Waxing is a time-tested method of hair removal that has seen a renewed popularity. While depilatories remove hair at the skin’s surface, “epilatories”, such as tweezers and waxes, pluck hair from below the surface. Waxing and tweezing may be more painful than using a depilatory, but the results are longer lasting. Because the hair is plucked at the root, new growth is not visible for several weeks after treatment. Simply stated, waxing is an efficient way of plucking hair from a larger surface. When performed properly, results can last from 4-8 weeks, depending on the site and the individual’s hair – growth rate [5,7]. Like shaving, epilation generally does not effect the growth rate of hair, however, duration of the anagen cycle may get effected [8,9].
A large variety of waxing products is available for professional use. Epilatory waxes are also available over the counter for home use. They contain combinations of waxes, such as paraffin and beeswax, oils or fats, and a resin that makes the wax adhere to the skin. There are “hot” and “cold” waxes. For hot waxing, a thin layer of heated wax is applied to the skin in the direction of the hair growth. The best hot waxes melt at just above the body temperature, reducing the danger of burning. The hair becomes embedded in the wax as it cools and hardens. The wax is then pulled off quickly in the opposite direction of the hair growth, taking the uprooted hair with it. Cold waxes work similarly. Strips precoated with wax are pressed on the skin in the direction of the hair growth, and pulled off in the opposite direction. The strips come in different sizes for use on the eyebrows, upper lip, chin, and bikini area. It is recommended that hair be at least 1/8" long before waxing. Labeling of over-the-counter waxes cautions that these products should not be used by people with diabetes and circulatory problems, who are particularly susceptible to infection. Side effects include folliculitis, pseudofolliculitis, postinflammatory hyperpigmentation, and scarring [5,10].
A typical epilatory preparation contains rosin and beeswax, modified by the addition of mineral or vegetable oil and/or other waxes. The preparations may also include such agents as camphor for its cooling effects, a local anesthetic, and/or an antibacterial compound. Since waxing stings the skin, many waxers use pain-reducing gels (usually 4% lidocaine) that are specially formulated to penetrate intact skin. The pain-reducing gels are applied 30-60 min before waxing.
Various mechanical epilation devices are also available that can quickly remove a relatively large body of hair. These devices use rows of tweezers that are designed to firmly grab and pull multiple hair from their root. Hair must be of sufficient length for the device to engage. Skin irritation, folliculitis and in-grown hair are some side effects that have been noted [10].
Another epilation method that is more common in the Middle East and India than other parts of the world is Threading or Khite [11]. Threading is generally performed by a cosmetologist who uses twists of a cotton thread to pull out rows of hair. This method is generally used on the face, especially to remove upper lip hair and shape the eyebrows. Like other epilation method, the results can last several weeks. Skin irritation and folliculitis and secondary pigmentary changes are some of the side effects that have been noted.