduce sulfhydryl bonds in the hair shaft, resulting in straighter hair growth, and thereby may potentially reduce the chance for re-entry of the hair shaft into the epidermis. Salicylic acid peels offer exfoliation and lightening in cases complicated by PIH. Reduced numbers of PFB lesions have been observed with both glycolic acid and salicylic acid peels.” Expert Rev Dermatol. 2009;4(6):595 Dermatologic Conditions in Men of African Ancestry by Marcelyn K Coley, Andrew F Alexis
Laser hair removal for skin of color, is challenging, but possible. If you have dark skin, be sure to find a laser technician that is also a skin specialist and has experience treating your skin type. Your specialist may recommend preconditioning the area prior to having laser treatment, it is important to comply with all instructions. We make these recommendations to prevent you from getting a burn. They may also suggest doing a test spot first to see how you respond to the laser treatment.
Treating the scars
Pigmented scars are the most common and can be treated consecutively with laser hair removal treatments. Pigmented scars can usually be treated with prescription strength skin care products, and chemical peels. Depressed scars require a deep treatment such as micro-needling, fractional laser resurfacing or dermabrasion. It is best to treat depressed or raised scars when the condition is well controlled. Keloid scars are very complicated and need to be diagnosed and treated by a dermatologist. I want to specify that keloid scars need to be diagnosed by a dermatologist, because raised scars are sometimes confused with keloid scars.
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Hollywood bombshells Marilyn Monroe and Elizabeth Taylor are said to have shaved their face. Shaving offers more benefits than hair removal, it is an excellent form of exfoliation, especially when done professionally. Dermaplaning treatments are popular among Hollywood A-Listers
Dermaplaning also known as epidermal leveling, microplaning or bladeing, is a gentle form of manual exfoliation. A surgical blade is used to gently scrape facial skin removing the outer most layers of dead skin cells as well as fine facial hair, leaving skin completely smooth and baby soft. Exfoliating the skin stimulates the production of new skin and allows for better absorption of topical skin products. Dermaplaning can be done as an independent treatment or used to enhance other treatments such as chemical peels.
Dermaplaning is completely painless in-fact most people say it feels good and there is absolutely no down time. Treatments only take about 30 minuets and regular blading treatments are scheduled about 3-4 weeks apart.
How does the hair grow back?
Despite popular belief, the hair does not grow back thicker. Fine facial hair is known as Vellous hair and when it is shaved, cut or removed it grows back the same way. If there is any dark, coarse facial hair present, I usually recommend laser hair removal. Dermaplaning can be used to remove coarse facial hair, but keep in mind that it will grow back the same way.
What if I have acne?
I don’t recommend dermaplaning for acne skin. Acne begins in the hair follicle and when the hair is removed it can aggravate or stimulate acne breakouts. Microdermabrasion is another form of manual exfoliation, and it is more appropriate for acne prone skin.
Have you evolved?
Modern humans (Homo sapiens sapiens) have replaced primitive forms of hair removal with the more efficient laser hair removal.
Your not alone
According to the American Society of Plastic Surgeons, in 2009 alone, 159,000 men had laser hair removal treatments.
Laser hair removal requires a series of treatments, a minimum of 8 treatment is needed on non-facial areas such as the back. Treatments are generally done every 6-8 weeks. Most people will require periodic maintenance treatments, after the initial series of 8 treatments. You may be told that you will only need 5 treatments, this is almost never true. During a consultation you may be told that they use a laser that is “better” than others and they can remove your hair with fewer treatments. ( That is a BS) Laser hair removal is only effective on hair that is in the anogen stage of growth, regardless of the laser. You may only have only 10% of your hair that is in this cycle at any given time. Even if all of your hair falls out with a treatment, only the hair that was in the Anagen stage at the time of treatment will be permanently removed.
Laser hair removal feels similar to a hot rubber-band snap, so a topical numbing cream may be used to reduce discomfort.
Cost of treatment
A consultation is needed to determine the cost of treatment. Treatment cost is based on the size of the area to be treated, some men have only small patches of hair on their back and others are completely covered. Obviously a man that is 5’10” and 150 lbs is going to have a smaller back than a man that is 6’3″ and 300 lbs.
It is important to go to a reputable laser technician, with plenty of experience with laser hair removal. It is tempting to go to discount laser chains, however a little on-line research will show that these places tend to have a lot of consumer complaints, including burns and disputes over money.
Bikini Hair Removal: Styles and Terms
Many of the terms used to describe the styles for bikini hair removal are used interchangeably, so always be sure to communicate exactly what you want with the person doing your bikini hair removal treatment.
Basic = Hair is only removed from outside of the standard bikini panty line.
American = ( modified) Hair is removed a little deeper inside bikini line than the basic.
French = Hair is removed from the sides, leaving a thin strip on top. Hair is not removed from the labia, buttock or peri-anal area.
Brazilian = Hair is removed from the sides, buttock and peri-anal area, leaving a small strip or triangle. Hair is not removed from the labia. (* Brazilian is often used to describe full hair removal including labia, buttock and peri-anal area.
Playboy = Hair is removed everywhere including labia, buttock and peri-anal area, leaving only a small strip on top. This sometimes is called a “landing strip”
Hollywood = Everything is removed, leaving the area completely bare.
Bollywood = bejeweling the top of the bikini area, with crystals.
Before you dare go bare, down there ………
Choose the “best” to do your bikini hair removal treatment.
Remember that the person that does your bikini hair removal treatment will know you almost as intimately as your gynecologist. You will be asked to get in some compromising positions, in order to thoroughly remove unwanted hair. You should feel comfortable with this person, and trust their professional abilities.
As providers we know that these types of treatments can be embarrassing, but I promise you we have seen just about everything and we are not judging. We are in the business of treating all shapes, sizes and ages ……. I have treated men, women, transexuals. I have treated clients with piercings, tattoos, hemorrhoids, surgery scars and tampons.
If waxing is the hair removal method you choose, look for someone that is experienced in “extreme waxing”. An esthetician that specializes in this type of waxing will be fast, thorough and their technique will reduce your discomfort. Be sure to ask your waxer in advance, how long the hair needs to be for it to be waxed, generally about 1/4 an inch is recommended. The length of time between waxing treatments will vary individually, typically 4-6 weeks. Those who are new to waxing, should expect to schedule treatments closer together. It will be more comfortable if there is not as much regrowth. Bringing us to another important tip. If you are getting waxed for the first time, it is not recommended to do it just before a special “occasion”
If you want a more permanent solution for hair removal, laser is the way to go. Laser hair removal can be a little uncomfortable, applying a topical anesthetic cream to the treated area 30-45 minutes prior to treatment make a world of difference. Laser hair removal does require a series of treatments, typically 8 treatments, scheduled 6 weeks apart. Laser hair removal is only effective on hair that is in the follicle at the time of treatment, so it can not prevent potential follicles from producing hair in the future. After an initial series, occasional treatments may be needed to treat any new hair that may have grown. Laser treatments can have complications, including burns and scars, which is why it is important that treatment are performed by an experienced laser technician.
Most of the lasers used for hair removal target melanin. We want the laser energy to be absorbed by the melanin in the hair, not the melanin in the skin, so it is important to not tan the treated area. Always tell your laser technician the amount of UV exposure there has been to the treated area. For laser hair removal, the hair should be a short stubble. It is best if you shave the area, to the desired shape, 3-5 days before your treatment. You do not want to wax or tweeze hair before treatment, because the laser targets the melanin in the hair, so the hair needs to be in the follicle at the time of treatment. Immediately after your first treatment, there is usually little red bumps called follicular edema, this is expected where the hair is coarse and usually resolves within 24 hours. The hair typically takes about 2 weeks to fall out after each treatment and regrowth begins about 6 weeks after each treatment. All or most of the hair will fall out with each treatment, but only a percentage will be permanently removed with each treatment. You can expect less and less hair to grow back after each treatment.
What to Ask During Your Consultation
During your consultation, ask if you will see the same Esthetician or Laser Technician for every treatment. It is also important to know how long your provider has been waxing or performing laser hair removal treatments. You also want to find out how long your provider has been at that location. Consider it a red flag, if a clinic has high employee turnover. If you are considering laser hair removal, ask if they offer topical anesthetic and are there discounted prices after your initial series. When considering laser hair removal, be sure to find out who the medical director is and if they are on site at that location. Finally, be sure you understand all of the risks invoked with treatment and be honest when discussing things like sun exposure, previous treatments and skin or health condition.
Be sure to let your provider know if you are using retinoid products (tretinoin) or on oral Accutane (Isotretinoin)