Hair Removal 101

Many women struggle with the issue of hair removal. Here's a guide to help you find the method that's best for you.

By Colette BouchezWebMD Feature
Reviewed by Norman Levine, MD

From peach-fuzz fringes to long, dark, or coarse growth, women have been doing battle with excess hair -- and hair removal -- for centuries.

For some, the problem is hereditary or related to ethnic heritage. For others, it can be caused by a medical condition such as polycystic ovaries or a hormone-secreting tumor, or even the result of hormonal changes linked to menopause. Still other women are interested in hair removal for areas such as legs, underarms, or bikini area, where growth is normal but sometimes undesirable. No matter the reason, there is no shortage of ways to cope. To help you decide which method of hair removal might be best for you, WebMD consulted several experts in the field. They helped us prepare this guide to the eight most popular methods of hair removal for women.

Hair Removal Method No. 1: Laser/Pulsed Light
What It Does: One of the more popular ways to remove hair is via laser or pulsed light - energy that goes through the hair shaft down to the follicle, where it destroys the hair's root. "The hair does not immediately come out during a laser treatment. Instead, it weakens and falls out over time because we've blown away the root," says dermatologist David Goldberg, MD, director of Skin and Laser Surgery of New York and New Jersey and the author of a medical textbook on laser hair removal. Goldberg says the newest laser, called DUET, combines laser with a little bit of suction for even better results. "It pulls the hair into the follicle, allowing the beam to penetrate deeper," says Goldberg. This means doctors can safely treat larger areas at one time and more comfortably for the patient, he says. Best For : Laser hair removal can be done anywhere on the body. The best candidates are women with dark hair and light skin. Lasers won't work on white hair, and they are much less effective on blond hair, which Goldberg says usually responds best to electrolysis. While most lasers work on the skin of Hispanics, only one, called the Nd:YAG, is safe for black skin. All other hair removal lasers increase the risk of hyperpigmentation (dark spots), as well as burning and scarring, which can lead to the creation of keloids (scar tissue). How Long It Takes : It usually requires 5-7 sessions, with a touch-up about once a year thereafter. Cost : The cost runs between $150 and $500, or sometimes more depending on how many treatments are needed.

Hair Removal Method No. 2: Electrolysis
What It Is : The only method of hair removal that is permitted to be called "permanent," electrolysis uses a tiny needle that slides down into the hair follicle until it reaches the cells responsible for hair growth. "Electrolysis destroys the cells that cause the hair to grow. The hair will release and slide right out and it won't grow back there again -- it's permanent removal," says Patsy Kirby, executive director of the American Electrology Association in Bodega Bay, Calif. The process can be uncomfortable, but local anesthetic creams can help. Best For : Like other forms of hair removal, it is safe to do electrolysis anywhere on the body, though Kirby says the most popular place for women is the face. How Long It Takes : Though the system requires that the removal be done hair-by-hair, Kirby says it's not as daunting a task as it might seem. "It can take up to 25 sessions, depending on how much you need removed, but each session may only be 5 or 10 minutes long," says Kirby. Cost: Costs run between $40 and $90 per treatment, with 10 to 25 treatments (or more) sometimes necessary for permanent, lasting results.
Potential Drawback : Electrolysis can cause tiny scars where the needle is inserted. Though for most people they heal unnoticed, for blacks it means an increased risk of hyperpigmentation and formation of keloids. Thus, it's not recommended for this skin type.

Hair Removal Method No. 3: Vaniqa
What It Is: This topical prescription cream, also known as eflornithine 13.9%, works by blocking an enzyme that would otherwise stimulate hair growth. Without the enzyme, hair growth is retarded in that area, and eventually may stop. Joel Schlessinger, MD, president of the American Society of Cosmetic Dermatology and Aesthetic Surgery, says Vaniqa is not a hair remover, so it is best used in conjunction with other methods, particularly lasers.
"If you apply it after laser treatments as an adjunct, it can help retard and then stop hair growth," says Schlessinger. Other experts say treatment can also work on its own, but requires a patient commitment of 8 weeks to 6 months before full results are seen. Studies show that the longer the cream is used, the better results will be. Vaniqa is applied twice daily. Best For : Vaniqa works best for facial hair growth on the upper lip, chin, and cheeks."Because of the cost, and difficulty and feasibility of applying it to large areas, it's not recommended for hair removal in large areas of the body, such as the legs or arms," says Schlessinger. Schlessinger says it is, however, an effective way to remove white or non-pigmented hair, which does not respond to laser treatment. Studies show Vaniqa is safe to use in combination with birth control pills and other hormone treatments when the cause of unwanted hair stems from reproductive problems such as polycystic ovaries. It is also safe for all ethnic groups and skin types. Cost : Vaniqa costs between $80 and $225 per tube.

Hair Removal Method No. 4: Waxing
What It Is : It's been around for centuries, but today's waxes are far different than the sticky honey treatments of the past. "Today we use a soy-based compound that does not stick to the skin, bonding only to the hair," says waxing technician Michelle Serniuk of Beyond Day Spa at the Hackensack University Medical Center. The soy cream is applied, then covered with special cloth strips. When the wax sets, the strips are removed, taking the hair with it."Because it only sticks to hair, not skin, it produces a kinder, gentler waxing, with less damage and pain when the wax is removed," says Serniuk. Best For : Waxing can remove hair anywhere on the body, including the upper lip, chin, eyebrows, arms and legs. A bikini wax removes hair that might show when you're wearing a skimpy bathing suit bottom, while a Brazilian wax removes all hair from the genital area. Cost: The cost of waxing runs from about $10 for an upper lip, to $70 for upper and lower legs or a Brazilian wax. The procedure must be repeated every few weeks.
Potential Drawback : Because soy waxing removes the entire hair -- the root, bulb and shaft -- Serniuk says it's vital to use an antibacterial lotion afterwards. "Because the follicle is so open you need to take some precautions to prevent infection," she says. Waxing is best done in a spa or salon, but home kits are available. However, experts warn that it's vital to do the procedure in hygienic conditions and to follow treatment with an antibacterial lotion. Done incorrectly, Surniak says, waxing can lead to a nasty skin infection.

Hair Removal Method No. 5: Shaving
What It Is: Whether done with an electric or straight razor, shaving is akin to cutting hair - only it does so ultra-close to the skin. Shaving does not remove hair at the root, nor does it disturb the follicle. That means the effects are temporary, lasting anywhere from a few hours to a few days. Although the myth persists that shaving makes hair grow back coarser or more plentiful, dermatologist Bruce Katz, MD, says this isn't so. In fact, as early as 1928, researcher Mildred Totter showed that shaving didn't affect hair growth - a finding that has been echoed in several studies since. Speaking at the American Academy of Dermatology's 2005 annual meeting, Katz said that ways to minimize shaving problems include: Making sure hair is thoroughly wet first.
Shaving in the direction the hair grows. Avoiding repeating strokes. Keeping skin relaxed while shaving. Potential Drawback: If hair is coarse - particularly in the bikini area - shaving can cause ingrown hairs. Katz says this occurs when the cut hairs curl back into the skin instead of growing out. This can be especially problematic for black women, who are prone to infections caused by the ingrown hairs.

Hair Removal Method No. 6: Depilatories
What It Is: These creams and lotions use a chemical compound designed to dissolve the proteins that make up hair. Unlike shaving, which leaves sharp, hard, hair stubble just below the skin, depilatories leave a rounded, smoother edge - so stubble is minimized and regrowth appears to take longer. Still, treatments usually need to be repeated at least weekly, if not more often.
Best For : Best used for hair on the face, arms, and legs, many depilatories are not recommended for eyebrows or for use in the genital area. Cost : Cost is between $5-$10 per tube or bottle.

Hair Removal Method No. 7: Tweezing
What It Is: Tweezing pulls hair out at the root. However, it does not affect the follicle, from which hair grows, so it's only a matter of time before another one sprouts up.
"Hair grows in cycles, so the time in the cycle when you remove it determines in part how quickly another will take its place," says Goldberg. Unlike shaving, which allows hair to grow back the same size as the follicle, hair that is plucked grows back with a tapered end, meaning it is softer and less noticeable when it first comes in. Eventually, however, it will grow back to its normal thickness. Best For : Tweezing is best used to remove hair on small areas of the face - such as the upper lip, chin, or eyebrows.

Hair Removal Method No. 8: Oral Contraceptives and Hormones
What It Is: For women whose hair growth is hormone-related -- most often caused by a condition known as polycystic ovary syndrome -- medications can help. The condition is known as hirsutism. Treatment includes drugs designed to reduce levels of androgens, the hormones linked to excess hair growth. Medications commonly include birth control pills and/or anti-androgens, such as spironolactone, cyproterone acetate, and flutamide.
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This is a fairly good article from WebMd which is one of my go-to websites. I have had PCOS and have to deal with the facial hair growth from that and it is no fun at all. I have tried almost every treatment available and wanted to tell you my personal experiences with each.

1. Laser Removal: I did a series of treatments about 6 years ago. I went every 6 weeks for a year. It was a fairly new technology back then and I thought it was fairly effective. It was about $1,200. It felt like someone snapping rubber bands on your skin. Annoying but not that painful. They put a numbing cream on prior to the treatment to help with the pain. I did go for a few follow up appointments for maintenance but did not keep it up thereafter. There have been many advancements in this technology and even though it is so costly, I think it is very effective.
2. Electrolysis: I have done electrolysis and think it is the most painful of all the treatments. It is expensive as well. I spent at least $500 on treatments. They stick a needle into the hair follicle and the electric current is supposed to kill the hair at the root. It does grow back and again, I think it is too painful for the effectiveness.
3. Waxing: I have had a lot of waxing done on my face. It can hurt but after doing it for so long I got used to it. Although, when she would do my upper lip it always brings tears to my eyes. I have never done anything other then my face.
4. Depilatories: I have never been much of a fan of depilatories. Mostly because of the smell. One time I did apply it to my face and it ended up burning and leaving marks on my face so I never tried it again.
5. Tweezing: Everyone has tweezed hairs. Painful but cheap and handy. No explanation needed here.
6. Shaving: Everyone has shaved. Some do more then others but basically no explanation needed here.
7. Threading: I am surprised that the article does not mention threading. I believe it is probably the oldest method of hair removal. I just started doing the threading last year and I really like it. It does hurt. I won't lie about that. However, I think it is one of the most effective ways because the regrowth does not occur as fast as the other methods. Plus it is inexpensive. It is only $10 to do my eyebrows and $20 for the whole face.
8. Medications: I have never used hormones or birth control pills for controlling hair growth. Not sure how effective they are.

Hope this sheds some light on some of the hair removal methods from a professional and personal standpoint. Everyone is different and has different pain thresholds but for now, I am going to stick with threading and shaving for my hair removal needs. Until next time...