Depilation and epilation: the mechanism of action, the technique of conducting, indications and contraindications

Most women and men constantly remove unwanted hair. However, the discomfort associated with unnecessary hair, excites all to varying degrees. Some people use a shaving machine or wax, without suffering at all because it has to be done frequently and regularly. Someone wants to solve the problem once and for all, trying to find the best way for themselves. And accordingly, to solve this problem, there are two approaches - depilation and hair removal.

Depilation - removal of the hair shaft, located above the surface of the skin, or "for a while".

Epilation - removal of hair with the root part, which causes damage to the hair follicle, or "forever". Depending on the task, customers can choose hair removal at home (plucking, shaving, chemical depilation), in the salon (wax depilation, electro-epilation) or in the centers of aesthetic medicine (all methods of hair removal).

In addition to women who come to the procedure for removing unwanted hair in order to improve their appearance, specialists are desperately turned to those for whom excess hair is already a symptom of a serious medical condition. After watching a beautiful advertisement, patients wait for a miracle and demand it from a doctor. In order not to provoke frustration, the doctor already during the first conversation should talk about real opportunities and explain the mechanism of the proposed method in this or that problem. First of all, it will be about hirsutism, hypertrichosis.

Hirsutism refers to excess hair growth in androgen-dependent zones, due to increased levels of circulating androgens (or hypersensitivity of hair follicles to normal androgen levels). The most frequent forms of hirsutism are idiopathic (constitutional, or primary) and secondary, associated with endocrine disorders. More rarely, the cause of hirsutism is the intake of androgenic or anabolic drugs. Idiopathic hirsutism occurs in boric women of some ethnic groups, with the level of androgens. They may be within the norm or slightly above the norm.

The most common causes of secondary hirsutism associated with ectocrine disorders are adrenal diseases, ovarian diseases, etc.

Diagnosis of hirsutism is based on clinical manifestations of the disease. Excess hair can be either thin or rough pigmented, and the excess hair itself can be limited to one or more anatomical areas. D Ferriman
(1961) defined hirsutism in women by the degree of hair growth in 11 zones, 9 of which are androgen-dependent: upper lip, chin, chest, upper back, sacrum, upper and lower abdomen, shoulders, forearms, hips and lower leg. The scale is four-point, the score "0" means no hair. The more points, the higher the degree of hirsutism in a woman. It should be noted that each ethnic group may have a different upper limit.

When collecting anamnesis, it is important to pay attention to a hereditary history, gynecological (infertility, menstrual disorder) history, taking any medications. It is often necessary to appoint consultations of related specialists (gynecologist, endocrinologist).

Hypertrichosis is an intense focal or widespread hair growth that is not associated with androgen stimulation.

It occurs in both sexes. There are congenital and acquired hypertrichosis. Congenital hypertrichosis is a very rare disease due to an abnormality in the development of hair follicles that produce depigmented thin hair without a brain substance. With hypertrichosis of this species, from the very childhood the whole surface of the skin (with the exception of the palms and soles) overgrows with hair, although there are also limited forms.

Acquired hypertrichosis can be a harbinger of malignant tumors, such as a tumor of the gastrointestinal tract, lungs, breast, gall bladder, uterine body, bladder. Often the cause of development of acquired hypertrichosis is the intake of medications, for example minoxidil, cyclosporine. There is also symptomatic hypertrichosis, which develops in the following diseases: hypothyroidism, alcoholism, late cutaneous porphyria, anorexia nervosa, in the place of recurring injuries or prolonged inflammation.

Diagnosis of hypertrichosis is also based on clinical manifestations of the disease. Allocate common and limited forms of the disease. When collecting an anamnesis, first of all, it is necessary to pay attention to the beginning of the appearance of complaints, the age of patients, the hereditary history, the presence of concomitant pathology; to find out whether the patient is taking any medications.

Thus, clarifying the causes of hirsutism or hypertrichosis and the possibility of their correction allows any method of epilation to be made more effective and not to discredit possible results.

[1], [2], [3], [4], [5]

Types of depilation and hair removal

Existing types of depilation and hair removal can be classified as follows:

Depilation:

1. Plucking.
2. Shaving.
3. Chemical depilation.
4. Wax depilation.

Epilation:

1. Electrolysis
2. Laser hair removal.
3. Photoepilation.

The most simple methods of depilation are plucking and shaving. Probably, there is not a single person who does not remove hair in these ways. Plucking is a simple and effective way to remove hair with tweezers. Usually this method is masterfully mastered by women who regularly follow the shape of the eyebrows. Often plucking exposed individual hair or restricted areas, as this is a slow and rather painful way. Often from the screens of our TVs there is an incorrect advertisement in which the concepts of depilation and depilation are confused. For example, hair removal with the help of home electric epilators "Braun soft epil" or "Philips satinelle Ice" is advertised. The basis is the depilation method - plucking. There is evidence that the growth of hair after plucking can increase and new hair often grows more rigid. The fact is that when plucking, traumatization of the hair follicle occurs, after which it changes and behaves absolutely unpredictably.

Shaving is a method of removing hair with a shaving machine, a blade, soap, foam and water. Distinguish between women's and men's machines, which differ in shape, color, material. But, as practice shows, there is no significant difference between them. Shaving was and remains a quick, easy, effective and cheap method of hair removal. Previously, it was assumed that multiple shaving of hair in one place stimulates the growth of their growth. Now it is unequivocally proved that this is not so. Disadvantages of this method are short-term effect, cuts, irritation, dry skin, ingrown hair, the possibility of infection.

Chemical depilation is a method of hair removal with the help of depilatories, made on the basis of various enzyme preparations, for example, sodium thioglycolate, which dissolve the protein basis of the hair, which leads to its easy separation from the skin surface. Depilatories are available in various forms: gel, cream, lotion, aerosol. Modern means can remove hair quickly and painlessly. It is important to remember that chemical depilatories can cause allergic dermatitis in people with a history of allergic anamnesis, less toxic. Therefore, use these tools should be extremely cautious, with the implementation of a preliminary skin test. Before using the follow-up carefully read the instructions and clearly follow the advice on using the manufacturer to avoid skin damage until chemical burns. It should also be noted that you can not use these funds in the eyelids and eyebrows, with burned or damaged skin.

Wax depilation (waxing, bioepilation) is the most ancient way of hair removal with the help of waxes (wax - wax), resin, burnt sugar. The essence of the method is extremely simple - with the help of an adhesive preparation there is a gluing of the hair cover, which is then removed by a single unit with the help of special napkins. In many beauty parlors, this procedure is often called bioepilation. This is incorrect, because there is a contradiction between the essence of the procedure and its name. Waxing is a more painful procedure compared to other methods of depilation, but it gives the most lasting results. On average, hair growth after the procedure begins in two to three weeks. The disadvantages of this method include irritation, redness, dry skin, ingrown hair, the possibility of infection.

Types of waxes for hair removal

Solid (hot) - is made on the basis of pine resin and oil products with the addition of oils. It takes 20-40 minutes to warm up. The disadvantage of this type of wax is that it very quickly seizes and this leads to incomplete adhesion. It is necessary to monitor the temperature of the wax before the procedure, as there is a high risk of burns to the patient's skin.

Soft (cold) - is made on the basis of a mixture of pine resin and softeners (beeswax, honey). In the basic composition can be added various soothing and emollients (azulene, olive oil, etc.). The disadvantage is that the soft wax does not dissolve in water. Therefore, the wax residues on the skin are cleaned with oil, which can promote the development of "oily folliculitis".

Some companies offer whole sets for depilation, which include cleaning preliminary and softening the skin before and after the procedure; "Wax heater" wax; special roller applicators; paper hygienic strips, waxes. The leading companies offering such products are "BEAUTY IMAGE", "ACADEMIE", "Clean + Easy".

When performing the wax depilation procedure, you must follow certain rules:

1. Before the procedure begins, treat the skin so that it is clean, free from grease and dry.
2. Wax is applied to the skin once in a thin layer in the direction of hair growth.
3. The strip is glued also in the direction of hair growth, and is removed by a rapid sharp movement against growth, but parallel to the surface of the body.
4. Wax residues are stripped as much as possible to minimize the use of cleaning oils.
5. Apply moisturizing and soothing post-depilation.

Waxing is considered a safe procedure, which is carried out by almost everyone. However, patients with diabetes mellitus because of their propensity for pyococcal complications and delayed regeneration should be extremely cautious. In addition, the risk group includes patients with severe varicose veins and multiple benign neoplasms.

For a proper understanding of the mechanisms of action and the prospects of epilation, one must know: the questions of anatomy, the phase of growth and chroma of the hair. In this aspect, the hair follicle itself plays a special role, since it is the "parent" of new hair. Regardless of the methods used to epilate, the conductor of exposure to the follicle is the hair channel. The result of hair removal is directly related to the phase of hair growth in the follicle. With any kind of hair removal, the hair follicle must be destroyed in the growth phase, or anagen, since it is in this phase that there is a close connection of the hair with the follicle. It is known that the amount of hair in the anagen phase varies and depends on the topical location.

Hair color is caused mainly by two pigments - black-brown (eumelanin) and yellow-red (pheomelanin) Variants depend on the quantitative ratio of these pigments, which can vary with age and depend on the hormonal background. Melanin is found not only in hair, but also in the skin. Skin in humans differs in the distribution of melanocytes, as well as in the ability to produce melanin. T. Fitzpatrick developed a classification of skin types based on the ability of the skin to respond and UV radiation. The same classification is used to predict the result of laser or photoepilation and when choosing a power.

Main skin phototypes (according to T. Fitzpatrick, 1993)

Skin Type	Characteristic
I	Never sunbathe, always burn
II	Sometimes they can get tanned, but they burn more often
III	Often sunbathe, sometimes burned
IV	Always sunbathe, never burn
V	Never burn
VI	Never burn

The effectiveness of laser hair removal increases with I and II skin phototypes by Fitzpatrick in combination with dark hair, and photoepilation - at I-IV.

Until recently, a long-term or permanent effect could only be talked about in case of electro-epilation.

Electrolysis

This is a method of removing hair with the help of an electric current.

All methods of electroepilation are divided into 2 groups:

• with tweezers;
• with a needle.

The tweezers method is more sparing and painless, but with a very low speed of the procedure. The essence of it is that each hair is taken with a thin tweezers-electrode, which is connected to the apparatus producing high frequency current. The time of exposure to 1 hair is 1.5-2 minutes. Hence it is clear that this method is not used in large areas.

Electrolysis using a needle is more widely used. There are 2 main methods:

1. Thermolysis. It is based on the action of alternating current of high frequency and low voltage. The current is fed through a thin needle, which is inserted into the skin at the depth of the hair follicle where local heating occurs - the destruction of the follicle.
2. Electrolysis. The method is based on the electrochemical action of the galvanic current. As a result of the anodic-cathodic reaction, hydrochloric acid is formed, which, decomposing, is converted to caustic alkali - electrolytic burn and destruction of the hair follicle. A sign of the end of the chemical reaction is the release of white foam - hydrogen bubbles. Electrolysis is a more painless method of electroepilation, and the risk of complications here is much less than in thermolysis. However, the speed of the procedure is rather low.

There are standard recommendations for the application of the current of a force and the choice of this or that method of electro-depilation, depending on the thickness of the hair and the depth of the location of the follicle, the epilation zone. Treated hair is removed with normal tweezers. Further, as a rule, the epilated area is treated with an antiseptic solution (chlorhexidine bigluconate, calendula tincture, beponen lotion).

[6], [7], [8], [9]

The combination of thermolysis and electrolysis

It is possible to combine two methods of electrolysis. During the procedure, a phasic effect is applied to the follicle - first thermolysis, and then electrolysis. During the first stage, a thermolytic reaction occurs "the follicle area with the dehydration of surrounding (perifocal) tissues. The second stage, electrolytic, provides a galvanic reaction, during which the formation of a much smaller amount of alkali is sufficient for the final destruction of the follicle. Due to the double effect on the follicle, the chances of its final destruction are doubled. At the same time with this method of electroepilation, there is a significant risk of developing folliculitis and burns.

The disadvantages of this method include soreness, redness of the skin, swelling, scars, hyperpigmentation, the possibility of infection. In rare cases, there is an individual intolerance of metal alloys (gold, nickel) that form part of needles, as well as intolerance to any current procedures.

There are also contraindications for performing this procedure. These include: the presence of an electrocardiostimulator, pregnancy, mental illness (in particular epilepsy), severe somatic diseases in the stage of decompensation, propensity to keloids, hyperpigmentation, herpetic infection in the acute stage, diabetes, tumors.

In addition, there is limited electroprocedures over time, associated with increased exposure to the electrical axis of the body. One session should not exceed 1-1.5 hours a day. As a result, the procedure for electrolysis of the legs can last for several days, if not weeks. A consequence of this is the unevenness of hair growth ("chess grid").

This method is very effective, but the results depend on many factors, for example, the level of professional training of a specialist. At the same time, the patient who came to electrolysis should be aware that a successful final result will require him a lot of patience, time and money.