Advanced Hair Removal

1. Advanced Hair Removal Pamela Hill, R.N. Helen R. Bickmore

2. Hair Removal Methods • Permanent Hair Removal • Permanent Reduction • Temporary Hair Removal • Camouflage - bleaching

3. Shaving • Most used • Least effective • Cut hair at surface of skin • Risk of cutting • Harmful side effects: • Pseudofolliulitis Barbae • Razor Burn • Electric Razor does not cut as close to surface of skin

4. Depilatories • Thioglycolate • Breaks down hair protein (Cystine) • Cystine – amino acid that bonds hair together, • Cystine contains sulfur • Reduces hair to a gel like substance • Disadvantages: effective for short time • Leaves shadow of former hair • Skin irration

5. Bleaching • Lightening hair to reduce appearance • Hydrogen peroxide • Don’t use on pelvis area or eyes • Done at home • Camouflages • Does not remove hair

6. Tweezing • Temporary Hair Removal • Hair & Root removed from follicle • Painful • Difficult in larger areas • Need steady hand • High pain threshold • Need length of hair to remove

7. Waxing • Effective methods of temporary hair removal on large areas • Practioner must be experienced

8. Electrolysis • Needle inserted into hair follicle • Energy of high frequency or galvanic current destroys derma papilla • Process injures follicle and renders it useless • Requires each hair be treated individually • Can be expensive, time consuming and a painful methods of hair removal • Electrolysis is as valid today as it ever was

9. Laser Hair Removal • Most popular method of hair removal is laser light • Not for everyone • Best candidate needs light skin and dark hair • Skin can be damaged • Extensive training needed for successful outcomes • Non-responders are patients that do not respond to laser hair removal

10. Diseases That Cause Hair Growth • Hypertrichosis • Hirsutism • Adrenogential syndrome • PCOS • Achard-Thiers syndrome • Cushing’s syndrome

11. Training of Technicians • Needs extensive training • Knowledge of Contraindications of procedures • Course should include clinic protocol • Training with extensive clinical time • Anatomy & Physiology

12. Continuing Education • Privilege • Annual recertification of office • Clinical recertification with score sheet of procedures • 90% score required of clinical skills • Continuing Education offer by AEA, SCMHR, and CTAO

13. OSHA & Safety Standards • Must be included in training • Safety and sanitary issues must be addressed • Bloodborne pathogens • Universal precautions • Original name for OSHA manual was the Safety Bill of Rights • Every office should have a safety manual and train staff yearly

14. Anatomy & Physiology of Hair & Skin • Fun facts: • Humans shed millions of dead skin flakes every minute • Adult skin covers 2 square meters ( about the size of shower curtain) • Weights about 7 pounds • 300 million skin cells • Touch is first sense to develop • Skin is sensitive enough to feel the weight of a mosquito as it lands • Each square inch contains ten hairs • 15 sebaceous glands • 100 sweat glands • 3.2 feet of blood vessels

15. Function of Skin • Appendages a smaller part of a greater part of the skin • Pilosebaceous unit • Sweat glands • Nail & Hair • External substances can absorbed through appendages of skin

16. Layers of Skin • Epidermis • Dermis • Subcutaneous – also known as hypodermis

17. Transepidermal Water Loss (TEWL) • Our body constantly loses water as long as we are not submerged in water • Water in the epidermis decreases the closer it gets to the surface • Water makes up 70% - 75% of the weight of layers beneath • 10% - 15% of weight of stratum corneum • When to much water evaporates from our bodies our bodies suffer

18. TEWL - Continues • Stratum Corneum - contains a natural compound that gives skin cells their ability to bind in water (NMF) • NMF - helps keep the skin soft and moistened in dry climates • NMF- is composed of amino acids and filaggrin, water–soluble chemical capable of absorbing large quantities of water • Filaggrin - essential for the regulations of epidermal homeostasis – it is a filament-associated protein that binds to keratin fibers

19. Other Water Loss • Transdermal water loss (TEWL) and natural moisturizing factor(NMF) has nothing to with water loss associated while sweating • Consumption of water does not improves hydration levels in the skin • Drinking water improves water level inside the body and is used there • The best way to rehydrate the skin is by applying a topical moisturizer • NMF is diminished by age and excessive exposure to soap • This is key to understanding the phenomenon of dry skin

20. Stratum Basal • Also known as the Stratum Germinativum • Lowest layer of epidermis • Mitosis takes place forming new epidermal tissue , replacing dead surface cells • Sun light react with tyrosine (amino acid present in melanocytes) to give protection from the ultraviolet rays

21. Specialized Epidermal Cells • Keratinocytes – basic skin cells that make up the skin and move up replacing old cells • Melanaocytes – Secrete pigment that gives color to skin, hair, and eye • Langerhan’s cells – patrol the epidermis for foreign invaders ingest them, for removal by the lymphatic system • Markel cells – function unclear, likely involved in sensation, usually close to nerve ending, numerous around the lip, hard palate, palms, fingers and foot pads

22. Specialized Epidermal Cells • Merkel cells are source of rare but aggressive skin cancer called Merkel cell carcinoma • Usually begins on the in the germinating layer and the hair follicle

23. Skin Pigmentation • The number of melanocytes is the same for all people • The major contribution to depth of skin of color is melanocyte activity rather than quantity • Melanocytes protect the skin from UV rays, never assume that darker skin is better protected from skin cancer

24. Skin Pigment • Malpighian is a skin layer made of stratrum mucosum and the stratum germinativum • Vitiligo affects 4% of the world’s population • Vitiligo affects the melanocytes of the skin causing hyper pigmentation that is irreversible • Possibly caused by an autoimmune disorder that destroys the melanocytes

25. The Dermis Referred to as the living layer or true skin made of connective tissue Crisscrossed with 3 types of fibers that lend strength and elasticity Reticular – a protein fiber Collagen – fiber made of protein that gives skin its form and strength Elastin– protein that creates stability Dermal-epidermal junction - on distal side it attaches to the subcutaneous Superficial side the dermis holds the epidermis

26. Papillary Dermis • Papillary dermis contains elastic collagen and reticular fibers • Reticular fibers are cone-shaped, finer like projections called papillae or rete-pegs which protrude into the epidermis, locking the layers together • Also contains the capillary blood vessels, small nerve endings, and lymphatic vessels • The capillaries help regulate temperature of the body • Vessels that widen in the rete-pegs cause broken capillaries

27. Papillary Dermis • Papillary Dermis contain glycosaminoglycans (GAG) a variety of “chains” that are made o polysaccharide ( a type of carbohydrate) • GAG re attracted to water and are capable of binding up to 1,000 times their weight in water • This moisture content is extremely important to electrologists

28. Reticular Dermis • Thickest layer of skin, located beneath the papillary dermis and rests on a thick pad of fat which provides the real anchor of the skin • Composed off dense bundles of collagen fibers The fibers run in parallel layers and are denser closer to the papillary layer

29. Specialized Dermal cells • Fibroblast Cells are the command center of the dermis – directing production of collagen, elastin, reticulin • Mast Cells are located in the dermis – protect skin against invasion and infection • Ground substance - located in the reticular dermis and papillary dermis provides nutrients and removes waste – integral to the healing process; wounds heal better because of the creation of moisture from the ground of the substance

30. Hypodermis or Subcutaneous Tissue • It’s the fatty layer beneath the dermis • Gives the body contour and smoothness • Acts as an energy source and protective cushion for the outer skin • This layer separates the dermis from the underlying muscular of the body • Its crisscrossed with connective tissues and layers interspersed with fat to hold it together • Fat pockets accumulate between the connective tissue bands beyond the ability of the connective tissue to hold it smooth, the appearance is called “cellulite” or “orange-peel”

31. Ionization Principles • To understand galvanic current, one must first understand the science of ionization and the use of positive and negative poles to separate substances into ions. • An ion is an atom or group of atoms carrying an electrical charge. • When negatively charged using the cathode pole, the ions are called anions, and the process is called anaphoresis. • When positively charged using the anode pole, the ions are called cations and the process is called cataphoresis. • Theanode cord for an electrolysis epilator is usually red, and the cathode is usually black.

32. PreelectrolysisEpilation Technique (PEET) • The hair is plucked from the untreated follicle, the needle is inserted into the empty follicle, current is applied. • Technique is worth utilizing if the hair has been inadvertently tweezed.

33. Postepilation Reentry Technique (PERT) • Standard electrolysis treatment is performed first, with the hair in the follicle. Then again, one the hair has been epilated. • Equivalent of double-dosing • If it is thought or observed that the epilated hair has not been completely destroyed, must take care with this technique not to overtreat

34. Postepilation Sustained Entry Technique (PEST) • Is acomplised by using the two handed method • First perform the standard electrolysis treatment to the hair follicle, and then, while leaving the needle in place with one hand, epilate the hair with the other. • Repeat the current application to the empty follicle and then remove the needle.

35. PEST and PERT • PEST is like PERT but by leaving the probe in the follicle, it insures that the same follicle is being retreated.

36. Post Care • Tanning in a tanning booth or natural sunlight should be avoided when undergoing electrolysis treatments, meaning treatments once every two weeks. • Presence of erythema while tanning, will cause skin to hyperpigmentate • Client should protect the skin from ultraviolet rays with SPF 15 • SPF 30 can be used on the body but is usually too clogging for the face • Using SPF 15 and reapplying it after a few hours is as effective as SPF 30, but less clogging

37. Steroid Dependent Dermatoses • A condition in which the long-term overuse of topical steroid creams cause the skin to require continued usage to keep the offending condition away