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Pluck or Poke?
Is Electric Current Tweezer Type Epilation as Effective as Professionally Administered Electrolysis Treatment in Permanently Removing Hair?
September 24, 2007
Since prehistoric times, humans have been seeking easier and more efficient ways of removing unwanted hair. In today’s American society, ease, efficiency, and expense are three driving forces in the advancement of technology. Bringing expensive clinical treatments into the homes of Americans is a booming business, and has resulted in many of the household conveniences we all enjoy. New developments in hair removal are happening all the time, and this paper will seek to explore one such method, called electric current tweezer type epilation, and compare it to a more time tested method, electrolysis.
What is the behavior, and what motivations lie behind it?
The basic behavior that leads into this discussion is the deliberate removal of human body hair. This behavior has existed throughout history for varying reasons, including hygienic reasons such as lice and body odor prevention, religious reasons, and social status reasons as defined by the contemporary culture (http://www.depilatory.com/ages.html). In modern North American society, hair removal is motivated by numerous interconnected factors. According to the biopsychosocial perspective on health and behavior, “all health behaviors are best explained in terms of three contexts: biological processes, psychological processes, and social influences” (Straub, 2007, p.15). In this case, these factors interact to motivate the behavior of hair removal. The biological motivations include hygienic instincts and reproductive instincts. Reproduction can also be considered a social or psychological factor, as society often sets the standard for what is considered sexually attractive, and those standards influence human psychological perception of self within the environment. Additional social factors include family, peer, occupational and religious expectations. Psychologically, humans consider what impacts certain behaviors will have regarding all of these factors, and then decide how to act. This balance of external and internal influence is what shapes our behavior.
What are the methods?
When discussing permanent hair removal, one of the most common methods is electrolysis. This method is designed to be carried out by trained professionals working with paying clients. The treatment is performed by inserting a needle along the hair shaft into the skin (without puncturing the skin) and sending an electrical current along the needle and hair. This causes the destruction of the hair follicle either by the resulting formation of sodium hydroxide, often called Galvanic electrolysis, or the thermal effect of the current causing the follicle to overheat (Bjerring, Egekvist & Blake, 1998).
Less common than electrolysis is the use of electrical current tweezer-type
epilators. These devices are intended to send an electrical current along the hair shaft, ultimately damaging the follicle and preventing further hair growth. These devices are on the market for consumer purchase, and are typically designed for personal, in-home use.
Are these methods effective?
To determine the efficacy of these methods, we must first consider the term “permanent” as it relates to hair removal, and whether these two methods fit into the “permanent hair removal” category. The United States Food and Drug Administration has cleared few products to use the phrase “permanent hair removal” in advertising. More often, the phrase “permanent hair reduction” is used. To determine the status of a treatment, the FDA defines permanent hair reduction as “the long-term, stable reduction in the number of hairs re-growing after a treatment regime, which may include several sessions. The number of hairs regrowing must be stable over time greater than the duration of the complete growth cycle of hair follicles, which varies from four to twelve months according to body location. Permanent hair reduction does not necessarily imply the elimination of all hairs in the treatment area” (http://www.fda.gov/cdrh/consumer/laserfacts.html). Despite this tough standard for permanent hair reduction, electrolysis and electrical tweezer epilators can be considered permanent hair removal methods based upon FDA decisions (although the final classification of tweezer epilators is still dependent upon the emergence of more supporting data) (http://www.fda.gov/fdac/features/796_hair.html).
What is the evidence of efficacy?
Electrolysis is an established form of hair removal that was first used in 1875. The first person to employ this method of hair removal was Dr. Charles E. Michel, who used electrolysis to correct problems with ingrown eyelashes. In contrast with this, electrical current tweezer-type epilators are a much more recent development.
One product that uses an electrical current tweezer-type epilator is called “Finally Free” and is advertized as a product for permanent hair removal. (http://www.nevershaveagain.com/default.aspx?source=google&adgroup=laser). The web page for this product claims it to be “clinically proven as effective as electrolysis”. The site provides an example of a study which “prove(s) that Finally Free is a[s] effective as needle based electrolysis but without the pain and side effects.”
The study was carried out by Peter Bjerring, Henrik Egekvist and Thomas Blake of the Department of Dermatology at Murselisborg Hospital in Aurhus, Denmark. They were examining three different hair removal methods, which included electrolysis and tweezer epilators. Their method for this clinical study was to administer each of the treatments to ten participants and track the hair regrowth progress at two weeks and nine weeks after treatment. The participants included seven men and three women, all of whom were Caucasian, between ages 25 and 55 with an average age of 38.3 years of age. Treatments were all administered in the same session, and one area was left untreated to serve as a control. The participants evaluated the level of pain after the treatment on a scale of 0 to 100, 0 being “no pain” and 100 being “the worst imaginable pain.” The results showed no statistically significant differences between the efficacies of the treatments. The most noticeable difference was in the pain rankings of the treatments. The electrolysis received an average pain score of 58.7 while the electrical current tweezer-type epilator received an average score of 13.0. The conclusion was that the two treatments were equally effective, although the tweezer-type epilator was significantly less painful (Peter Bjerring, Henrik Egekvist and Thomas Blake, 1998).
While this study was set up for a good comparison of treatments, it has several limitations. This study had a very small number of participants to be making such generalized claims. Ten participants may be considered insufficient to prove the comparative efficacy of the treatments because variance among participants will be exaggerated in the results as compared to a large participant pool. Additionally, the study can only seek to draw generalized conclusions within the Caucasian population. People of differing ethnicities have different hair and skin qualities, making this study inapplicable to any ethnicity not included in the participant pool. Another major limitation of this study is the duration. Nine weeks is far too short for a study for which the standards are measured over a time period of four to twelve months, as stated by the FDA (http://www.fda.gov/cdrh/consumer/laserfacts.html). In addition to the limitations of the study, the reliability of the website advertisement raises questions about the true efficacy of the device. The website originally states that there are two supporting clinical studies. Upon examining the original study itself, which is not made available by the website, it is clear that there is indeed only one study that drew multiple conclusions. The site also tampered with the data, changing the “pain” values from 13.0 and 58.7 to 7.3 and 53.1 respectively, making the tweezer pain score appear lower than the study reported. The limitations of this study, and the lack of additional studies cited by the “Finally Free” website demonstrates that there is insufficient evidence for the broad claims the site makes.
This investigation demonstrates the level of reliability of websites advertising alternative health related treatments. Even with credible scientific research backing their claims, the information from the study can easily be exaggerated and misrepresented, showing the need to do further research when dealing with health questions. The conclusion drawn from this information is that there is not yet sufficient research to prove that tweezer epilators are as effective as electrolysis.
Bjerring, P., Egekvist, H., & Blake, T. Comparison of the efficacy and safety of three different depilatory methods. Skin Research and Technology 1998; 4: 196-199.
Finally Free; Permanent Hair Removal.
Marzena; Hair Removal Through the Ages. http://www.depilatory.com/ages.html
Straub, Richard O. Health Psychology; A Biopsychosocial Approach Second Edition. 2007.
United States Food and Drug Administration. http://www.fda.gov
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