Dr. Mikki Bain's article on hair removal from Transformation Magazine Issue #29

Hello everyone!

"Flash is fast, flash is cool!" (Blondie, "Rapture"). What if I told you that in the past 9 weeks 95% of my dark coarse beard hairs have fallen out-and most will never grow back?

You might think that as an aging disco queen maybe all those nights being hammered by the big Altec Lansings and the funny smokes have caught up with me.. .Mary Jane is notorious for reducing testosterone levels.. .and get "Blondie, the Remix Project," on Chrysalis Records...

As we all know too well, the bete noir which can make even the prettiest of us look like tarted up DQ’s is harder to get rid of than cockroaches or telephone solicitors. And from what my butch squeeze Robin (another 101st Airborne "Chick") tells me, the blend method is a lot like a root canal-25,000 times over, and a whole lot more expensive ($6,000 to $9,000, and maybe even more). And then there is always the risk of scaring and waiting 1 to 2 years for noticeable results. That’s all way too much for a big wuss like Dr. Mikki.

For all these reasons, and more, there has been a lot of work done in the past few years on alternative methods of permanent epilation. Most of the attention recently has been focused on lasers.

Unfortunately, as attractive as the approach seems (the image of Mr. Bond’s crotch being approached by Goldfinger’s industrial laser beam readily comes to mind), the utility of all available lasers for epilation has been disappointingly limited. To understand why this is so and see how the Epilight system has become the epilation world’s first effective weapon of mass destruction, we need a brush up on some relevant anatomy and physics.

The skin can be viewed as a translucent coating about 6 mm deep. Dispersed within this medium are the hair follicles. The follicle has a bulb at it’s base and shaft which opens onto the surface of the skin, or epidermis.

Just above the bulb is a bulge in the shaft which helps forms new hairs, and closer to the epidermis is the sebaceous gland which produces skin oil or sebum. This whole structure is called the pilosebaceous unit.

There are two types of pilosebaceous units. The first kind is the villous pilosebaceous unit. These hair follicles are found on areas of the body which appear to the naked eye as being essentially hairless. This nude appearance is due to the fine blond and almost invisible hairs produced by thee smaller follicles. The second type of follicle is called the terminal pilosebaceous unit. These follicles produce hair found on the scalp in both sexes and also comprise the beard in men. The villous pilosebaceous follicles on boys faces are transmogrified at puberty by increasing levels of testosterone derived dyhydrotestosterone into, in my opinion, the most disfiguring and repulsive male secondary sexual characteristic imaginable.

If you have explored other methods of beard removal, as many of us have, you likely are wondering why lasers have been so disappointing as epilation devices and why the Epilight is so successful. To answer this question we now turn from anatomy to physics.

As I mentioned, the skin is a like a translucent 6 mm medium in which hair follicles are dispersed at depths from 1 to 2.5 mm in the upper lip, 2.5 to 4.0 mm in the chin and cheeks, 3.0 to 4.5 mm in the legs, trunk and groin and pubic areas. These follicle contain a dark pigment, melanin, in varying amounts with darker hairs possessing more and lighter hairs less of this light absorbing "chromophore."

Common experience tells us that darker objects absorb more of the sun’s heating rays than lighter ones, and it is this differential absorption between the darker hair follicles and the semi-transparent surrounding skin which allows an intense light source such as laser or a high powered xenon flash tube to heat up or ‘cook" the hair shafts while sparing the adjacent tissues from significant burning. The trick is to get as much light energy at the proper depth to target the hairs selected for destruction while minimizing skin damage.

Lasers are an excellent source of high energy light, and indeed, some have been used successfully for photo-epilation. There are some practical problems with lasers which significantly limit the use of this light source. Firstly, lasers emit a fixed wavelength determined by the physical characteristics of the type of laser used. It is well known that longer wavelengths penetrate more deeply and shorter wavelengths more superficially

Medical lasers are very expensive devices. It is a costly impracticality to have on hand the multiple units needed to effectively treat various areas of the body, or even just the face.

Secondly, lasers emit coherent fixed wavelengths. This means that every wavelength generated by a laser is in perfect phase with every other one. This "lock step" progression of light waves, of course, is what makes laser light so powerful and unique. All other light sources emit wavefronts that are noncoherent or "random phase." While the "in phase" nature of laser light makes your laser pointer work great, it causes some problems beneath the skin. Any laser light not absorbed by a hair follicle can reflect off other structures within the dermis and cause considerable collateral damage because in phase trains of light waves do not disperse or refract as randomly as non coherent light, thus retaining much more of the direct beam’s energy

The Epilight system overcomes these problems. Firstly, it’s light is non-coherent, being generated by a flash tube much like that which sets atop your camera-except this $175,000 flash units weighs 395 lbs and is 1/2 the size of a refrigerator! That kind of power supply can deliver a flash with up to 64 joules per sq. cm of skin. Even Mr. Goldfinger would be pleased. This instrument also has six filters delivering light from 590, 615, 645, 695 and up to 1200 nm in wavelength to penetrate to all hair depths. The controller software allows the operator to select up to 5 separate pulses and to vary the pulse duration from 2.5 to 7 m sec. with a duty cycle between pulses from 1 to 300 m sec. Thus the target follicles can be repeatedly heated in short bursts while allowing the surrounding translucent skin, which doesn’t take up as much light energy time to "cool oil’ thereby avoiding thermal damage to the dermis while efficiently "cookin" the target "chromophore" hair follicles.

These pulses are delivered through a garden hose sized fiber optic cable attached to a 10 x 45 mm $10,000 quartz crystal which is applied directly to the skin. ( a cooling gel is applied to the skin first.) The light is so powerful that after 10,000 flashes the quartz starts to fracture and must be replaced. We have come from the hot needle to this high performance masterpiece of photo-electronic engineering. As Robert Lewis Stephenson once said, "Look long on an engine. It is sweet to the eyes!"

While all these details turn on a "Bavarian-American" machine head like Dr. Mikki, most non-geek readers are much more interested in how well this monster works and how much it hurts. Being the big fem that I am, let’s deal with the hurt first. Imagine one of those 1/4 inch USPS rubber bands being pulled back a couple of inches and snapped on your face. It stings more about the mouth and especially on the upper lip. How many "snaps?" My first session took 204 to cover my whole beard. It was 164 on the second go round.

Incidently, it is best to have 1 to 2 mm of stubble going into the treatment so the operator can see if some of the hairs come out with a gentle wipe of the cooling gel with a piece of gauze after a flash. The odor of your beard going up in smoke is a pungent delight!

Next, how well does this technology work? Very well. After considerable swelling (much like that seen with ingrown hairs) subsides in 10 to 14 days, 80% of my dark beard hair fell out, was painlessly pluckable, or could be "extruded" -much like squeezing a ripe zit. After the first treatment, some hyperpigmentation, or redness, remains, especially along the jawline and neck where the dark beard hairs were the heaviest. This gradually fades away

About 40% of my beard is light blond. As a child I was a blond several shades lighter than the hair piece I prefer to wear now Since these lighter hairs have less melanin, they are more resistant to photothermolysis. After about 4 weeks 80% of my beard shadow was gone and I was getting a stubble free dry shave in less than 2 minutes with my Panasonic foil electric. Previously, I would have to soak my beard and then use a lubricated shaving cream and Gilette’s newest and most effective "Mach-3" blade system to get this close-and still have plenty of beard shadow to cover.

My second treatment, at 8 weeks, resulted in less inflamation and has totally eliminated my dark beard hairs and shadow. Some of the coarser blond hairs were taken out, but plenty remain. Those that do are somewhat finer and less visible. I can now go 2 1/2 days without shaving and still look presentable-as a man, of course.

Since the dermis, while not burned, is irritated by this process, there is an upregulation of collagen production which has improved the look and feel of my lower face and neck. This improvement in skin texture and pore structure is also the goal of other treatments designed expressly for this purpose such as "chemical peels," "dermabrasion," or "laser resurfacing," This additional cosmetic benefit is in marked contrast to the very real, and all too common, scarring that can occur with improper electrolysis technique.

I intend to have my face treated again for the third time at 16 weeks, as well as at 24 and 32 weeks. There will be some grow back of the darker hair and I suspect a significant reduction of blond hairs will be seen after further treatments, based on what I have seen after two treatments, although complete elimination of all my blond beard hairs may not be possible.

How much does this cost? The going rate is $400 to 500 per session. The Vein Center of Tampa Bay charges $500 per treatment. While this technology can not remove all hair, therefore likely necessitating some clean up needle work for those who want to be totally denuded, it is still, even including the cost of follow up electrolysis, much more cost effective than doing it all the "Old Fashioned Way" (If you a have beard like "Tricky Dick Nixon" not much electrolysis will be needed).

Since I am not a ‘full timer," my total cost will be about $2,500 to $3,000. Two friends of mine have spent $8 to $12,000 over many years to achieve perhaps 25% better results. After a 2 minute shave, my face will look and feel almost as good as theirs for the rest of the day

In the Jan. 2000 issue of "Dermatological Surgery" (26:37-41) Gorgu, M. et al compared the effectiveness of electrolysis and long-pulsed alexandrite laser therapy in removing 24 areas of unwanted axillary hair in 12 patients. "Six months after the initial treatment, hair counts decreased and average of 74% with laser treatment and 35% with electrolysis. Laser treatment was 60 times faster, and patients considered it less painful than electrolysis" (emphasis added). Indeed, as Ms. Harry says, "Flash is fast, flash is cool!" (pun intended).

Next to availing myself to this wonderful technology, the best part of this experience for me has been my visits to the Vein Center.

This is the commercial name for Dr. Jeffrey Hunt’s practice. Dr. Hunt is a nationally recognized expert in laser, IPL, sclenotherapy and other forms of dermatologic therapy. He possesses a first rate intellect coupled with an elegant sense of style. His quiet and kindly manner puts patients at ease immediately. And, as is usually the case, Dr. Hunt’s dignified and compassionate approach to the practice of medicine sets the tone for his whole office.

Dr. Hunt spoke frankly about the the Epilight’s less than 100% effectiveness in removing light blond hairs, offering insightful criticisms of references I cited to the contrary He showed me a $75,000 microwave prototype a manufacturer had lent him for his evaluation. Dr. Hunt feels that this technology holds some promise for epilation but needs further refinement. He will be returning the machine with several suggestions for it's improvement.

Dr, Hunt has trained and supervises Denise, one of his medical assistants who administers the IPL treatments. In the 3 years this technology has been in commercial use, Denise has acquired extensive experience specializing in facial epilation. She is a pleasure to work with, always putting you at ease, aware that this is not a fun experience, being just as concerned as you are about getting rid of the monster as safely and effectively as possible. I am the 7th or 8th TG patient she has treated. As always, I was up front about who I am. Dr. Hunt, Denise, and the rest of the office staff are completely comfortable having me as a patient. I distributed copies of some my columns and showed everyone some of my better 8 x 12s. Everyone was genuinely interested in me as a person.

Denise has enough experience so that she can safely and effectively "break the rules" in her approach to machine operating parameters. She employs more aggressive machine settings which result in more efficient and complete epilation. There is a bit more pain and subsequent hyperpigmentation and occasional scabbing which all subside in days to few weeks or months.

The Vein Center has my highest recommendation. Both as a physician and as a TG. Their office is located 2 miles from Tampa International Airport. Denise would be happy to answer any questions you might have. You can reach her at 813-282-0223, 800-499-VEIN or on the web at wwwveincentertampa.COflt

I’ll keep you updated on my progress. I also want to state that I have not asked for or been offered any special consideration based on my status as a physician or as writer for Transformation.

Stay well and be hairless,

Dr. Mikki Bain