Safely coping with excessive body hair

Dear Dr. Peg
I enjoyed your column on balding in the Dec. 8 issue of the Daily Lobo.
At 52 years old, balding has never been a problem for me. I’m actually a hairy beast. Not only do I have plenty of hair on my head, but I’ve got it on my chest, back, arms, legs … everywhere.
As a guy, I’ve never really concerned myself about this issue. However, if I did want to take the energy to be a little easier on the eyes, I wonder, what healthy options could I pursue to minimize all that hair and look more attractive and youthful?
— Hairy Beast

Dear Hairy Beast,
You may think that being “follicularly well-endowed” is unattractive, but some might disagree. Listen to the ancient Roman Juvenal who asserted, “A hairy body and arms indicate a manly soul.” In more modern times, Kahlil Gibran exhorted us to “forget not that the earth delights to feel your bare feet and the winds long to play with your hair.” Grecians used to offer locks of hair as sacrifice to the gods, and legends from Samson to Rapunzel speak of the power of the pelt.

That being said, as you are so clearly aware, modern American culture does tend to scorn the Sasquatch look. Visions of the beautiful body bald surround us in advertising and entertainment. Women shave, wax and pluck from pits to pubes and beyond. Men are following suit, dispatching hair from arms, back, chest and even scrotum, along with the traditional facial scrape. As a physician, I have witnessed every variation, believe me. So if you want to join the ranks of hair-free Americans, or even just curb some of your curls, here are your options:
Hair removal methods can be loosely divided into temporary and permanent categories. I say loosely because often the so-called permanent methods turn out to be temporary.

Shaving, plucking, waxing and depilation are the usual temporary methods.
Depilation uses chemicals to dissolve the exposed hair. Shaving cuts the hair off at the base. Waxing and plucking pulls the hair out by the root. These are all pretty safe methods, although the skin can become irritated and infected by any of them, most commonly by shaving.
Shaving is the most temporary of these methods, since it only cuts the hair, which continues to grow from the hair follicle. To look and feel hairless, most people have to shave at least daily. A common myth is that your hair grows back thicker if you shave; this is not true. It’s just that the cut end feels coarser.

Waxing and plucking last longer than shaving because they pull the whole hair out, and the follicle then has to make a new hair. Waxing is better for large areas than plucking, which is usually used on areas like eyebrows. Sometimes waxing and plucking can lead to permanent damage of the hair follicle, a desired result if you’re aiming for fuzz-free. Yanking your hair out by the roots is also painful. Remember the scene from “The 40-Year-Old Virgin” where he got his chest waxed? I’d think any man who saw that would steer clear of the wax pots, but no. We tolerate a lot when it comes to our personal image. Ask any woman who has had a Brazilian bikini wax.

Depilatory creams were all the rage when I was an adolescent, but are less popular now, probably because of the nasty smell and the risk of skin irritation. Still, they are a decent solution for some people, and the results last about two weeks. Another kind of cream, called Eflornithine or Vaniqa, is perfect for the bearded lady. This cream reduces hair growth by chemically inhibiting a crucial enzyme, and has been combined with laser therapy (see below) for quicker results. So far, it is only approved for facial hair on women.

Speaking of the bearded lady, I’d be remiss if I didn’t mention bleaching as another option for follicular management. Many women find this to be a good way to hide their unwanted moustache. Using a special, gentler bleach than your kitchen bleach or your hair dye bleach, these creams just lighten the hair that is there rather than remove it. Guys can use this easy, inexpensive method too, but just remember all it does is change the hair color. A furry blond back is still a furry back.

“Permanent” methods include electrolysis, laser and pulsed light treatments. Electrolysis uses a needle to apply electricity to the hair bulb. There are two kinds of electrical currents, DC (direct current) and AC (alternating current).

Direct current applied to the tissue turns natural saline into sodium
hydroxide, which chemically destroys the bulb. Alternating current, the more recently developed method, creates heat, which obliterates the follicle. Sometimes both are used together. As you might imagine, a hot needle in the skin can be painful, and the resulting destruction of tissue can cause scarring and pigment changes. Reportedly, even in the best hands, you’ll get 15 to 25 percent re-growth in six months, and one problem with electrolysis is that just about anyone can call themselves a professional. There are no standardized regulations for wielding the needle.

Laser and pulsed light are called photoepilation therapies. A laser can be set to a specific wavelength, and the one used for hair removal targets the melanin in the hair bulb. Melanin is the chemical that gives hair and skin its color. Because of this, one complication can be removal of pigment from nearby skin as well. Consequently, laser was originally best-suited for light-skinned people with dark hair. Advancements have been made, however, and new laser types can work on dark-skinned people as well. Laser is best suited for large areas, and usually requires four to six treatments spaced several weeks apart. Unpleasant side effects can include pain, redness, blistering, irritation and scarring. Oh, one more thing: Some people apply a topical anesthetic balm to the skin before a laser treatment to try to minimize the pain. A year ago, the FDA issued an alert after two women died — yes, died — after doing this when the balm was absorbed and wreaked havoc on their nervous system. So, be careful!

Clearly, there is no magic pill to help you lose those locks, but as you can see, there are many options. Good luck with your manscaping project!

Peggy Spencer, MD is a board-certified family physician. She has been a UNM student health physician for 17 years, and a Daily Lobo contributing columnist for 3 years. She is co-author of the book “50 Ways to Leave Your 40s,” released in March 2008. Drop your questions in her box in the lobby of Student Health and Counseling, or e-mail her directly at pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health care provider.