Removal of unwanted hair
- Donald W Shenenberger, MD, FAAD, FAAFP
Donald W Shenenberger, MD, FAAD, FAAFP
- Assistant Professor of Dermatology
- Eastern Virginia Medical School, Norfolk, VA
- Section Editors
- Robert P Dellavalle, MD, PhD, MSPH
Robert P Dellavalle, MD, PhD, MSPH
- Section Editor — Dermatology
- Professor of Dermatology and Public Health
- Denver VA Medical Center, University of Colorado School of Medicine and Colorado School of Public Health
- Jeffrey S Dover, MD, FRCPC
Jeffrey S Dover, MD, FRCPC
- Section Editor — Cosmetic Dermatology
- Associate Clinical Professor of Dermatology
- Yale University School of Medicine
The majority of post-pubertal persons in the world regularly practice some form of hair removal. Be it by shaving, plucking, or by other methods, most of us have hair on some part of our bodies that we try to remove.
This topic reviews options for removal of unwanted hair. There are only limited data from clinical trials, so much of the information presented here is based on expert opinion. The evaluation and management of hirsutism are discussed separately. (See "Pathophysiology and causes of hirsutism" and "Evaluation of premenopausal women with hirsutism" and "Treatment of hirsutism".)
We are born with all the hair follicles we will ever have . At puberty, as a result of androgenic effects, some of these follicles enlarge and produce their characteristic growth patterns (beard growth, pubic hair). In some people, hair growth has a strong genetic influence leading to some of the more predictable ethnic patterns of hair distribution and thickness. The cells of the matrix at the base of the hair shaft differentiate under the influence of the dermal papilla and then proliferate to form the growing hair. Melanocytes within the matrix give the hair its color. The primary growth phase of the hair is called anagen, and it makes up the majority of the time a hair spends in the growth cycle. The other two phases are called catagen and telogen. (See "Evaluation and diagnosis of hair loss", section on 'Hair cycle'.)
During catagen, the hair follicle involutes, bringing an end to the active growth phase (anagen). The next phase, telogen, is the quiescent or resting phase that typically lasts for several months. At this stage, hair may be shed by brushing or during washing. Most hairs spend the majority of time in anagen (80 to 90 percent of the growth phase); however, this depends upon where the hairs are located. Scalp hairs typically spend the most time in anagen and can remain in anagen for several years before transitioning to telogen. Eyebrows and lashes have a much shorter anagen phase, and thus a relatively shorter length. It is during anagen that a hair is most susceptible to some of the newer methods of removal [2,3].
Temporary methods — The following methods typically result in only temporary removal of hair; however, in some circumstances the dermal papilla may be damaged by the removal, leading to permanent removal of hair.
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