Susan's Place Transgender Resources

Hi Everyone

I was reading "Val's Voyage" blog on "Hair Discussion" (https://www.susans.org/index.php?topic=254047.msg2343254#msg2343254) and was intrigued by the discussion on hair removal.  Devlyn said:

Quote from: Devlyn on Yesterday at 03:09:40 AMPerhaps we should move this discussion to the hair removal section and give Val her blog back?

Devlyn was correct in suggesting that the hair removal discussion be moved to an appropriate section and continued there.

So I did some research and the following is what I came up with.

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Plucking, Waxing, Epilation and Permanent Hair Removal: Separating Evidence from Common Beliefs
Introduction
People seeking permanent hair removal are often told to avoid plucking, waxing or epilating before electrolysis or laser treatment.  This advice is sensible, but some extra claims are often added, such as that these methods make hair roots stronger, cause thicker regrowth or turn fine vellus hairs into terminal hairs.

This paper looks at what the evidence actually supports.  It separates well-supported facts from clinical observations and repeated claims that may not yet be proven.

This matters because practical experience can be useful, but it is not the same as scientific proof. The aim is to give a clear and balanced view of the concerns around plucking, waxing, epilating and permanent hair removal.

Claim	Current evidence	Supporting papers
Plucking, waxing or epilating makes every hair grow back thicker	Not supported. Human studies do not show permanent thickening after routine hair removal.	Olsen (1999) [7]; Wanitphakdeedecha & Alster (2008) [8]; Randall (2008) [6]; Paus & Cotsarelis (1999) [5]
Regrowing hair may temporarily appear coarser	Supported. Hair may look or feel coarser as it grows back, but this does not mean the follicle has become stronger.	Olsen (1999) [7]; Kang et al. (2021) [12]
Repeated plucking, waxing or epilation may irritate follicles	Supported. Repeated pulling can irritate skin and follicles, and waxing can cause folliculitis in some people.	Khanna et al. (2014) [10]; Evans et al. (2020) [9]; Kang et al. (2021) [12]
Distorted follicles may make electrolysis more difficult	Clinically accepted. This is often reported in practice, but direct controlled studies are limited.	Sperling (1991) [11]; Kang et al. (2021) [12]
Plucking converts vellus hairs into terminal hairs	Insufficient evidence. This claim is sometimes repeated, but it has not been clearly proven in human studies.	Chen et al. (2015) [2]; Randall (2008) [6]; Paus & Cotsarelis (1999) [5]
Paradoxical Hypertrichosis occurs following laser or IPL	Well supported. It is an uncommon effect linked mainly to laser and IPL hair removal.	Alajlan et al. (2005) [1]; Desai et al. (2010) [3]; Snast et al. (2021) [4]; Kontoes et al. (2006) [13]; Vlachos & Kontoes (2002) [14]

Plucking, Waxing and Epilation
Current evidence does not support the commonly repeated assertion that plucking, waxing or epilating permanently strengthens hair follicles or causes all hairs to regrow thicker.  Hair diameter is determined primarily by genetics, hormones and hair follicle biology rather than by routine mechanical hair removal [5][6][7][8].

Repeated plucking can, however, produce local inflammation, follicular distortion and an increased risk of ingrown hairs.  These changes may alter the direction or shape of the follicle and can make subsequent electrolysis treatments technically more challenging because the probe must accurately follow the natural follicular canal [9][10][11][12].

Experimental research has shown that patterned plucking can stimulate neighbouring hair follicles through immune-mediated signalling in mice.  Importantly, these findings have not been shown to produce the same effects in humans under normal cosmetic hair removal practices and therefore should not be interpreted as evidence that routine plucking converts vellus hairs into terminal hairs [2].

Paradoxical Hypertrichosis
Paradoxical Hypertrichosis is a recognised but uncommon complication of laser hair removal and intense pulsed light (IPL), characterised by increased terminal hair growth within or adjacent to treated areas.  Multiple clinical studies and systematic reviews have documented this phenomenon, particularly in individuals with darker skin types and when treating fine facial hair [1][3][4][13][14].

Clinical Observation versus Scientific Evidence
Many recommendations used in practice come from years of experience before they are tested by scientific research.  These observations are valuable because they can highlight trends that deserve further study.  However, observations alone do not prove cause and effect.

Some recommendations about plucking, waxing and other forms of hair removal, including the suggestion that repeated physical trauma may cause fine vellus hairs to become terminal hairs, are still being discussed.  While this idea is possible, there is currently little published evidence in humans to support it.  It is therefore important to distinguish between what has been demonstrated by research, what is based on clinical experience and what still requires further investigation.

Conclusion
Avoid plucking, waxing or epilating before electrolysis because it delays treatment and can irritate or distort follicles.  However, the claim that these practices generally make hair roots thicker and stronger or convert vellus hairs into terminal hairs is not supported by current scientific evidence.  Paradoxical Hypertrichosis is a recognised phenomenon, but it is primarily associated with laser and IPL treatments rather than ordinary plucking, waxing or epilation.

Bibliography
[1] Alajlan, A., Shapiro, J., Rivers, J. K., MacDonald, N., Wiggin, J., & Lui, H. (2005). Paradoxical hypertrichosis after laser epilation. Journal of the American Academy of Dermatology, 53(1), 85-88. https://doi.org/10.1016/j.jaad.2004.06.054
[2] Chen, C. C., Wang, L., Plikus, M. V., Jiang, T. X., Murray, P. J., Ramos, R., Guerrero-Juarez, C. F., Hughes, M. W., Lee, O. K., Shi, S., Widelitz, R. B., Lander, A. D., & Chuong, C. M. (2015). Organ-level quorum sensing directs regeneration in hair stem cell populations. Cell, 161(2), 277-290. https://doi.org/10.1016/j.cell.2015.02.016
[3] Desai, S., Mahmoud, B. H., Bhatia, A. C., & Hamzavi, I. H. (2010). Paradoxical hypertrichosis after laser therapy: A review. Dermatologic Surgery, 36(3), 291-298. https://doi.org/10.1111/j.1524-4725.2009.01433.x
[4] Snast, I., Kaftory, R., Lapidoth, M., Levi, A., Hodak, E., & Mimouni, D. (2021). Paradoxical hypertrichosis associated with laser and light therapy for hair removal: A systematic review and meta-analysis. American Journal of Clinical Dermatology, 22(5), 687-698. https://doi.org/10.1007/s40257-021-00611-w
[5] Paus, R., & Cotsarelis, G. (1999). The biology of hair follicles. New England Journal of Medicine, 341(7), 491-497. https://doi.org/10.1056/NEJM199908123410706
[6] Randall, V. A. (2008). Androgens and hair growth. Dermatologic Therapy, 21(5), 314-328. https://doi.org/10.1111/j.1529-8019.2008.00214.x
[7] Olsen, E. A. (1999). Methods of hair removal. Journal of the American Academy of Dermatology, 40(2 Pt 1), 143-155. https://doi.org/10.1016/S0190-9622(99)70181-7
[8] Wanitphakdeedecha, R., & Alster, T. S. (2008). Physical means of treating unwanted hair. Dermatologic Therapy, 21(5), 392-401. https://doi.org/10.1111/j.1529-8019.2008.00220.x
[9] Evans, R. L., Marriott, R. E., Rehder, D. S., & Hall, M. G. (2020). The impact of different hair-removal behaviours on the biophysical and biochemical characteristics of female axillary skin. International Journal of Cosmetic Science, 42(6), 644-654. https://doi.org/10.1111/ics.12660
[10] Khanna, N., Chandramohan, K., Khaitan, B. K., & Singh, M. K. (2014). Post waxing folliculitis: A clinicopathological evaluation. International Journal of Dermatology, 53(7), 849-854. https://doi.org/10.1111/ijd.12056
[11] Sperling, L. C. (1991). Hair anatomy for the clinician. Journal of the American Academy of Dermatology, 25(1 Pt 1), 1-17. https://doi.org/10.1016/0190-9622(91)70166-Z
[12] Kang, C. N. Y., Shah, M., Lynde, C., & Fleming, P. (2021). Hair removal practices: A literature review. Skin Therapy Letter, 26(5), 6-11.
[13] Kontoes, P., Vlachos, S., Konstantinos, M., Anastasia, L., Myrto, S., & Gregoriou, S. (2006). Hair induction after laser-assisted hair removal and its treatment. Journal of the American Academy of Dermatology, 54(1), 64-67. https://doi.org/10.1016/j.jaad.2005.06.010
[14] Vlachos, S. P., & Kontoes, P. P. (2002). Development of terminal hair following skin lesion treatments with an intense pulsed light source. Aesthetic Plastic Surgery, 26(4), 303-307. https://doi.org/10.1007/s00266-002-1515-4

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"Out, damned hair! Out, I say! But perhaps not by plucking..."

Best Wishes Always
Sarah B
Global Moderator
PS With apologies to Shakespeare's Macbeth (Lady Macbeth, Act 5, Scene 1)"Out, damned spot! Out, I say!"
@Valerie.Val @Stottie Girl @Petunia @tgirlamg @Courtney G @KristaFairchild @Devlyn @Lori Dee

My only experience has been tweezing, then switching to a Braun Silk Epil 9. I've been using that for a decade or more and haven't had any issues. I actually rarely need to use it anymore.


I was constantly told (here) not to do so, and especially not to ever use it on my face. But it comes with a specialized narrow attachment for the upper lip and corners of the mouth. I figure the global leader in hair removal products probably has a pretty good grasp on how it works, so I followed their advice rather than opinions I saw on the Internet.

Having said that, I will now offer my opinion. 🤣

I suggest getting used to pulling hairs out singly with tweezers before trying an epilator. Pulling a hair out of your upper lip basically feels like you're pulling an eyeball out through your nose. 😁 An epilator does it many, many times per second.

You get used to it. When I epilate or tweeze now I feel the tugging on the hair, but not pain.

Interesting info, for sure. I don't have a horse in this race; I'm merely a student of hair removal at this point. One thing I believe is that the electrology industry actively seeks to discredit any other hair removal methods!

But I do have a bit of a problem with this statement: "causes all hairs to regrow thicker."

It should be "may cause a thickening of the roots of some hair follicles or cause the conversion of some vellus hairs to terminal hairs."

I'm not saying the above statement is true/not true, just that "all hairs" is pretty well designed to fail. Like, who wrote that?