Paradoxical hypertrichosis after laser epilation

“The use of lasers to remove hair has become very popular in recent years. However, there are sometimes strange phenomena that occur when lasers are used to remove unwanted hair. On rare occasions, instead of removing hair, laser treatments can actually promote hair growth. This phenomena, known as hypertrichosisis, is paradoxical effect of laser epilation. The new hair growth is actually created in part by the effect of the laser although this effect and how it occurs is not yet completely understood. Scientists are now searching for a better understanding of the mechanism behind this paradoxical effect of laser induced hypertrichosis so as to prevent it in future cases.

In order to better understand this phenomenon, scientists set up an experiment using an alexandrite laser to remove the unwanted hair of 489 patients. The patients had all been customers at a single laser hair removal clinic at the University of British Columbia Dermatology Division in Canada, and were treated by trained nurses and supervised by board certified dermatologists. Out of these 489 patients, only 3 cases of laser induced hypertrichosis were identified, but these cases were enough to offer further information on this rare phenomenon.

The three patients who had experienced an increased amount of hair growth instead of a decrease became the focus of further study. Paradoxical hypertrichosis had been seen before in other cases, but it had not been so carefully watched. Scientists first identified the hypertrichosis in each of the three patients by noting an increase in hair density, hair color or hair coarseness after laser application. Once this definition was established, they began to examine each individual case more closely.

One of the patients who experienced this increase was a 39 year old Mediterranean woman with black hair. At first, when the laser was applied to an area with unwanted hair, the hair growth decreased just as it was supposed to. However, the continued applications of the laser resulted in increasingly stubborn hair that would simply not respond to the treatment. Eventually, the woman reported a gradual increase in hair density around that area rather than a decrease.

A second patient who experienced an increased quality of hair growth was a 30 year old white man with black hair on both his arms and his back. The man had wished to have some of this hair removed from his back, but the treatment was not successful. During the first three sessions, he experienced a positive result where the unwanted hair began to slowly disappear. However, further treatments began to require higher and higher intensities of laser light in order to be successful. After six visits to the clinic, the man began to notice an increase in hair growth rather than a decrease. This was only noticed at the specific locations where he had been receiving the treatments. Even with a further increase of laser intensity, there was no success and the man abandoned the treatment entirely.

The third patient who experienced laser induced hypertrichosis was a 21 year old Chinese man with black hair. Besides the common factor of black hair, which existed in all three of these patients, there was a similar skin type amongst them known as Fitzpatrick “Skin Type IV”. Skin type IV indicates a darker level of skin that rarely burns with sunlight exposure (as opposed to skin type I, which is very white skin that easily burns when exposed to sunlight). Out of six different skin types in the Fitzpatrick skin type classification; this skin type IV was the only type of skin that was known to have been adversely affected by laser hair removal treatment in any of the 489 patients. Hair color and skin type may have obviously contributed to the hypertrichosis because, just like the other two patients, this third Chinese man began to notice an increased growth after 11 days of the laser epilation.

The results of the testing were compiled and analyzed so that the most obvious cause of the hypertrichosis was determined to be a result of the laser epilation itself. This was evident from the fact that the increased hair growth only occurred in the areas that were treated by the laser but, more specifically, scientists have determined that the problem may be a result of the wrong intensity of laser light rather than just the laser light itself. These ideas are being tested further and it is the hope of scientists that a solution to this rare adverse hair growth occurrence can be corrected in type IV patients.”


Paradoxical hypertrichosis after laser epilation references

Alajlan A, Shapiro J, Rivers JK, MacDonald N, Wiggin J, Lui H. Paradoxical hypertrichosis after laser epilation. J Am Acad Dermatol. 2005 Jul;53(1):85-8. PMID: 15965427

Polycystic Ovary Syndrome (PCOS) and Hirsutism

“What exactly is PCOS and how does it cause hirsutism in our clients? PCOS is one of the most common endocrine disorders facing women today, affecting as many as five million

women in the U.S. It affects up to 10 percent of women of reproductive age (12 to 45 years) although it can be found in girls as young as seven or eight and women well past menopause.
This disorder is thought to be the leading cause of diminished capacity for fertility in women. Although PCOS is one of the leading causes of infertility, the reproductive aspects of the disorder are secondary as PCOS is not limited to women of reproductive age and may not improve after menopause.

PCOS is known as polycystic ovarian syndrome. Common symptoms of PCOS may include irregular or no menstrual periods for women of reproductive age; irregular ovulation with or without bleeding; severe acne including cystic acne; thinning scalp hair; excessive hair growth on face and body (hirsutism); build up of follicles on the edges of the ovaries, these are often mislabeled as “cysts” and called “polycystic ovaries.”
It is not necessary to have all of these symptoms to have PCOS and in fact, it is not necessary to have the “polycystic ovaries” to have PCOS.

Weight management issues are found in over 60 percent of those suffering from PCOS. This can lead to obesity even with normal caloric intake due to the glucose which is stored as fat instead of being used as energy, or being made available for other functions within the body. This can lead to chronic fatigue and under nourishment. It is important to note that 40 percent of women with PCOS exhibit normal weight and may even fall under the normal weight range. Insulin resistance and diabetes are also exhibited in those with PCOS. More than 50 percent of women with PCOS will have diabetes or impaired glucose tolerance(pre-diabetes) before the age of 40.
Acanthosis nigricans may also be present. This is the medical term for darkened, velvety skin on the nape of the neck, armpits, inner thighs, vulva, or under breasts. This skin condition is a sign of insulin resistance.

The risk of heart attack is almost seven times higher in women with PCOS than those without this condition. These women also have a greater risk of high blood pressure, stroke, higher LDL(bad)  cholesterol and low levels of HDL(good) cholesterol, and often develop sleep apnea, when breathing stops for short moments during sleep. PCOS sufferers may also develop anxiety and depression.
Women with PCOS may also be a risk for endometrial cancer. Estrogen is produced, but progesterone is not due to the irregular menstrual cycles and lack of ovulation. Without progesterone the lining of the womb, called endometrium, will become thick and will not shed during the menstrual period. Over time this can cause heavy or irregular bleeding and can lead to a condition where the lining grows too much and may cause cancer.

More than 75 percent of clients with PCOS have some level of hirsutism. This is an over production of the hormone, androgen. Hirsutism can be caused by an increased level of androgens or an oversensitivity of hair follicles to androgens. New studies implicate high circulating levels of insulin in women that contribute to the development of hirsutism. It is speculated that innsulin, at high enough concetration, stimulates the ovarian cells to produce androgens.

While the actual cause of PCOS is unknown, these factors likely play a role: Insulin is the hormone produced in the pancreas that allows cells to use sugar(glucose), it is the body’s primary energy supply. If the body has insulin resistance, the ability to use insulin effectively is impaired, and the pancreas has to secrete more insulin to make glucose available to cells. The excess insulin is thought to boost androgen production by the ovaries.

Heredity may also play a role in PCOS. If a female family member has PCOS, the client might have a greater chance of having it, too.

There is no specific test to definitely diagnose polycystic ovary syndrome. The diagnosis is one of exclusion. A medical history and physical exam will take menstrual cycles, weight, blood pressure, and various symptoms into consideration. A pelvic examination and ultrasound will inspect reproductive organs for signs of masses, growths, or other inconsistent abnormalities. Blood test will also be performed to measure hormones, cholesterol, and tryglyceride level.

Treatment of PCOS is usually centered on specific concerns. The physician might suggest regulating menstrual cycles through prescription medications. As professional electrologists we work with the PCOS clients to assist in removal of the excess hair associated with hirsutism. In addition to prescription medications, clients with PCOS might investigate more holistic or natural forms of care such as a diet rich with complex carbohydrates such as whole grains, brown rice, and beans; increased exercise program and supplements like alpha lipoic acids, B12 and B6, folic acid, vitamin D, magnesium, and cinnamon root.

Treatment of symptoms can often mask the underlying issues which can lead to more serious conditions, like diabetes and endometrial cancer, so a team approach to care includes a primary physician or ob/gyn, endocrinologist, dermatologist, nutritionist, physical trainer and electrologist!

Helping our clients deal with the hirsutism or acne associated with PCOS will alleviate some of the stress that goes along with this condition. Understanding the underlying causes and symptoms may allow you to help a client struggling with undiagnosed PCOS to seek a physician’s care and perhaps discover the answer to a long time health concern.”

by Nadine Toriello, The Society for Clinical & Medical Hair Removal, Inc

More on Electrolysis for PCOS

Seven Keys To Successful Hair Removal

“When it comes to permanent hair removal, getting each step just right is an art form! To achieve quick and permanent results, it is not enough to simply perform the treatments; one must be able to effectively combine all the necessary steps. Here are seven key factors to guarantee successful hair removal treatments to our clients.

1. Match the Right Treatment Option to Each Client

Initial consultation is required before any hair removal treatments can begin. During the first meeting, we obtain information about a client’s medical history, observe the condition of the skin, as well as the density and type of hair to be removed. Based on our observations, we will clearly explain the treatment options and anticipated results that will ensure client satisfaction.

2. Perform Treatments During the Right Phase of Hair Growth.

To achieve permanent hair removal, treatments must be performed during the anagen phase (growing stage) in order to fully destroy the hair. In fact, it is during this phase that the follicles contain the most cells responsible for hair growth, and hair has the most pigmentation. It is very important to plan treatments so as to allow for a maximum number of hairs to be synchronized into the growing stage.

3. Use the Best Equipment Available

The type of equipment your electrologist uses greatly impacts the treatment outcome. The higher the power level of the device, the faster you will achieve permanent results. It is clear that any electrolysis device, even decades old, can lead to permanent hair removal. However, achieving it will be longer and less comfortable for the client. Several options and resources can also improve the results. We use insulated probes that allow for more effective and targeted destruction of the growth cells, leading to quicker permanent results. WE offer all of our clients effective solutions and increased comfort level!

4. Choose the Most Suitable Treatment Parameters.

Every electrolysis expert must determine the most suitable treatment parameters to ensure the best results. Several factors influence the selection process: the individual hair type, the depth of the hair follicle, the particular area being treated, the growth phase and density, intensity level, et cetera. Usually, the greater the professional expertise, the better the evaluation.

5. Adopt Effective Work Methods

During electrolysis treatment a probe is inserted into each follicle. This technique of hair removal requires a high level of precision. The electrologist delicately inserts a probe the size of a hair into the follicle until it reaches the base. This is where the electric current must be emitted for the full and successful destruction of the growth cells to occur. A common myth about electrolysis is that treatments are painful. This is simply not true! Electrolysis treatments are quite comfortable, especially when the technique is correctly performed. A client should never feel anything when the probe is inserted or when the hair is extracted. The client should only feel a slight current lasting a few milliseconds.

6. Your Skin Needs Pampering

Did you know that well hydrated skin can tolerate heat more easily? We perform treatments using a safe but higher degree of heat so more growth cells will be effectively destroyed and the desired results will be achieved more quickly. You should use an exfoliant and moisturizer to treat your skin. Thoroughly moisturizing your skin the next day and on will promote healing and regeneration. All clients must apply protection against UV rays before and after the treatment. This will minimize the risk of hyperpigmentation.

7. Discipline is a Must

In order to achieve permanent results, treatments should be performed during anagen (growing) stage. It is absolutely essential for clients rigorously attend appointments which have been set according to the hair growth phase. If a client pushes back their appointments, they will not see success of the treatments in the shortest amount of time. In conclusion, there are several factors that influence the success of permanent hair removal. Proper training of the electrologist, the right device, well-informed and cooperative clients, and the exercise of sound professional judgment on the part of the electrologist all contribute to safe, comfortable, rapid, and above-all, effective treatments.”

Dermascope magazine, by Karine Beaumont

Does Electrolysis Treatment Hurt?

Electrolysis is a comfortable treatment but it is important to keep in mind that pain is a very subjective thing. The goal of electrolysis is to kill a hair follicle so there has to be enough current flowing into your hair follicle to destroy the cells responsible for hair growth. It is impossible to destroy hair growth tissue without at least some sensation because each hair follicle is surrounded by its own network of nerve endings. The sensation you might experience depends on many reasons including where one is having treatment and what method is used. Some parts of the body are more sensitive than others. The upper lip is a little more sensitive because the skin is thin, especially right beneath the nose. In many cases electrolysis on the upper lip stimulates sneezing. Also, as the skin is more sensitive around one’s menstrual cycle, very often we advise our clients to avoid treatment during that time. Our clients have described the sensation as a sting, a mosquito bite, a pinch or gradually building warmth.  Many adjustments can be made which help make the treatment more comfortable. We have a lot of young girls (as early as age 9) that we work on and in those cases we sometimes recommend a numbing cream. In all other cases our clients DO NOT require any type of numbing creams. We utilize the latest Apilus computerized state-of-the-art electrolysis equipment for the most comfortable and effective permanent hair removal procedure available.

*** A note to clients who had electrolysis treatments at other places: You should not feel the insertion of the probe. One of reasons that your previous treatments may have hurt a lot could be that the insertions of the probe into the hair follicle were wrong.