A Dermatologist Comments on Hair Removal Methods

Question 1: I am a 55-year-old woman with facial hair. Originally, I used depilatories (like Nair), but they irritate my light, sensitive skin. I don't think shaving is practical and I'm concerned that electrolysis would be painful. What do you suggest?

Question 2: I'm tired of shaving my legs. In a previous column, you answered a question about electrolysis. What about laser? Is one better than the other? If I try laser or electrolysis, will the hair just grow back thicker anyway?

Dr. Mitchell answers:
Thick, dark hair above a woman's lip or on her chin can sometimes run in families. However, this nuisance should first be distinguished from abnormal hair growth due to a medical problem like polycystic ovary syndrome or a testosterone-producing tumor. Treating the underlying medical problem, when it exists, will treat the excess facial hair.

If you do indeed have a benign form of hair overgrowth, Dr. Janet Fairley, a Medical College of Wisconsin Professor of Dermatology who practices at the Zablocki VA Medical Center, lists several options: shaving, tweezing, waxing, chemical removal like depilatories, and permanent removal (electrolysis or laser). A prescription cream called Vaniqa (eflornithine) can also chemically inhibit hair growth. Remember that for any product applied to the skin, be it wax, depilatory, or prescription cream, first test the product on a small area to be sure you do not have an allergic reaction or display hypersensitivity and, of course, follow the package directions.

Electrolysis applies electric current to individual hairs and destroys the hair root. However, because sometimes the electrolysis needle isn't on target, you often need several treatment sessions to completely remove all hair in a particular area. If you are using electrolysis for a large area, like your legs, you may require many months of weekly appointments. Dr. Fairley warns that this may become costly.

For a small area like your face, electrolysis may be an option. Make an appointment to discuss what your treatment plan would be. Choose an electrologist wisely to minimize risks of infection and scarring. In Wisconsin, electrologists must be licensed by the state board of cosmetology, but there are no national standards. Look for members of the International Guild of Hair Removal Specialists, the American Electrology Association or the Society for Clinical and Medical Hair Removal.

Dr. Fairley tells me that laser is a more effective way to remove hair from large areas such as the legs. Laser works by killing hair follicles with heat. First a black-colored solution is applied to the legs, and this solution is absorbed by the hair follicles. The laser then targets its heat to the black spots.

But laser is relatively more expensive, and it still isn't perfect. A recent study showed that laser therapy removed about 30% of hair in about two-thirds of people undergoing treatment. So again, multiple visits may be necessary. Most people decide how to treat excess hair based on cost, convenience, and/or a nearby or recommended practitioner.

Dr. Fairley also clears up a myth: no method of hair removal has ever been shown to result in an increase in hair growth. Shaven hairs sometimes appear thicker than hair that has been allowed to grow, and thus, with time, have a weakened shaft and softer ends, but they aren't actually any thicker.