The effectiveness of these methods also leaves something to be desired. What woman hasn't been on a beach vacation and looked down at her bikini line to see three coarse hairs that she missed earlier? Or how about discovering an ugly thick chin hair after you tweezed the night before? Naturally, we want to have better options. As a result, many women are considering permanent hair removal as an ideal alternative to inconvenient, time-consuming and imperfect temporary hair removal techniques.

So what do you have to choose from? The two classes of permanent hair removal, electrolysis and laser hair removal are very different in their cost, duration and number of treatments and level of pain and discomfort. Also, one size doesn't fit all; for instance, the best hair removal method depends on your skin and hair type. Some methods work best on different areas of the body. But for every woman, there's at least one permanent hair removal technique that'll liberate her from waxing, shaving, tweezing, bleaching and threading.

What electrolysis entails

Electrolysis has a long history; the first article on the use of electrolysis for hair removal was published in 1875. Currently electrolysis is the only hair removal technique the FDA considers "permanent," and medical science has more than a century of data on the long-term effects of electrolysis.

The current method involves insertion of a needle into the hair follicle, followed by administration of an electrical current to the follicle from this needle. Three types of electrical current can be applied, which destroy the follicle in different ways:

1. Galvanic electrolysis uses direct current, which causes salt and water in the skin to form sodium hydroxide (NaOH), the active ingredient in drain cleaners. This sodium hydroxide destroys the follicle.

2. Thermolysis uses alternating current to heat water in the skin and destroy the follicle.
3. Blend is a combination of both galvanic electrolysis and thermolysis, using just one machine.

Today, most electrolysis machines use the blend variety. Considered outdated, galvanic electrolysis takes too long — during the time the needle must be inserted into the follicle — and thermolysis alone is known to cause the most pain and skin reaction. Blend electrolysis has lower rates of regrowth than either galvanic electrolysis or thermolysis and is less painful than thermolysis.

The experience of electrolysis. As you're getting electrolysis, you'll feel a small needle prick followed by an electrical shock. The thinner your skin and the closer the follicle is to a nerve, the more pain you experience from the shock.

Additional factors that affect the pain include the intensity used (higher intensity means greater pain) and the type of needle inserted into the follicle. An uninsulated needle will pass electrical current through the entire length of the follicle and the surrounding skin, which is much more painful than an insulated needle that maintains the focus of the electricity within the cells responsible for hair growth at the base of the follicle. Many women also report that electrolysis is more painful immediately before and during a menstrual period.

Electrolysis indications. As electrolysis treats unwanted hair one hair at a time, it can be time-consuming for large areas like the legs. For an area such as the eyebrows, however, removing one hair at a time is ideal for proper shaping and symmetry between the two brows. And most hair removal clinics that perform both electrolysis and laser hair removal agree; they recommend electrolysis over laser hair removal for the eye brow area.

Similarly, electrolysis is the best method for stray facial hairs, such as those on the chin, cheek and neck, as well as upper lip hair. Also, because electrolysis targets individual hairs, the surrounding non-hairy areas aren't exposed to the effects of the electrical current.

Cost and complications. The duration of a session depends on the area of interest. Typically the upper lip takes 20 minutes in the first session; both eyebrows can be completed in about half an hour. The "permanent" results depend on several factors including the growth stage of the individual hair treated, the number of times the electrical current is applied to that follicle in one session and the intensity of the current used.

Hair follicles are more likely to be permanently destroyed when you use a higher intensity current and the hair is in an active growth stage. With increasing intensity or number of applications, pain, inflammation, scabbing and even the risk of scar formation increase.

Most women beginning electrolysis treatments visit their esthetician weekly; as more and more follicles become permanently destroyed and regrowth slows then stops, they may decrease treatment frequency to as little as once a month.

The cost of electrolysis is usually $1 to $2 per minute with many salons offering package deals when large amounts of time are purchased in advance. You must receive regular electrolysis sessions for a year or longer before permanent hair removal is achieved within a given area. The total time before permanent hair removal occurs depends on the thickness of the hair, your cooperation regarding not plucking or shaving between treatments and the frequency of treatments.

Looking into laser hair removal

The first laser hair removal machines were used in the late 1960's. Today's technology has resulted in better results and fewer side effects, although long-term effects aren't known. Laser hair removal uses light of a particular wavelength to destroy the follicle by both thermal and mechanical damage. The laser is absorbed only by the dark pigment of the hair, so technically the surrounding skin is spared.

The technician applies the laser using a hand piece the size of a hairbrush, so targeting of the light to any particular follicle is much less exact than electrolysis. Needles aren't used in laser hair removal, and several follicles are treated at the same time. This means it's less painful, but also less precise; it's a quicker method, best for large areas of unwanted hair, like the legs.

The FDA doesn't classify laser hair removal as a permanent hair removal method, but calls it a permanent method of "hair reduction." After the first laser session, some hairs are permanently removed, and others may regrow, but regrowth is finer and lighter.

Are you a good candidate? Because the target of the laser is dark pigment, damage to the surrounding skin can occur in people who have similar skin and hair color. Laser burns occur more commonly in dark-skinned people with dark hair and light-skinned individuals with light hair (including gray hair), because the laser has difficulty distinguishing between the hair and the skin.

The ideal candidate for laser hair removal is a light-skinned person with dark, coarse hair. Laser hair removal can't be used on tattooed and pigmented areas with unwanted hair, as the pigment will absorb the laser, causing a skin burn.

Cost and complications. Laser hair removal on a large area such as the legs is usually done in two separate appointments over one week. For lower legs, you'll spend an hour and a half during a single session and another hour and a half on a different day for the upper legs. The overall treatment is repeated every six to eight weeks usually a total of six times, before permanent hair reduction is achieved, though many hairs will never regrow after the first session.

A single session for both legs varies in cost from $500 to $1,500. Avoid sun exposure after each treatment to reduce pigmentation of inflamed areas and until all sessions are terminated.

Lifestyle between treatments

With laser therapy, in addition to avoiding tanning, you shouldn't use artificial bronzers; this will increase damage to surrounding skin, because the laser is less able to distinguish between skin and hair when your skin is pigmented. But you can shave in between your sessions. That's because shaving increases the pigmentation of the regrowth, and thereby increases the likelihood of permanent hair removal at the next laser session.

Between electrolysis treatments, however, you can't shave, wax, thread or tweeze. All these things strengthen and thicken the regrowing hair, which adds more work during electrolysis treatments. Effective electrolysis is more likely if you have easy and frequent access to your practitioner, considering the overwhelming temptation to pluck visible hairs between sessions. Tanning is permitted, with the exception of two to four days immediately after the session, when sunlight can cause increased pigmentation of inflamed areas.

Treating ingrown hairs

This is another difference between the two techniques. A laser can effectively target an ingrown hair, but electrolysis can't, because a needle must be inserted into the follicle beside the shaft of the hair. If you have curly hair and frequently experience ingrown hairs, this is another factor to consider when choosing a laser hair technique.

Regulation of practitioners

Wondering who can actually perform your laser treatment? Regulations vary by country, province and state. Many plastic surgeons and dermatologists have laser machines in their practices, but these are operated by nurses or technicians. Most provinces and states have a board or association that laser and electrolysis practitioners may join, but often membership in these associations isn't mandatory for a technician.

In most regions, there are no unifying regulations regarding a practitioner's training in electrolysis or laser hair removal. Generally speaking, the practitioner's technique is more important in electrolysis, as a needle must be precisely inserted into an individual follicle, following the orientation of that follicle. On the other hand, laser hair removal involves the machine itself targeting the hair within the follicle.

Practitioner experience with both techniques is important as burns and scarring may occur with inexperienced practitioners who apply the laser for too long or at the wrong wavelength or electrolysis needle?s electrical current at too high an intensity.

Special considerations

Some individual conditions may also influence your choice of hair removal technique. Electrolysis may affect the function of cardiac pacemakers and cause cardiac arrhythmias. Both laser and electrolysis might reactivate Herpes simplex virus in affected areas.

Women who form keloids (thick over-reactive scars) should use all methods of permanent hair removal with great caution. The use of electrolysis and laser hair removal hasn't been studied in pregnant women. Most physicians and practitioners will advise against electrolysis and laser treatments during pregnancy, although anecdotally many women have had such treatments during pregnancy with no obvious negative effects.

Bottom line. Remember, choose the method that's recommended for your particular skin and hair type and consider the use of different techniques for different areas. As with all important choices, an informed decision is the wisest decision. After you've chosen a reputable and experienced practitioner, make sure to follow his or her advice.

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