Hair Removal

There are many reasons why people choose to remove their body hair; aesthetics, convenience, self esteem, cultural, religious, or medical reasons. Some medical indications for hair removal include hirsutism, hypertrichosis, ingrown hairs, and hair growth from skin graft donor sites.

There are 3 types of hair removal methods which can be achieved by different techniques. The three methods of hair removal include: temporary and permanent hair removal, and temporary hair reduction.

Temporary Hair Reduction Techniques

Laser Assisted

Lasers can be used to remove excessive and cosmetically disabling hair. Laser treatments are most effective on dark hair. It may take 3 to 6 months before regrowth occurs. Several treatment cycles are required and the time in between each cycle depends on the body area being treated.

How can the laser remove the hair?

The laser emits an invisible light, which penetrates the skin without damaging it. The pigments of the hair follicle absorb the laser light and the heat from the laser light selectively damages the pilous follicle, and damages the hair. Not only is the function of the follicle impaired but so is its ability to fabricate hair.

Is laser hair removal a permanent solution?

One generally speaks of extended periods of hair removal, with a decrease in the amount of hair and in their diameter. Thus, after each session and according to, the area of the body involved, one can notice increasingly long periods in-between hair removal sessions (4-6 weeks at the beginning).

How safe is laser hair removal?

Laser hair removal is an effective and proven method. Laser can be used as a medical device since it can be exactly tuned according each patient's type of skin, guaranteeing an effective treatment. Observance of instructions and precautions are essential for safe treatment. Thus, the use of a powerful device adapted to each skin type allows for effective and safe treatment. Complications are rare but superficial burns, pigmentary changes and even scarring may occur.

Temporary Hair Removal Techniques


Shaving is the method used most frequently to temporarily remove unwanted hair. Shaving is fast, easy, painless, effective, and inexpensive. Shaving is performed with a razor on wet skin using shaving cream or other lubricants, with the razor oriented against the direction of hair growth. Contrary to a widespread misconception, shaving does not result in increased hair growth. The primary disadvantages and/or adverse effects of shaving include skin irritation, cuts in the skin, ingrown hair, and the need to shave daily. Results are temporary, lasting 1-3 days.

Chemical Depilation

Depilatories have been described as chemical shaving. Depilatory creams are available in gel, cream, lotion, aerosol, and roll-on forms. They contain an alkaline chemical, usually calcium thioglycolate, that dissolves the protein structure of the hair and causes it to separate from the skin. Sometimes, chemical depilatories don't work very well for naturally "hairy" people. Some depilatories can increase acne and cause skin irritation or chemical burns if the formula is too strong or the cream left on too long. Depilatories cost $5-$10. Results last about a week.


Epilation is the term used to describe mechanical removal of body hair, including the hair root, by means of mechanical device, tweezer, threading, or waxing. Epilation is the most effective method for temporarily removing hair. Waxing is the most effective method of epilation because it removes hair completely from the hair shaft in large quantities.

  • Mechanical machines
    Mechanical epilators have a rubber roller or coiled spring that is rotated by an electric motor. It catches the hair and pulls it out from the roots. The speed of the rollers or the coiled spring can also be adjusted in some models. The epilator may have the option of regulating the tweezer strength which can be modified according to the type of hair (coarse or fine) that needs to be removed. Hair must be about 1/4 to 1/3 inches long for the epilators to work. Epilators should be used with caution in sensitive areas such as face, genitals, or armpits because it can be extremely painful. Mechanical epilators cost anywhere from $50-$100 and results last about a week.
  • Plucking
    Plucking is performed using hand-held or electrical tweezers. Hand-held tweezers are best used for removing the occasional coarse hair or a small group of hairs, such as those found on the eyebrows, chin or nipples. Tweezing pulls hair out from its root, but is a very laborious method since each hair must be removed individually. Some pain, skin irritation, and inflammation of the hair follicle can occur. Tweezers cost anywhere from $3-$30 and results last about 3-8 weeks.
  • Threading
    Threading is an ancient method of hair removal still used in many countries in the Middle East and India. The technique involves a long loop of cotton thread that is twisted and rolled along the surface of the skin. Hair is caught within the entwined coils and pulled from their roots as the thread rolls along.

    It is used to give clean lines and is good for shaping eyebrows and removing hair from the upper lip and other facial areas. It is considered to be less painful than plucking, waxing and sugaring.
  • Abrasives
    These work by physically rubbing away hair form the skin surface. Abrasives used include pumice stones and devices or gloves made from fine sandpaper. This method irritates the skin and is seldom used these days.
  • Sugaring
    Sugaring is similar to waxing but instead of using wax a sugar mixture is used. The sugar mixture is made up of sugar, lemon juice and water heated together to form a paste. Like waxing, a thin layer of sugar paste is applied to the skin and a cotton strip placed on top. The strip is then pulled back sharply against the direction of the hair growth. Sugaring is a suitable alternative to waxing for people sensitive to wax.
  • Waxing
    Waxing is an effective method of removing unwanted hair in both large and small areas. Waxing is one method of epilation, which means that the entire hair shaft is removed from below the skin's surface. It is one of the most effective methods for temporary hair removal.

    Waxing can be painful, particularly in sensitive areas. Pain experienced, however, depends on the pain threshold of each individual. Waxing can cause redness and increase skin sensitivity for a few hours. If you're using oral retinoids (isotretinoin and acitretin), waxing should not be performed until these medications are stopped for at least 6 months to 1 year. Taking these medications and waxing may cause tearing of the skin and possible scarring. Individuals using topical retinoids (e.g. Retin A?) should stop the medication 3-4 weeks prior to.

    Waxing should not be performed on skin that is irritated, sunburned or broken.

How effective is waxing?

Waxing is one of the most effective methods of epilation because hair is removed completely from the hair shaft in large quantities. After waxing it may take 2-3 weeks for hair to regrow. It is unknown what the long-term effects of repeated waxing have on hair growth but the repeated damage to the hair follicles may result in permanent reduction of unwanted hair.

Precautions to waxing

It is very important not to have the wax too hot to avoid burning the skin. Side effects from waxing include pain, folliculitis, scarring, hyperpigmentation, ingrown hair.

Permanent Hair Removal Techniques


Electrolysis and laser hair removal are the only methods that may provide a permanent result. Electrolysis involves the insertion of a small fine needle into the hair follicle, followed by a small electrical current that damages and eventually destroys the hair follicle. There are 3 different methods (modalities) to achieve this:

  • Galvanic electrolysis
    This uses direct electric current passed down a needle into the hair follicle where it creates a chemical reaction. This reaction converts tissue saline into sodium hydroxide, a caustic agent that then destroys the hair bulb.
  • Thermolysis
    This uses a high frequency alternating current that is passed down through the needle to the hair follicle. The high frequency causes vibration in the cells of the hair follicle to produce enough heat to cauterize the hair bulb.
  • Blend Method
    This combines both the galvanic and thermolysis modalities. No clinical trials have been carried out to compare the methods and any claims of one method being more effective over the other is based on anecdotal evidence only.

How effective is electrolysis?

Effectiveness of electrolysis is dependent on the skill of the technician (electrologist) performing the procedure. Proper electrolysis requires accurate needle insertion technique and use of appropriate intensity and duration of current. The technician, based on the patient's pain threshold, sets the intensity measured in milliamps, Electrolysis is a very slow method of hair removal that may also be prolonged by having to do repeat insertions into the hair follicle. The amount of pain experienced during the procedure is dependent on the individual's pain threshold. Topical anaesthetic creams applied one hour before the procedure may help to reduce discomfort. However, it is desirable to maintain some sensation as the pain is related to the amount of damage to the hair follicle.


Some degree of redness about treated hair follicles for a few days is not uncommon. Potential risks of electrolysis include scarring and increased or reduced pigmentation i.e. brown or white marks. Secondary local infection with bacteria, (impetigo), or reactivation of herpes simplex are also possible complications. It should not be used for patients with pacemakers because it can interrupt the electronics to cause potentially dangerous heart rhythms.

This article on Burn Surgery was provided to by Dunya Atisha, M.D.

This information is intended only as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor does it guarantee results of your elective surgery. Further details regarding surgical standards and procedures should be discussed with your physician.

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