Advanced Hair Removal

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Advanced Hair Removal

• Pamela Hill, R.N.
• Helen R. Bickmore

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Hair Removal Methods

• Permanent Hair Removal
• Permanent Reduction
• Temporary Hair Removal
• Camouflage - bleaching

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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

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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

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Bleaching

• Lightening hair to reduce appearance
• Hydrogen peroxide
• Dont use on pelvis area or eyes
• Done at home
• Camouflages
• Does not remove hair

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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

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Waxing

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

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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

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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

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Diseases That Cause Hair Growth

• Hypertrichosis
• Hirsutism
• Adrenogential syndrome
• PCOS
• Achard-Thiers syndrome
• Cushings syndrome

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Training of Technicians

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

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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

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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

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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

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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

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Layers of Skin

• Epidermis
• Dermis
• Subcutaneous also known as hypodermis

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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

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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,
  watersoluble 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

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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

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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

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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
• Langerhans 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

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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

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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

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Skin Pigment

• Malpighian is a skin layer made of stratrum
  mucosum and the stratum germinativum
• Vitiligo affects 4 of the worlds population
• Vitiligo affects the melanocytes of the skin
  causing hyper pigmentation that is irreversible
• Possibly caused by an autoimmune disorder that
  destroys the melanocytes

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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

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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

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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

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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

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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

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Hypodermis or Subcutaneous Tissue

• Its 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

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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.

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Preelectrolysis Epilation 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.

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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

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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.

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PEST and PERT

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

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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

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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