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Electrical Epilation Level 3 Beauty Therapy
Hair & Beauty
Hair Growth Related to Epilation As revision please label the following diagram The Hair Follicle
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The Hair and the Effects of the Endocrine System on Hair Growth The Cycle of Hair Growth You will need to understand the hair growth cycle because: •
It affects the success of needle diathermy
•
You can explain why new hairs appears during a course of treatment
•
It becomes clear why treatment can take variable amounts of time.
There are three stages of hair growth: 1.
Anagen
-
the active stage
2.
Catagen
-
the changing stage
3.
Telogen
-
the resting stage
Follicles all over the body are in one of these three stages at any one time, but adjacent follicles are not necessarily in the same stage. ANAGEN - THE ACTIVE STAGE At the beginning of the anagen the germ cells which form the dermal cord undergo mitosis, producing a new follicle by extending the depth and width into the surrounding dermis. The germ cells are remnants from the outer root sheath of the previous follicle and extend in a solid column from the base of the catagen or telogen follicle. These germ cells are vital for the production of a new anagen follicle. The basic dermal papilla remains in the lower dermis until the new follicle surrounds it. Once this happens, the papilla enlarges and a bulb forms around the papilla. The bulb is responsible for the production of the hair cells, the lower part of the bulb is known as the matrix, where mitosis takes place to produce the new hair. These Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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cells move upwards through the bulb becoming differentiated to form the different structures of the hair, that is the cuticle, cortex and medulla. The inner root sheath is produced at the same time, growing up the follicle with the hair, protecting it and anchoring it in the follicle. Two thirds of the way up the follicle, at the level of the sebaceous gland, the inner root sheath stops, the hair emerges from the inner root sheath and eventually leaves the follicle.
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CATAGEN - THE CHANGING STAGE The matrix of the bulb suddenly breaks away from the dermal papilla and both structures degenerate. The hair breaks from the bulb which has shrunk and is only attached by the inner root sheath. It is known as a club ended hair. Over a period of days, the hair rises up the follicle and the area of the follicle below the hair shrinks upwards. During this period undifferentiated cells, from the matrix of the bulb and the outer root sheath, will form new germ cells. The hair continues to rise to a point just below the sebaceous gland, where it becomes free of the inner root sheath and can be brushed out. TELOGEN - THE RESTING STAGE The follicle rests until stimulated again by local enzymes and hormones to return to anagen. The follicle is approximately half the length of its anagen stage. It may help to condense this information into an abbreviated version from which you could make simple diagrams illustrating the different stages of hair growth. Telogen
-
Follicle dormant, half its anagen length
-
Germ cells/dermal cord equivalent
-
Mitosis forms dermal cord and new follicle
-
Follicle surrounds dermal papilla
-
Bulb forms around dermal papilla
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Follicle full length
-
Dermal papilla and bulb fully active
-
Bulb forms new hair surrounded by inner root sheath
Anagen - stage three
-
Follicle and hair fully grown
Catagen
-
Hormone stimulation ceases
-
Mitosis ceases in bulb
-
Bulb breaks away from dermal papilla
-
Hair breaks away from bulb and is club ended
-
Hair moves up follicle-only attached by inner root sheath
Anagen - stage one
Anagen - stage two
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Follicle shrinks -
Dermal cord forms
Telogen
-
Hair falls out
-
Follicle rests
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During Anagen the follicle grows down into the deeper layers where concentration of moisture is higher. In catogen the follicle begins to collapse and retract. In telogen only the dermal canal is left so the follicle is near to the skin’s surface where moisture is low.
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Types of Hair Hair is found all over the body except on the lips, umbilicus, palms of hands and soles of feet. Different types of hair are evident and these may be divided into two main types - vellus and terminal, as well as lanugo hair which is present on the foetus. Lanugo hair - soft downy hair, usually colourless, which covers the foetus and is normally shed prior to birth. It may be seen on premature babies. It is non-medullated and its function may be to hold the vernix in place. Vellus hair - soft, short, downy hair covering most of the body and not easily visible. It has a shallow follicle and a poorly developed dermal papilla. In some cases there is no papilla and the hair and follicle are nourished by the connective tissue sheath. Vellus hair may be pigmented or non-pigmented, medullated or non-medullated. VELLUS HAIR IS CONSIDERED TO BE AN APPENDAGE OF THE SEBACEOUS GLAND Accelerated vellus hair - if vellus hair is stimulated by the endocrine system or by topical irritation the follicle may deepen to produce a terminal hair. This changeover may take place in gradual stages over a few months or several years. In the early stages of this change the vellus hair is termed accelerated vellus hair. This means the hair is longer than surrounding hairs, but has not attained the vigorous growth of a terminal hair and may not have a bulb. If stimulation continues the accelerated vellus hair will develop pigmentation and the follicle will deepen. The bulb will form with a dermal papilla, and a terminal hair is produced. Terminal hair - strong, normally pigmented hairs, growing on the head, pubis, axilla and eyebrows. They have a well developed papilla, bulb, and grow from deep follicles which may extend to the subcutis. Terminal hair is present in large visible amounts on areas that need protection, such as scalp, brows and genetalia. Terminal hair structure consists of cortex, cuticle and medulla - which may be continuous or fragmented. This is the obvious, strong hair, which if pigmented, is the type the electrologist will be asked to remove. Hair types may also be further broken down to include simple, fine, coarse etc. You will see examples of all these hair types during treatments.
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Describe each of the following hair types.
Hair Type
Description
Simple
Compound
Straight
Curved
Fine
Coarse
THE OPTIMUM STAGE FOR TREATMENT WITH DIATHERMY Diathermy needle treatment is most effective if given during the anagen state of growth. Current released at the base of an anagen follicle will destroy the outer root sheath, dermal papilla and bulb. All these structures are necessary for the regeneration of the follicle and hair. This level of destruction is only possible in anagen, when these structures are situated around the base of the follicle and therefore destroyed by the heat produced.
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Hirsutism This is a male pattern of hair growth in women caused by hormones. Vellus hairs are converted into larger terminal hairs due to high levels of androgens/over-sensitive hair follicles. 1.
Which hormones cause hirsutism?
2.
List the places where unwanted hair growth occurs in a hirsute woman.
Hirsutism is caused by one of two factors. 1.
An abnormally high level of androgens produced by the adrenal cortex or ovaries.
2.
The level of androgens in the female is normal but her hair follicles over react to the hormone.
Factors Effecting Hirsutism Hirsutism caused by Normal Levels of Androgens In the cases of race, age, stress and medical treatments, there is no disorder of the endocrine system. Race People of different ethnicity inherit a different tendency to develop hirsutism. Growth of coarse facial hair is common for a white British woman as she gets older, but is rare in a Japanese woman. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Below is a list of geographical areas. Women who originate from these areas, and are more likely to become hirsute, are listed at the top. More likely to become hirsute
Less likely to become hirsute Less likely to become hirsute
Mediterranean/India/Pakistan Northern Europe Africa China/Japan China/Japan
Age At certain times in a woman’s life, normal changes in hormone levels occur, which disturb the level of androgens and may lead to hirstuism. These times are puberty, pregnancy and the menopause. Puberty:
The adrenal cortex and to a lesser extent, the ovaries will produce androgens. These cause the growth of pubic and axillary hair. Some girls may be more sensitive to androgens or may produce a slightly higher level of androgens and start a male pattern of hair growth - such as coarse hair on her upper lip or hair growing around the nipples, on her chest and up towards her naval.
Pregnancy: Sometimes a woman may produce more androgens than normal, when she is pregnant. Menopause: During the menopause, levels of oestrogen and progesterone fall. The adrenal cortex still makes androgens and the relatively high level of androgens can cause hirsutism. Stress Periods of severe emotional stress can cause the adrenal cortex to produce higher levels of androgens than normal, leading to hirsutism. Medical Treatments Lathric hirsutism is superfluous hair growth caused by medicinal drugs. Androgens may be given to women with breast cancer and as part of hormone replacement therapy (HRT) to women suffering from menopausal problems.
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Anabolic steroids have some androgens in them and are sometimes given to threat osteoporosis and muscle wasting. (They are also illegally given to athletes to build up their muscles. Some progesterones in the contraceptive pill may be broken in the body to form androgens.
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A Brief Synopsis of the Causes of Hair Growth All hair growth can be attributed to one of the following causes. CONGENITAL This is the pattern of hair growth that is genetically determined from the moment of conception, by two factors: 1.
Racial characteristics - some races are hairier than others. Mediterranean races have more hair producing follicles than the far Eastern races. The hairs are often coarser and longer too.
2.
Parental - this is a hair growth pattern passed on by parent. A mother or father who has a dense hair growth, or hairs that are longer than normal or any other variant may pass this on to the next generation. This may result in a growth that is socially unacceptable but not medically abnormal.
3.
Topical - an external stimulus results in an increased blood supply and nourishment to the follicles in the affected area resulting in longer stronger hairs. The irritation may be caused by burning, friction, or damage to a follicle resulting in the formation of scar tissue, for example waxing or naevi.
4.
Systemic - the endocrine system can produce an imbalance of androgens. As you will see later, this is the ultimate cause of hair growth. The hormonal imbalance may occur for many reasons - poor functioning of the adrenal cortex or the ovaries are two examples. This results in hair growth that not only may be longer and stronger than is normal for the age and sex of the client, but may follow the male pattern of hair growth. This client may also have other signs and symptoms of endocrine imbalance, such as weight gain, male pattern baldness.
The Endocrine System and Hair Growth You have already seen that hair growth causes fall into three categories - one of which was systematic. This is directly attributable to the endocrine system and the hormone androgen. Normal or expected changes in hair growth occur is females at puberty, to prepare the body for its childbearing role, during pregnancy, and at the menopause when the childbearing period is over. During these periods hair growth may appear in the axilla and groin and become longer and darker on the rest of the body.
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Abnormal or unexpected changes in hair growth occur when there is malfunctioning of the endocrine system, or drugs and surgery have upset normal hormone levels. In this case, one of several endocrine glands may be involved. Follicles are sensitive to levels of circulating androgens. This sensitivity varies from person to person, and from area to area on individuals, resulting in wide variations of hair growth patterns, coarseness and length. However, a long or strong growth of hair does not necessarily mean high levels of circulating androgens and present, only that there may be follicle sensitivity to its presence. Unusual Hair Growths Lanugo Comedone This is a problem for people with very oily skins and is not benefited by electrolysis. This is a bundle of tiny lanugo or vellus hairs protruding from a follicle, it looks like a short thick dark hair, but it can be tweezed without traction. Observed under a microscope it would be a tiny bundle of hair held together by sebum. These can be dealt with by a beauty therapist if only one or two present, but if many are present it is a dermalogical problem. Telogen Hair that fails to shed Sometimes coarse telogen hairs stay trapped in the follicle; being large in diameter and the bulb being stuck they are usually colourless and thick and can be felt easier than they can be seen. They are colourless because the source of pigment has been cut off. Treat as normal. Cork Screw When treatment in an area is coming to an end sometimes cork screw hairs appear. They seem to be produced by remnants of pilo-sebaceous units that have become disorientated by the treatment. These hairs are usually very shallow and may be distorted. Treat them as normal hairs or tweeze if loose. Hair will probably not regrow again. Tombstones This is the remnant of a small anagen hair which is left unepilated in a treated follicle. Sometimes an electrologist will treat a follicle and take out a hair. But unknown to her a new anagen hair was growing. The old hair was taken out but the new anagen hair was left in the follicle. This new hair will work its way to the surface like a splinter. Just take them out with the forceps. They sometimes look like a big blackhead. It will come out with tweezers with no traction Considered to be a sign of a departed follicle. Embedded/ingrowing hair Resulting from the skin growing over the follicle entrance from over treatment or distorted follicles from waxing. Also from clothing constantly rubbing. If the hair has caused infection Ely to free the hair with pointed tweezers. Cut the hair short and Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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leave it alone until the infection has gone, then treat the hair. If you remove or treat the hair the skin may then grow over the pore and trap the infection Compound follicle (pili multigemini) This is when two hairs are growing sharing one follicle. Each hair has its own papilla and inner root sheath with one outer root sheath surrounding them both. Red and non pigmented hair has a higher sulphur content and are very strong. They require a higher current intensity of SWD. Review Questions 1. State how to remove hair from a compound follicle. 2. Define the term “in growing hair� and discuss how to treat. 3. State how the therapist should treat red and non pigmented hair. 4. State two ways in which age effects hair growth in women.
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Epilation Range Considerations Task Sheet
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Treatment Area
Position require Length of ments Needle size Angle of time client and growth treatm & type ent therapi st
Upper Lip
Nape Neck
Chin
Fingers/Toes
Legs
Underarm
Bikini Line
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Breast
An Introduction to Epilation Methods of Hair Removal
Electrolysis The History of Electrolysis Electrolysis dates back to the 19th century, when electrical currents were first discovered. However many of the methods that were used to remove hair were extremely unhygienic and often caused great pain and scarring. It wasn’t until 1923 that Dr Bordier of Paris, France revealed to the world how safe and easy an electrical current was to use in the removal of unwanted hair. How Electrolysis Works Electrolysis is the only accepted method of permanently removing unwanted hair. It is a progressive treatment which requires a course of regular sessions to achieve successful results. Electrolysis works by introducing an electrical current accurately to the growth area of the hair by the means of a fine probe. The skins tissues react against the electrical current and heat is produced, which in turn causes the hair to detach itself. After each treatment the blood supply to the hair is reduced so that the hair cannot be fully nourished, therefore the hair grows back weaker and not as noticeable until it is fully diminished. Hygiene This college has very high standards of hygiene and cleanliness. Therefore sterile disposable probes are used for every treatment. Areas which can be treated Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Electrolysis can be carried out on the following areas: • • • • • •
Facial area Bikini line Legs Breasts/nipples Arms Abdomen
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High Frequency Short Wave Diathermy The high frequency alternating current used for diathermy is several million cycles per second. The precise amount varies from country to country. The frequency is in the same band or range as radio waves. In diathermy the electrons do not move in one direction they move up and down, alternating between the negative and positive poles. The rapid alternating of polarity creates friction heat in the hair follicle molecules by continually attracting and repelling them. This heat builds up rapidly and is very destructive. It is the same type of action found in the microwave oven. The high frequency alternating current passes down the needle and creates most heat in the moist lower part of the follicle.
Diathermy Effect Heat production begins at the tip of the needle in a pear to tear drop shape and then travels up the needle to the skin surface. The lower part of the follicle is heated more intensely and for longer than the upper part. This is a very quick way of treating the follicle but has a lot of regrowth.
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Legislation Detailed below are the Legislation and Bye-laws which you must comply with when providing an electrical epilation treatment. Health and Safety at Work Act 1974 This piece of legislation gives rights to both the employer and the employees. Employers must provide: • • • • •
A safe and healthy workplace. Proper safety procedures eg fire exits. Safe equipment which is regularly serviced. Adequate training to all staff in safety procedures. Access to a health and safety policy.
Employees must: • • •
Follow health and safety procedures. Act to protect themselves and others. Treat all equipment properly and report any faults.
Electricity at Work Act 1992 This piece of legislation states that all pieces of electrical equipment in the workplace should be checked annually by a qualified electrician. They should discontinue using any equipment that is broken or damaged, exposed wires, cracked sockets etc and that sockets should never be overloaded. COSHH Please state the COSHH regulations
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Industry Codes of Practice Personal Presentation Hygiene is very important not only to prevent infection and offensive odours but also to give a professional image to the client. Your presentation is also important from a safety aspect, you must present yourself in a manner that prevents the risk of any accidents or injuries to yourself or others. As an electrologist a client will expect you to portray a certain image, which means that you must appear professionally well groomed at all times. Below is a list of what is required: 1. Always wash hands before and after treating each client. Hands should be washed using soap from a sealed dispenser and dried using disposable hand towels or a warm air dryer. 2. Have clean teeth and avoid eating strong smelling foods and smoking. 3. Bathe daily. 4. Clean, pressed overall daily. 5. Legs should be covered with tights/trousers to protect legs against any product spillages. 6. Shoes should be a full court shoe with a low heel. This will protect the foot and prevent against and minimise any injuries if you fall or trip. 7. Hair should be short or tied back, this is to prevent the risk of the hair being caught and causing an injury. 8. Nails short, clean and free from enamel to prevent the risk of scratching a client or causing an allergic reaction. 9. Any cuts or abrasions on the hands must be covered. 10. No jewellery should be worn except a plain wedding band if applicable. Jewellery dangling from any area could easily be pulled or caught therefore causing an accident. Hygiene Requirements When Performing an Electrical Epilation Treatment The list below is a summary of what is stated in the Industry Codes Of Practice when performing an electrical epilation treatment: 1. Waste must be treated as contaminated waste and disposed of in a sealed plastic bag. 2. All needles must be disposed of in a sharps box. 3. All metal tools should be sterilised in autoclave. 4. Plastic/metal tools to be sterilised in Perasafe. 5. Cloth - anything that comes into contact with the skin must be washed in detergent. 6. Disposable paper must be used on the floor if the client is going to stand with bare feet.
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Cross infection occurs due to certain micro-organisms being contagious and these may then be transferred through direct contact - personal contact, touch, inhaling airborne droplets such as coughing or indirect contact - implements which are not sterile, from a person to an object e.g. towel, jar of cream etc. Secondary infection can occur as a result of bacteria penetrating a cut, for example and causing infection. Below are the different methods of Sterilisation and brief description of effective procedure. Autoclave Sterilises by high steam pressure (higher than boiling point) at varying times (15 mins at 121oC to 3 mins at 134oC). Most effective method of sterilisation - used for metal tools and some plastics. Chemical Sterilises by chemical - usually Perasafe. Used for metal and plastics which need to be immersed for 12 minutes for effective sterilisation. An activator liquid in normally mixed together and once the chemical is mixed it will be effective fox 24 hours. After this time it should be flushed down the sink with cold water and a new liquid mixed. Always refer to manufacturers instructions. Glass bead steriliser Sterilises by heat - heat of between 190 oC - 300oC is used to heat small glass beads to a high temperature. Used for small metal tools and needles which need to be placed in-between the beads for 10 minutes for effective sterilisation. This equipment takes approximately 30 minutes to heat up and only the parts touched by the glass beads are sterilised, therefore it is now not often used in the salon. There is a possibility that repeated exposure to high temperatures can impair the needles and this in turn could affect the current distribution of the needle. This is another reason why this method of sterilisation is not often used for needles today. Methods of Sanitisation. UV Cabinet. This produces UVC rays which have disinfectant properties only and therefore does not sterilise. This is a safe environment for sterilised tools to be stored in ready for use.
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Disposal of Waste Any waste materials which come into contact with body fluids should be placed into a lined bin, which has a lid. A yellow bin liner should be used as this indicates that the contents have come into contact with body fluids. Any other waste materials should be disposed in the same manner, except a normal bin liner may be used. The waste bin should be emptied at least daily or as regularly as required throughout the day. In college environment the therapist should empty their waste after each time they have completed their treatment at the work area, and not left for the next therapist to empty their waste for them. Preparation of Work Area It is important that, before, you greet your client you have prepared your working area for the electrical epilation treatment. It would look most unprofessional to your client if you did not have all your equipment at hand or if your equipment would not work. It also wastes valuable time. Checking Equipment and Materials Safety of Electrical Equipment What precautions should be followed when using electrical equipment? • • • • • • • •
Equipment must comply with British Standard of Safety. The equipment must be correctly wired and checked by a qualified electrician every 12 months - a sticker would indicate this. The equipment should be placed on a solid, stable trolley. The trolley should be in easy reach of the operator to prevent over stretching of wires. No liquids should be near the electrical equipment. Leads should not be dangling. Regular cleaning of equipment must be maintained. It must be earthed or double insulated (This symbol indicates double insulation).
Checking Equipment You must ensure that: • •
All equipment and materials are clean and hygienic. Tweezers and chuck caps have been sterilised. You have a plentiful supply of towels and linen.
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• • • • • • • •
All products are available and have an adequate quantity of product. They should be neatly arranged on the trolley in the order that you require them. Shower and toilet facilities are clean and in working order. Sink and water supply are in working order and you have adequate soap and paper towels. Sharps box is available for the disposal of needles. An empty, lined and covered bin should be available for your use. Massage couch is cleaned, protected and has clean linen. It is also in full working order and safe. When using electrical equipment you have checked that all plugs, wires and switches are safe and that equipment is working correctly. Trolley has been wiped down with disinfectant or surgical spirit and has paper protecting it. Levels of Lighting, Heating and Comfort
Lighting When performing an electrical epilation treatment you require very good lighting in order to see clearly the hair follicles. In addition to the normal lighting of the room you will also require a magnifying light, which should be adjustable, to assist your vision of the hair follicle, skin condition, direction of hair growth etc. If you do not have adequate magnification and lighting when performing the treatment your judgement can be affected and an ineffective treatment would result. For example missing the hair follicle when probing, inserting into the wrong hair follicle, causing bruising or bleeding of the skin or inserting at an incorrect angle. Room Temperature As the client may be undressed throughout the treatment the room temperature should be slightly warmer than normal. The room temperature should be able to be adjusted throughout the treatment as required. The minimum room temperature as stated in the Health and Safety At Work Act 1974 should be 16°C within I working hour, with the preferred room temperature being 23 - 25°C. The client can also be covered over with additional towels and blankets to keep warm. Adequate ventilation should also be provided to prevent cross infection of viruses and diseases, carbon dioxide saturated air, stale smells and odours. Ambience The ambience of the room is vital as it sets the atmosphere for the treatment. Three main areas should be considered when setting the ambience: 1. 2. 3.
Colour Aroma Sound
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Colour - this concept of colour therapy has become more popular over the last few years. Colour should be considered when painting walls, as well as the colour choice for lighting, soft furnishings and towels. It is important that when making a decision you also take into account the gender of your clients, as male clients may feel uncomfortable in a room which is very feminine in colour. The effects of colours: Blue - reduces tension and anxiety. Violet - deeply relaxing. Yellow - stimulating and uplifting. Orange - boosts energy levels. Red - increases motivation and circulation is increased. Green - balancing, calming and sedating. Aroma - can be introduced into the room to produce specific effects on the client however only a qualified aromatherapist should use oils. You may wish to use a diffuser or burner to introduce an aroma such as spring, sea breeze, alpine etc. which would give the room a fresh and clean atmosphere. Sound - the room should be tranquil and music can be used here to produce excellent effects. There are many tapes which are manufactured entirely for this purpose and contain sounds from rain forests, the ocean, wind chimes, piped music etc. These have been proven to be very popular with most clients during a treatment. Correct Positioning Operator’s Positioning If the therapist is working in the correct working position it should enable you to: 1. 2. 3.
Maintain correct posture - back straight, body tilted slightly forwards, shoulders relaxed, weight evenly distributed between both feet and both the hand and arm should not be strained. Align the probe in the direction of the hair growth, so aiding entry of the needle into the follicle. Easily reach the area requiring treatment.
To achieve all of the above the operator must work at the correct side of the treatment couch, a right handed operator should work at the left side of the couch and vice versa. The use of a height adjustable chair or stool should be used to enhance the operators working position. Client Positioning The client should be positioned on the couch ensuring maximum support and comfort. A pillow or towel roll can be supplied for support. The position of the client should be central to the bed and also allow the therapist access to the areas which are being treated. Where there is a problem with breathing difficulties the client should be raised slightly to ensure that the breathing is not hindered. Do not be afraid to enlist your clients help by her moving to help you achieve perfect insertion.
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Equipment Positioning The machine should be placed on the top self of the trolley so that it can easily be accessible during the treatment. This is important as it will enable the operator to easily adjust the current when necessary and see the machine and current output easily. Leads from the machine should be placed so that neither the client nor therapist are at risk from tripping over or catching themselves on them. The equipment and products should be placed on the trolley, with all items easily accessible. Any liquids must be placed away from the machine to prevent accidents from occurring. The lamp should be placed so as to light the area clearly, without causing any shadows. When magnification is required the lens should be placed parallel to the area to avoid any distortion of the hairs. If positioned correctly the operator should be able to move their hands freely without knocking the lens. When treating fine vellus hairs it is often necessary to angle the light for maximum visibility. The Epilation – Safety Checks Before commencing your treatment you should always carry out the following safety checks. This will help ensure that your treatment is safe and effective and allows you to maintain continuity of treatment. 1.
The epilation unit should be clean, free from grease and placed securely on the trolley.
2.
The following electrical connections should be checked for wear and tear or damage, i.e. bare wires, loose connections, broken parts. •
Wall socket and plug.
•
Connection into epilation.
•
Needle holder/foot switch socket on the epilation unit.
•
Connection into needle holder and/or foot switch.
3.
The epilation unit should be plugged into the trolley and not directly into the wall socket.
4.
Flexes should not be left trailing where they may cause an accident. Fully extended flexes may also lead to accidents or break the wires inside the flex so this must also be avoided.
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5.
If your unit appears not to be working always check the following: •
The trolley is plugged in.
•
The mains power supply is on and the socket is switched on.
•
The trolley is functioning correctly.
•
The machine is switched on! (Indicated by pilot light where one is present).
•
All electrical connections are secure.
Any unit that is not operating correctly should be brought to your tutor’s attention immediately. Equipment The couch Your couch is adjustable and it should be used to alter the position of your client prior to and during your treatment as required. Pillows can also be used to provide support when necessary. The height of your stool should be altered in line with your own height and the area you are working on. This will allow the client to be as comfortable as possible during the treatment and it will improve your efficiency by: •
Allowing you access to the treatment area.
•
Ensuring you have good visibility of the area you are working in.
•
Preventing back strain due to poor posture.
•
Preventing tension in your working arm resulting in probing difficulties.
•
Allowing you to work for longer periods of time and achieve better results.
•
Allowing the client to relax and cope more easily with any discomfort caused by the treatment.
The magnifier The magnifier is illuminated by a neon tube in a strip or horse shoe shape. This provides you with a constant form of shadow free light. Regular use of the magnifier will help to prevent eyestrain and allow you to work accurately for longer periods of time. The position of the magnifier is very important, whether you are using it just as the source of light or to magnify the treatment area. The magnifiers position should be readjusted to ensure that you are always obtaining the best vision possible. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Equipment & Probing Techniques
The Electrolysis Needle
The electrolysis needle for blend epilation is both a probe and an electrode, it should be made from very high quality stainless steel. The needle both positions and discharges the current, its correct use and positioning is the most important element of electrolysis along with the correct level of current. Using your textbooks find out the ideal shape and characteristics of an electrolysis needle. DIAMETER The diameter of the needle should be the same as that of the hair being treated. Most needles come in sizes 003, 004, 005 and 006, these are measurements of 1000th of an inch, 003 for example is 3 thousands of an inch wide. Some needles are available in 002, these are needles of one piece. One piece needles are made from one solid piece of metal becoming progressively wider from the tip of the needle up to the shank, this is called an ‘increasing taper’. A one piece needle may be 002 at the tip but at the follicle opening it may be 003 or wider. Care must be taken to prevent possible over stretching of the follicle opening or even bruising.
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DEPTH OF INSERTION The depth of the needle should be long enough to reach the dermal papilla of the deepest anagen hair. The most common length of the needle in the U.K. is 3/16” and is denoted by the letter ‘S’ after the number, ie. 003S, the slightly longer length is ¼” and is denoted by the letter ‘R’, ie. 003R, R’s are used mainly in America. GOOD HYGIENE TECHNIQUES Make sure when you load your needle into your needle holder you don’t touch it. It is perfectly okay to touch the protective plastic cap, that is what it is there for, but not the shank. Some needles come in individual packets that can be opened using the easy tear facility. Remove the needle from the packet by holding its plastic cap, (this enables you to aseptically position the needle into the needle holder). Remove the cap with a firm twist and pull. See diagram below.
Sterex Electrolysis International Ltd Some needles come in strips of 5, care should be taken with these as they do not have a protective cap. Carefully pull back the paper, hold the needle through the plastic bubble (watching you don’t bend the needle) and place into the needle holder.
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NEEDLE STERILISATION There are two methods used to sterilise the pre-sterilised, disposable, single use needles. The most popular one is Gamma Irradiation, the other is Ethylene Oxide Gas. THE NEEDLE AS AN ELECTRODE During blend and galvanic treatments the needle acts as the negative electrode. It is important therefore that it is smooth and straight, for a good current flow, and have a rounded point for comfort. HOW THE NEEDLE DIAMETER AFFECTS CURRENT FLOW If you have the same amount of current, the treatment area around a small diameter needle will be smaller than it will be around a large diameter needle. It makes sense then for you to use the largest size needle that can comfortably fit into the follicle. The larger the needle the greater the treatment area and the more comfortable your client will feel, this is because the sensation is spread over a larger area. The smaller needle gives a very intense sensation for your client. Think of current flowing through a needle like water flowing through a hosepipe, the narrower the nozzle (needle) the more intense the spray (treatment area), the larger the hoses nozzle the larger and more spread out the spray. THE INDIFFERENT ELECTRODE You may know the indifferent electrode by other names such as the ‘positive’ electrode or the ‘hand held’ electrode, both of these are correct but we shall refer to it as the indifferent. The indifferent electrode is the positive electrode, (the needle is the negative electrode), and the client needs to hold it to complete the circuit of galvanic current. You will need to make sure there is good contact between the client and the indifferent electrode. The electrode is usually hand held, and the client will need to hold it firmly and consistently. There must be good all round contact with the clients skin, they should hold it in a fist. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Sterex Electrolysis International Ltd Too little contact decreases the level of action, the client should hold it firmly but comfortably. If for any reason the client cannot hold the electrode, perhaps due to arthritis or some disability, the next best place for it is under the armpit or placed behind the shoulder. If your client asks why they need to hold the indifferent electrode your answer should simply be that they need to hold it to make it work. If you talk about currents flowing through their bodies it may be off putting, not to say frightening, to most clients. The indifferent electrode needs to be wiped over in between clients, with a mild antiseptic, it can also be covered with a damp tissue or in a sponge wallet, but this is not necessary unless your client has very dry hands.
Preparing for Treatment To prepare for treatment you must first prepare your couch, trolley and equipment. Tweezers or forceps must be sterilised and available for use. Set up your blend epilator in accordance with manufacturer’s instructions. These will probably be to insert the indifferent electrode into the positive outlet (normally red), the needle holder lead into the negative outlet (normally black or silver) and the footswitch into the footswitch outlet which is usually at the rear of the unit. Ensure the footswitch is easily accessible for you and wipe over the indifferent electrode and needle holder with antiseptic. IT IS VERY IMPORTANT TO READ MANUFACTURER’S INSTRUCTIONS PRIOR TO USING ANY MACHINE AS THEY MAY VARY SLIGHTLY, IE. COLOUR OF LEADS, DIAL POSITIONS ETC. It is very important to have a comfortable working position. The blend modality is mainly used with the footswitch, it is important that whenever possible the treatment should be given with you sitting down. If you work with a footswitch when standing, your whole body weight would be on one leg as the other needs to be free to depress the footswitch. Some machines can be used with finger buttons for all the modalities, with others you must use a footswitch and a few give you both options. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Needles Having positioned your client comfortably and carried out general hygiene and safety procedures on the area and yourself, you will need to select your needle. All needles are now pre-sterilized and disposable so you will only have to concern yourself with selecting the correct size and type of needle. Needles used in diathermy epilation must be designed to perform two distinct functions. As a probe, the needle must have the correct diameter, length and tip shape for effective insertion. As an electrode, it must be the correct diameter, length and tip shape to distribute current at the crucial area without over-treating the upper follicle. THE NEEDLE AS A PROBE Diameter
The needle’s diameter should be small enough to enter the follicle easily, but strong enough so bending does not occur. The needle diameter should be equal to that of the treated hair.
Tip Shape
A sharp point will pierce the base of the follicle and a blunt end will make probing difficult. An ideal shape is one that is slightly rounded.
Length
Length should be determined by the depth of the anagen area being treated. When correctly inserted approximately half the needle shaft should be above the surface of the skin when the tip of the needle is at the base of the follicle.
THE NEEDLE AS A CONDUCTOR Diameter
The action of the current and its intensity is determined by the diameter of the needle. The greater the diameter of the needle, the weaker is the field produced by a fixed amount of current.
Tip Shape
Current is always released at the tip first, and a smooth slightly rounded tip will release current more effectively than a rough, blunt tip, so a lower current can be used which makes treatment more comfortable for the client and does less damage to the upper follicle.
Length
A short needle will not carry current to the depth of the dermal papilla, bulb or outer root sheath. The needle must be long enough to reach these structure when the follicle is anagen. It is better to have a needle too long, than too short.
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The needle must be smooth and highly polished to facilitate easy insertion and enable current to flow evenly down the needle. Electrical current will always flow to the point of least resistance. In this case the tip of the needle, where it will be discharged first. NEEDLE DIAMETER Needle size always refers to the diameter of the needle and this varies from .002 used to treat fine vellus hair, to .010 - usually used for the treatment of warts and skin tags. The diameter of the needle should be equal to that of the treated hair, so the coarser the hair, the larger the diameter of the needle. A large diameter needle means a better opportunity to effectively treat the target structures at the base of the follicle. A needle that is too small may mean some of the structures are under treated or treatment may be more painful, as the intensity is concentrated in a small area and will be applied for longer to reach all the target area. However, a needle that is too large makes probing more difficult and puts pressure on the follicle walls causing dilated capillaries. NEEDLE TYPES There are several designs of needle available, these include the tapered needle, the two-piece needle, the one-piece needle and the insulated needle. The one-piece needle is made from a single piece of stainless steel with a larger diameter at one end to enable it to be held in place by the chuck. It then tapers sharply to various diameters to allow for insertion into the follicle. The two-piece needle has a fine shaft which is crimped to a sturdy shank. The tapered needle may be of one or two-piece construction and allows for a graduating difference in diameter from the shank to the tip. The insulated needle has a coating of material down the majority of the needle - only leaving the extreme tip exposed. NEEDLE HOLDERS Several types of holder are available which vary in shape and length, but most fit all the machines. Some have a finger button to release current, others release current with a foot pedal, which is connected to the machine. In both cases, the length of current application can be determined by a timer on some epilation machines. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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The needle holder consists of several parts:
1.
The connection
This should fit securely into the socket on the epilation.
2.
The flex
This should be treated with care and not wrapped tightly around the needle holder before storing. This will extend the life of the flex by precenting breakage of the electrical wire. On some models the flex is replaceable.
3.
The holder and chuck
The holder is made of plastic and its shape is similar to that of a pen. The chuck holds the needle in place. It is made of metal to allow the flow of current through to the needle.
4.
The cap
The plastic cap is screwed on to the needle holder. It covers the metal chuck and secures the needle in place.
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The Needle Holder There are three main types of needle holders:
1.
Button controlled needle holders -
The flow of the current through to the needle is controlled by pressing down the button.
2.
Switch controlled needle holders -
The flow of the current through to the needle is controlled by the pressing of a switch.
3.
Foot switch needle holder
The flow of current through to the needle is controlled by pressing down a foot plate.
Needle holders also come in different lengths. The shorter length holders are especially useful when working in restricted areas such as the bikini line or under the jaw bone. The choice of needle holder will often depend on your personal preference, especially when working with SWD (Short Wave Diathermy). It is usual to use a footswitch needle holder when carrying out galvanic or blend epilation.
The epilation unit should always be positioned on the trolley so that it is close to you. This enables you to adjust the intensity level when necessary and allows you to see the controls without incurring any unnecessary movement or interruption to the flow of the treatment. The trolley should be placed at the working side of the client (usually on the clients right if you are right handed and vice-versa). This avoids trailing flexes over the client.
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The Machine 1.
ON/OFF SWITCH
2.
PILOT LIGHT
Indicates when the unit has powder flowing to it, and gives guidance of intermittent performance.
3.
INTENSITY CONTROL
This may be graduated in different ways, normally one to ten, it shows the amount of current that will flow when the connection through the needle holder is made.
4.
VISUAL DISPLAY PANEL OR METER
Indicates actual amount of current flowing.
5.
CONNECTION SOCKET FOR NEEDLE HOLDER
6.
CONNECTION SOCKET FOR FOOT SWITCH
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Probing – The Key to being a Good Epilator Initially you may find the prospect of inserting a fine needle into a hair follicle a daunting one. However, with practice and concentration you will gain the ability to complete this task accurately and confidently.
Carefully read the following points on technique and apply them to your practical work. The choice of needle size/type and the implications this has on your treatment will be discussed in a later package
The needle holder is normally held between the thumb and middle finger of your working hand. The index finger is used to depress the button or switch, on the holder, when an accurate insertion is made. To avoid pressing the current on by accident the index finger should not rest on the button/switch during insertion. The needle holder should be held lightly between your fingers, to allow you full use of your sense of touch. Your shoulders and arm should be held in a relaxed and comfortable position. The movement of the needle holder should occur at the fingers, it is not a movement that involves the whole arm and/or shoulder. Your supporting hand will hold your forceps, as discussed earlier, and will help with the insertion, by gently stretching the skin around the hair presented for treatment. Over stretching of the skin should be avoided as this may cause distortion of the follicle. The comfort of your client is extremely important and so avoid placing any undue pressure on the treatment area. The needle should follow the direction of the hair’s growth in order to enter the follicle correctly (See Diagram 1). Note that it is the first 1/8” of the hair shaft leaving the follicle that indicates the line to follow to the hair root. You must also note the angle at which the hair presents itself in relation to the skin. This will indicate the angle of your insertion. It can be seen in diagram two that the angle which hair grows can vary considerably from one area to another.
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Diagram One: Direction of hair growth
Diagram Two: Angle of inclination
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The insertion into the follicle should be smooth. You should never ‘jab’ at the skin. A slight resistance should be felt when you reach the base of the follicle. A depression or puckering at the mouth of the follicle indicates that you have over inserted. If you are unsure about the accuracy of your insertion, withdraw your needle and reinsert.
Once insertion is achieved, depress the finger button/switch gently to allow the current to flow through, to the needle. A jerky depression will result in the needle moving in the follicle. This can lead to increased tissue damage and/or the base of the follicle being pierced. Always remove your finger from the button/switch before removing the needle from the follicle. (This also applies to foot operated needle holders). You can now transfer your forceps to your working hand to remove the treated hair. Place the successfully epilated hair on a clean piece of cotton wool, positioned in close proximity to your area of work. This avoids wasting time and allows you to quickly return to the next hair without disruption or change to your working position.
The diagram below shows an accurate insertion into a hair follicle. On the following page use diagrams to illustrate the path of the needle when incorrect insertions are made. Correct Insertion
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INCORRECT INSERTION WRONG ANGLE PROBE ENTERS SEBACEOUS GLAND
INCORRECT INSERTION PROBE TOO SHALLOW
INCORRECT INSERTION PROBE TOO DEEP PIERCES BASE OF FOLLICLE
INCORRECT INSERTION ANGLE TOO STEEP PIERCES FOLLICLE WALL
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Contra-indications to Epilation A contra-indication is something which can prevent the treatment from being carried out. Below is a list of contra-indications to an electrical epilation treatment. Contra-indications which you should be able to recognise which require medical referral before the treatment can be carried out are: Epilepsy A client would have fits where they lose control of their body and are unaware of their surroundings. It is considered a risk that the use of the electrical current may disturb the electrical impulses to the brain which could result in a fit. A client who has their epilepsy controlled by medication is safe to receive an electrical epilation treatment using short wave diathermy, however doctors consent must be sought first. Pregnancy Seek medical consent prior to treatment in case there are any complications due to the pregnancy. Hair growth which appears during pregnancy should not be treated as it will often disappear once the baby is born and the hormone levels re-adjust. If treating, the client may feel more comfortable using a short wave diathermy current as this current is not passed through the body whereas blend and galvanic currents are. Diabetes A diabetic client has reduced healing and low pain threshold thus care must be taken. They particularly suffer with problems of the lower leg and foot, such as bruising and blood vessel bleeding. Seek medical advice prior to the treatment. If treating it is recommended to offer shorter treatments with an increased length of time between treatments to allow for healing. Naevi There are different types of naevi which you may come across: Pigmented naevi or moles appear as a flat raised, round lump on the surface of the skin. They vary in size and colour ranging from pink to brown or black. It is rare for this type of naevi to become malignant, however doctors referral must be sought if client wishes to have any hairs removed from the mole. This is to ensure that the mole does not have any malignant cells present, as any interference with the mole through tweezing or electrolysis could cause the cells to spread. Port wine stain is due to an accumulation of dilated capillaries in the dermis and deeper layers of the skin. It is present at birth and may vary in colour from pink to deep purple. It is irregular in shape and varies in size; it is not raised above the skin’s surface. It the client wishes to have any hairs removed from the port wine stain, doctors referral must be sought first, Haemangiomata appear as a small, raised red papule which can easily bleed. What causes these to appear is unknown, however it has been noted that they often appear after vigorous squeezing of skin lesions. If a client wishes to have any hairs removed from the haemangiomata then a doctors approval must be sought.
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Cardio-vascular conditions You would have to ask the client if they had any heart conditions or circulatory problems. You may be able to identify possible high blood pressure by high colouring in the face. Doctors referral is required before you can perform the treatment as we do not know the current may effect the particular condition of the client, we are not medically trained. Dysfunction of the nervous system There are numerous conditions which relate to the nervous system which may make the client very sensitive to pain or feel no pain at all, the body may also have uncontrollable spasms. For these reasons it is vital that doctors referral is sought because you could cause the client severe harm or pain. Hormone imbalance Depending on which hormone is effected various endocrine disorders can occur. Once the correct balance of hormones are maintained in the body, generally, the hair growth problem will return to normal and therefore treatment will not be required. However it is worth noting that electrical epilation treatment combined with medication will treat the unwanted hair growth much more quickly than medication alone. Only treat a client with any type of hormone imbalance with doctors referral. Metal plates or pins If the client has metal plates or pins in the body you will require doctors referral before commencing the treatment as when using a concentration of high frequency current, overheating can occur at the sight of the metal. If the metal plate or pin is only very small and a distance away from where you wish to carry out treatment the doctor may give approval. Psoriasis Appears as an area or red or pink skin with silver, waxy scales covering the skin. Although the true cause is unknown the condition is often hereditary or stress related. A client wishing to have hairs removed from the area must seek doctors referral to treat the condition before the treatment can be carried out. It is important that you do not treat the area as you could cause secondary infection to the area, or if the skin is weeping cross infection would occur. It would also be very difficult to treat as the scale like cells would prevent the needle from entering into the hair follicle. Eczema Eczema is often genetic and appears most commonly in joints or warm areas. It will appear as an area of red skin which cracks and oozes serum. The cause of eczema is often an internal irritant taken into the body. Although it is not contagious it can often leak body fluids which could cause cross infection. Secondary infection would easily occur if you treated the area and also the build up of dead skin cells would make needle penetration very difficult. Doctors referral must be sought so that a treatment can be prescribed to clear up the condition before electrical epilation can be carried out.
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Scabies Is caused by a contagious parasite which causes an infection in the skin. The female mite burrows into the skin and lays eggs which eventually hatch and burrow deeper into the skin. The whole cycle then begins again. It appears as a white or greyish zigzag line of approximately 1cm which may be slightly curved and scaly. The first symptoms are intense itching which is worse at night, a red rash may then appear followed by papules, pustules and crusted lesions. The condition is contagious and therefore doctors advice must be sought to treat the condition. Only once the scabies has totally disappeared can treatment be performed. In addition it is also recommended that clients under the age of 16 should not be treated. This is because the conditions which cause the hair growth often arise during puberty and often regulate themselves naturally once the hormones stabilise. This in turn generally corrects the hair growth problem. If the client is very insistent that they receive treatment then doctors recommendation must be sought prior to treatment. Treatment would be appropriate if the client was very distressed about the hair growth and was considering treating the growth with a temporary method. In this instance electrical epilation would be far more appropriate. If the client suffers with any of the previous conditions you should recommend the client to seek medical advice before proceeding with the treatment. This is for the clients benefit to prevent any detrimental effects to the client, and for your benefit for insurance and safety reasons. A doctors note should then be produced before a treatment can be carried out and attached to the clients record card. It is important that you do not diagnose any condition as this may worry the client unnecessarily. We are not medically trained and it is therefore unprofessional to attempt to diagnose any condition. Contra-indications which restrict the treatment: Viral infection For example warts, these should be totally avoided when treating an area as they are infectious. Gloves must be worn when treating a client who suffers from warts. If the area cannot be avoided then the treatment can not be carried out. Treatment of the area could cause cross infection or secondary infection. Fungal infection For example ring worm (appears as a circular, red lesion which heals from the centre outwards), the area must totally be avoided when treating the client. Gloves must be worn. If the area cannot be avoided then the treatment can not be carried out. Treatment of the area could cause cross infection or secondary infection.
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Bacterial infection For example boil which appears as a crusty blister which oozes serum and is often itchy. Most commonly found around the mouth area. Treatment can only be performed if the area can totally be avoided. Gloves must be worn. If the area cannot be avoided then the treatment cannot be carried out. Treatment of the area could cause cross infection or secondary infection. Cuts or abrasions Would appear as an area of broken skin and dry blood will often be present. The treatment can only proceed if the area is avoided. Gloves must be worn. Treatment of the area could cause cross infection or secondary infection. Severe bruising This would appear as an area of yellow to purple skin and is caused by damage to the blood vessels within the skin which then leak blood into the surrounding tissues. Treatment over the area would be very uncomfortable for the client and may make the condition worse. Recent scar tissue (up to 6 months) This appears as an area of shiny skin which is often red or purple in colour. The area must be totally avoided as pressure may cause the scar tissue to re-open, secondary infection may also occur. Dermatitis Dermatitis appears as an area of red, irritated skin and is usually caused by an external irritant. The area should be avoided as the build up of dead skin cells makes insertion very difficult. Secondary infection could also occur at the site. Often once the source of irritation has been removed the condition will disappear on its own. These will restrict your application and should be avoided when proceeding with the treatment. If you are treating a client which has a contra-indication which should be avoided you must explain to the client that the treatment cannot be performed in the normal manner. This is because the contra-indication will restrict the treatment to a certain degree. The client may be satisfied with the treatment proceeding, however, it should still be pointed out to the client that the benefits would be far greater if the treatment could be applied without restrictions. You are therefore effectively recommending that the client seeks medical advice to rectify the contra-indication as soon as possible.
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Contra-indications which prevent treatment: Hepatitis Hepatitis A and B viruses are more resilient than HIV viruses and are capable of existing on hard surfaces for a considerable time. Hepatitis A is of a short duration with an incubation period of approximately one month and is lost from the body fairly easily. This can be contracted from contaminated water or food. Hepatitis B is a far more serious condition of a long duration, with an incubation period of between 40 150 days, during this time the patient is highly contagious. The symptoms are feeling generally unwell and fatigued for a long period of time i.e. months, followed by a long convalescence. Symptoms in the early stages show nausea, vomiting, loss of appetite, with the whites of the eyes, skin and gums taking on a yellow appearance. A fever may then become present. A hepatitis B virus may be transmitted by contaminated needles and blood. The virus can remain on hard surfaces for several years, so strict hygiene levels must be maintained. As the disease is so contagious it is recommended that you do not treat a person with this virus. If treating you must receive a doctors note, wear gloves and the strictest hygiene procedures must be followed. The clotting mechanisms of the blood are often affected, skin heals slowly and bruises easily. A therapist may receive vaccination against hepatitis B, which consists of three vaccinations over a period of 8 months. This is strongly recommended and details are available from your doctors surgery. HIV Is a virus which may lead to AIDS. HIV interferes with the immune system so reducing the body’s ability to cope with disease or infection. A Person who is HIV positive may show signs of general fatigue, inability to recover from infections, enlargement of the lymph nodes, weight loss or diarrhoea. The virus can be transmitted by infected blood entering an open wound or through electro-epilation needles. The virus is however very fragile when exposed to air and also easily destroyed by the use of disinfectants. Because there is a small risk that blood may be drawn when treating the client the treatment should not be performed. Ear hair Hair in this area is produced to protect the body and filter out dust and bacteria. Due to the moistness of the environment of the ear it is also very difficult to keep hygienic and therefore infection could easily occur. This area of the body is also very sensitive, treatment must therefore not be performed. Nostril hair Hair in this area is produced to protect the body and filter out dust and bacteria. Due to the moistness and unwanted bacteria in the nose it is also very difficult to keep hygienic and therefore infection could easily occur. This area of the body is also very sensitive, treatment must therefore not be performed.
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Electronic implants Such as a pacemaker. The application of an electrical current into the body can cause interference in the functioning of the electronic implant, this could prove to be fatal. These conditions will prevent treatment application because of the reasons outlined. If you are unsure of any contra-indication you may wish to contact a Professional Electrical Epilation Asociation, such as the Institute of Electrolysis. Referring Clients to a Medical Practitioner As you can see from the previous list there are many instances when a client may require doctors referral. Doctors are busy professionals and often do not have time to write letters to a therapist. It is therefore more productive for you to compose a standard letter for you to send with your client to the doctor which they can easily complete. An example of a standard letter is as follows:
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Consultation When greeting the client it is important that you welcome the client, preferably greet them by their name, and introduce yourself by name before beginning the consultation. A thorough consultation is vital in order to perform a safe and hygienic electrical epilation treatment. The consultation is the most important part of the treatment as it is at this point that you discuss the clients needs and decide what treatment to carry out to meet those needs. In order for the client to be satisfied with the treatment you need to know what is expected. As a therapist you must be exceptional at encouraging the clients to give you this information. You must therefore have the following: •
•
•
•
Good communication skills - this not only being verbal but also non verbal in the form of body language. Examples of good body language are good posture, eye contact, smiling, encouraging head nods. When communicating you should be tactful and adopt a reassuring and caring approach to the client. This will prevent any discomfort or embarrassment and make the client feel that you genuinely want to help. Reassurance is of particular importance as clients with a hair growth problem often feel very embarrassed, insecure and lack confidence because of their appearance. If you can reassure the client that the hair is not as noticeable as they believe, and also that it is a common problem, they will feel more comfortable about their appearance and this will restore their confidence. Always sit next to the client, a table or couch in between the client and the therapist can create a barrier to communication. Good questioning techniques - this is vital to retrieve the information that you require to carry out the treatment Open questioning techniques should be used where ever possible as this encourages the client to give much more information. To ensure a question. is open ended begin with How?, Where?, When?, Why? etc. Whereas if you begin a question with Do?, Is? etc. you will only get a yes or no answer which will lead to a one sided conversation. It is also important that you speak clearly and accurately when carrying out the treatment. Good listening skills - it is important that you can listen to what the client is telling you in order to meet the clients requirements. This will also make the client feel important and feel that they are a valued customer. After asking the client your questions you should encourage the client to ask any questions and then listen carefully to their concerns. A client will not feel cared for if you do not listen to what their concerns are, or what they are saying, - they will feel unimportant. If a client has not been allowed to ask questions then they may worry unnecessarily throughout the treatment which will not make them feel comfortable and at ease. Good answering techniques - when answering questions you must be honest and you should give the person the required information as concisely as possible. If your answers are very long winded the client will become distracted and not take in the information offered. If you are asked a question which you do not know the answer to you should ask for the assistance of a colleague who may be able to help or direct to the appropriate source of information.
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When using the previous techniques correctly it will guarantee that the client will feel as comfortable as possible within the treatment environment. During the consultation procedure you would: •
Introduce yourself
•
Discuss the clients requirements
•
Match a treatment to the clients needs
•
Explain the treatment procedure
•
Give the client the opportunity to ask any questions.
•
Discuss cost, time, frequency and possible courses of treatments
•
In some instances aftercare advice, homecare advice and recommendations of desirable product purchases would be given. This is to ensure that the client understands the commitment etc. required if a certain result is to be achieved.
•
Record card completion
•
Devise the treatment plan
Important Note Never presume the area which the client wishes to have treated, as it could easily be a totally different area. This incorrect presumption would leave both the client and yourself feeling very embarrassed.
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Questions Clients Often Ask Through experience there are common questions which most clients ask during an initial consultation for an electrical epilation treatment. The following is a list of some common questions with acceptable answers outlined ready for your use. Although all clients are different you will find this very helpful whilst training to be a qualified electrologist.
What happens during the treatment? • • • •
• • •
First your skin is cleansed with an antiseptic product which has a distinctive smell and feels cool. A new sterile needle will be opened in front of you on each visit to reassure you that there is no risk of cross infection and that I am following the strictest hygiene precautions. The needle will be inserted into the hair follicle which is a natural opening and will slide alongside the hair to be treated. It does not involve any piercing of the skin. Once the needle is in place the current will be applied for (state how many) seconds which will feel warm, similar to a bee sting sensation (if using short wave diathermy). This effectively cuts off the blood supply to the hair, preventing the hair from receiving any nourishment. Explain to the client about the hair growth cycle with the use of the chart. Reinforce to the client the importance of removing the hair in an anagen stage of growth. The treated hair is then removed using sterile tweezers, a tugging sensation should not be felt if the hair has been treated successfully. This treatment is a progressively permanent method of hair removal which causes the hairs to re-grow slower and finer until they eventually cease to regrow.
Is the treatment painful? •
The treatment is slightly uncomfortable, it will feel warm and similar to a bee sting sensation. The majority of clients find the current tolerable because they can see the long term benefits of the treatment. The area does become used to the current when being treated regularly. I suggest that during your consultation we remove just a few hairs so that you can experience the current for yourself.
How many hairs will be removed in one session? •
This depends on the sensitivity of the area, your tolerance to the current, skin reaction and the area being treated. It is easier to work in some areas than others.
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• •
There is no set speed which I work, as accuracy is much more important than speed to get an effective result. This also depends on the time of the session.
How will my skin appear after the treatment? •
•
This varies depending on the individual. Usually the skin will appear pink for a few hours after treatment There is a possibility of a contra-action developing (explain) however this is very unusual if the treatment is performed accurately. I will apply an after care lotion immediately after treatment If you follow the after care advice and purchase your own aftercare product the skin reaction will be minimal. If electrical epilation has been performed correctly the skin will appear perfectly normal after the treatment course has been completed.
How much will the treatment cost? • • •
This varies depending on the length of time the treatment takes - explain the sessions that your salon offers and what you recommend. You may wish to recommend to the client that it is more cost effective to purchase a course of treatments. The client must be made aware that they will require regular treatment.
How frequently will I require treatment? This question should never be answered without a thorough examination and consultation: • •
•
• •
This depends on how the skin heals in between treatments. This also depends on the hair growth in the area, you must know if the client has been using other temporary methods as often not all hair growth is present when the client attends the consultation. A client often thinks that it is the same hair that they have been tweezing every day for the last 3 months when in fact there is likely to be a large quantity of hairs which will require treatment. Clarify exactly which areas the client wants treating, reinforce to the client that the more areas they require treating in the session the more time they will need to treat the hairs. Often clients come for just one area and once they start to see the results wish to have other areas treated. This is fine, except now you must reevaluate your treatment plan to incorporate the new treatment area. Regular appointments are vital to ensure progress and treat the hairs in the anagen stages of growth. Each follicle has to be treated individually and therefore it does take time to treat each hair.
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How long will it take before all the hairs are removed permanently? This question is the most difficult question to answer. You should base your answer on the following points, however remember never commit yourself to a time scale as there are a lot of contributing factors.
• • • • • • • • • •
This depends on how often you attend treatments How long the session is for What areas you have treated Your skins healing rate Your tolerance to the treatment Your commitment to the treatment The treatment technique which is used If the hairs are treated in the anagen stage of growth The causes of the unwanted hair growth How much hair growth is actually present
Record Keeping A record card should be completed for all treatments during the consultation and before the service is carried out. It contains confidential, personal information about the client, that is specific to each treatment. When carrying out the consultation and completing the record card you should firstly ensure that you are in a private environment. Both you and the client should be sat at the same height, on the same side of the beauty couch. You should ask the client a question and then write down the response. Do not question and write at the same time. It is the therapists responsibility to complete the record card. The procedure that you should follow for completing client records is to ask the client the details that you require, if the client is unsure of your requests you could also show the client the record which you are completing. For most treatments you would also judge what the clients needs are by visually assessing the area which is to be treated. If there are any questions to which the client answers ‘no’, make sure that you indicate this on the record card with a line or a cross. Do not leave blank as this would appear that you had not asked the client for the information. Once you have obtained all the required information ask the client to check the details and then sign in agreement that the information is accurate. Once complete, the record cards should be stored in alphabetical order, in a locked metal filing cabinet or box, which should be easily accessible to the therapist when ready to perform a treatment. When a client returns for further treatment the information on the record card should be updated. This information could also be Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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updated onto a computer system but you must be aware of your responsibilities under the Data Protection Act A record card should contain the following information: • • • • • • • • • • • •
Clients name Address Telephone number Doctors name and telephone number Any medical details List to check for contra-indications Treatment aims and outcomes Treatment plan on which to base future treatments Services, specific products used and retail sales Aftercare advice Client signature Client feedback
In addition for an electrical epilation treatment you will also need to note down:
• • • • • • • • • •
Intensities being used Specific piece of equipment being used Needle type and size Any contra-actions which may have occurred Results from previous electrical epilation treatments Any temporary methods which have been used to remove the hair growth, how frequently etc. When the hair growth first became apparent Possible causes of hair growth Type of hair growth Condition of skin for example dryness, pigmentation or scar tissue
Record cards should always be updated after each treatment. When would record cards be particularly useful? • • • • •
If you needed to contact a client urgently due to a cancellation, double booking etc. If you needed to check up on a particular detail of the treatment. For keeping a check on course details. If the client wished to purchase a product which you had used in a previous treatment. If another therapist was to take over the treatment.
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If you follow all the advice which has been given to you within this package then you should be able to give effective consultations. If a consultation is carried out ineffectively the possible consequences are that: • • • • • • • • •
You would be less likely to meet the clients requirements. The client would not relax during the treatment as they do not feel confident in your service. You would not give a professional image to the client. You would feel less confident performing the treatment as you do not have all the required information. The client would be dissatisfied with the result which could result in complaints and refunds. If you did not obtain important information such as client signature or check for contra-indications then you could put the client at risk This could result in the salon being sued You would not get repeat business from the client They would not recommend the salon to friends etc. All the above would have a negative effect on the salons takings
Psychological Effects of Unwanted Hair Growth on a Client Unwanted hair growth often has a demoralising effect on a woman which results in loss of self confidence. The individual may show signs of being inhibited, defensive, shy, argumentative or aggressive in order to hide their feelings of embarrassment. It is therefore vital that as an electrologist you are sympathetic and understanding to the clients needs on a professional level. Remember that although you will treat a lot of clients for unwanted hair growth, to the individual client they feel that they have a very unusual and embarrassing problem. You must reassure the client that superfluous hair growth effects the majority of women to a certain degree, and that the problem is quite common. It takes a lot of courage for the client to approach an electrologist for treatment, and it is vital that you demonstrate an approachable and professional manner which will instil confidence in the client of your capability to help her solve this problem. Remember a male client may also require treatment for unwanted hair growth and they should be treated in the same sympathetic and professional manner. Once the client sees the progress and success of the treatment you can often notice slight personality changes as they become more self confident in their appearance. They will appear more confident and content with themselves. Clients who have commenced or undergone this treatment always comment that they wished they had come to the electrologist sooner for treatment. This is always reassuring for the electrologist to hear as it indicates that the client is content with the treatment and feels that you are producing the required results. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Treatment Plan An initial treatment plan should be discussed with the client during the consultation . All the details should be noted on the record card and agreed to by the client. It is very important that you write down the contents of the treatment plan as important details can easily be forgotten. Also if another therapist was to treat the client, they would need the treatment plan to refer to. The treatment plan details should be recorded on the record card and updated regularly as progress is made and the clients requirements change. The following information should be taken into account •
Medical history - certain conditions may effect how the client needs to be positioned for the treatment, how long the client can lie still or how the treatment should be performed.
•
Contra-indications - contra-indications may restrict your treatment application and this would need to be taken into account.
•
Contra-actions - if a client suffers from contra-actions to the treatment you will need to adjust the treatment accordingly to prevent the contra-actions from reoccurring. Usually this will be a reduction in treatment time, current intensity, increased time in between treatments or needle size change for example.
•
Areas to be treated - should be taken into consideration as this will control the treatment to a certain extent. For example - depending on the sensitivity of the area, noticeably of the area, type and quantity of hair growth. The more hairs which require treatment the longer it will take to remove the hairs, therefore, the client will require longer treatment times or more frequent appointments.
•
Previous epilation history - this should be taken into account is it will give the therapist a guideline as to the clients suitability for the treatment It can indicate how dedicated a client is to the treatment and success rate of previous treatments.
•
Type of treatment agreed - this must be agreed by both the client and the therapist. The therapist should guide the client and give all the available information. This allows the client to make an informed choice as to which type of electrical epilation would be most suitable for their needs.
•
Physical condition - this is probably the main point which needs to be taken into consideration when producing the treatment plan- The skin type and condition, hair quantity and hair texture should all be taken into account to produce the most effective treatment plan for the client. It is fair to say that if the client has only a few coarse hairs which need to be treated the client will not require a 30 minute treatment as there are insufficient hairs to warrant this treatment time. Also, generally the client would not be required to return until 4-16 weeks have passed, to allow the hairs to re-grow.
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•
Emotional condition - is an important factor which must be taken into account before deciding on the treatment plan. Some clients may be very nervous about the treatment and may feel that they do not wish to have treatment too frequently as they find it very stressful. Another client may be very conscious of the hair growth and desperately want it removing as quickly as possible to prevent any embarrassment. Remember that superfluous hair growth can be emotionally upsetting for a person, to the extent that some people consider committing suicide. You must be very tactful when dealing with all clients to ensure minimum embarrassment and maximum reassurance, instilling selfconfidence into the client.
Assessment Techniques There are 3 techniques which you should always use when assessing client requirements: 1.
QUESTIONING - should be carried out in a polite and professional manner to find out all the information which you require from the client. There are some things which only the client can tell you such as: “When did you first notice the hair growth?” “Which area would you like to have treated?” “What methods have you used previously to control the hair growth?” “How often do you tweeze the hairs?” “Have you had electrical epilation treatments before?”
2.
OBSERVATION - a magnifying light should be used to look at the hair growth. This will allow you to see how coarse the hairs hair, the number of hairs, the density of hairs, hair growth patterns, skin condition and any pigmentation or scar tissue. You will also need to observe the clients body language as this will give you an indication of how the client feels about the treatment
3.
MANUAL EXAMINATION - this should also be performed at the same time as using the magnifying light as it allows you to feel the coarseness of the hairs, feel for any short hairs, judge the hair growth patterns and analyse the clients skin.
Constraints Surrounding Treatment
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Although you may have an ideal treatment plan mapped out for the client there is always an occasion when your plan has to be adapted slightly to deal with particulars such as: COST - the client may not be able to afford to have treatments as often as you recommend. To work within a clients budget you could recommend: • • •
Purchasing a course of treatments. A longer treatment time (one 30 minute treatment is always cheaper than two 15 minute treatments). The client does not visit as frequently as required.
TIME - the client may not have the time available for the treatment plan that you have recommended. You could work within the time constraint by recommending to the client that:
• • •
They plan their visit when they are already in the area i.e. shopping They have longer treatment duration’s with a longer period in between treatments Make the most of lunch hours for having treatment
NUMBER OF TREATMENTS - a client may be limited on the number of treatments they can receive. You could adapt the treatment plan by: • •
Offering the most suitable treatment for the clients hair growth and reinforcing to the client that they must follow your treatment plan exactly Recommend the use of a hair retardant product to reinforce the effect of the treatment
HEALING RATE - some clients have a very slow healing rate. You would adapt your treatment plan to accommodate this by: • • • •
Increasing the time intervals between treatments to ensure that the skin has maximum time to heal adequately Using caution with the current intensity Taking care not to overwork the area Reinforcing the importance of regular use of an aftercare product and homecare routine
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Verbal Reassurance New clients are understandably apprehensive when arriving for a treatment which they have not experienced before, especially if they have heard that it involves the use of needles and electrical machines, and they may experience discomfort. Even established clients may not relish the idea of treatment. You have already identified ways in which your appearance and that of the treatment area may have an effect on the client’s receptiveness to treatment. Other ways you may help clients feel more relaxed and comfortable are by your manner and use of verbal reassurance. Salon Pricing Structure Pricing Structure It is crucial that you have a pricing structure clearly identified for all treatments and products on offer. This is to ensure cost effectiveness, consistency within each treatment and also to prevent confusion when calculating clients bills. You also need to be aware of the Trades Descriptions Acts 1968 & 1972 which states what is required of the retailer under the act. When working out the price to be charged for the treatment you need to take into account: • • • • • • •
Treatment time Materials used Electricity etc used Cost and maintenance of equipment Price charged by competing salons Percentage profit required You may also want to take into account the experience of the therapist as some salons have increments in pricing for more experienced members of staff.
When calculating the price of a product you should take into account: • • • •
The manufacturers recommended retail price The amount of profit you wish to make The prices charged by other salons which you are competing against Your clientele
Services and Products Offered within the Salon You should be able to inform clients of all services and products which are offered within the salon. This is important as it will give a professional image to the clients as you will be able to you will be able to answer most queries. If you are unsure of the information that a client requires you should seek advice of a colleague or supervisor rather than guess at the answer, as you could be supplying misleading information. Cost Effectiveness Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Minimising Waste In order for your business to run cost effectively, therefore making a profit, it is important that all wastage is minimal. Some employers will choose to monitor the use of products and materials by operating a system where stock requisition forms are used to identify what employees are using. This system gives an insight into what employees use in relation to the treatments they perform and the money that they take. Even if you are self-employed it is important that you keep wastage to a minimum as the more you waste the money you will lose. Some employers will calculate what is required for an average treatment and then distribute exactly this amount to prevent wastage. If you work cost effectively, this won’t be necessary. To work cost effectively during a treatment: • • • • • • • • • • • •
Split tissues if appropriate. Always use the minimal amount of towels. Always use the minimal amount of products to produce the desired outcome. Store all products in the specified environment – usually dark, cool, dry and upright. Ensure that all product tops are cleaned each time after use to prevent the product from becoming thick in consistency and therefore ineffective. Always place tops back on products to work hygienically and prevent spillage. Turn out lights when not in use. Always turn off taps. Switch off any machines when not in use. Have machines serviced annually to prevent malfunction. Ensure that you work within your time constraint for each treatment. Always work to a commercially acceptable timing, this will ensure that you complete services within given time.
Timing of Treatments It is important that for all treatments a calculation is made for how long each treatment should take, and that once the timing for a treatment has been set that the therapist completes the service within the given time. This ensures that the price charged for each treatment can be calculated correctly, time wastage within the salon is prevented, clients can calculate the time required for the treatment and an effective appointment system is guaranteed. For all the previous reasons your work place will work out in advance the acceptable time duration for each treatment. This is known as a commercially acceptable timing.
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It is often beneficial to both the therapist and the client for the client to purchase a course of treatments. These usually come in courses of 5-10 treatments and offer the client to buy the treatments at a discount. It is beneficial to the therapist as it guarantees repeat custom and the salon owner will also benefit from an increase in salon turnover. The client benefits as they will get an improved result when completing the course as recommended, they will also make a financial saving. Although a client will benefit from a one off treatment the results will only be temporary, not as pronounced or as long lasting as if the client were to have regular treatments. This is particularly true with electrical epilation treatments as they are progressively permanent methods of hair removal. This means that the client must have long term, regular treatment in order for the hair growth to cease. The client will be more satisfied if you are honest and explain this principle, and will therefore be more likely to recommend your services to friends. Always remember to think long term when devising your clients treatment plan. When planning a course of treatments, on your treatment plan you should discuss this with the client how frequent, duration of each treatment and an estimation of how long they will require to receive the treatment. A general outline will be given by the manufacturers for these points which you must be aware of, however, all clients should have a personal treatment plan devised to meet their own individual needs. Possible Risks of Ineffective Positioning The possible risks of the client, therapist or equipment being incorrectly positioned: • • • • •
Therapist may develop shoulder, back or neck problems which may lead to postural faults in the long term. Therapist will find it difficult to focus on the hairs which may result in eye strain. The client may experience discomfort during the treatment which could lead to muscular aches and pains. Risks or incorrect probing are considerably increased. Products or equipment could easily be knocked over or broken.
Client Preparation Removal of Clothing It is important that you give the client clear instruction on how to prepare themselves for the treatment. Depending on the treatment being given will depend on what clothing is required to be removed. •
When treating facial hair the client will not normally be required to remove any clothing unless the client is wearing a high necked sweater and wishes to have the chin or neck treated. A towel should be placed over the chest area to protect the clients clothing.
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• •
When treating the bikini line the client will need to remove clothing from the lower half of the body, leaving underwear on. A towel should be placed over the leg which is not being treated to maintain the clients modesty. If treating the breast the client should be instructed to remove clothing from the upper half of the body including underwear. A towel should be placed over the breast which is not being treated to maintain the clients modesty and keep the client warm.
Removal of Accessories The client should be given instruction on removal of accessories to include all jewellery, spectacles, contact lenses and any metal objects. Advise the client that this is only for client comfort and safety. Preparation of the Skin The skin should firstly be cleansed to remove any make-up from the area. A swab containing chlorhexidine should then be used to wipe over the area, this has antibacterial properties and low toxicity, therefore it is ideal for wiping over the skin. Surgical spirit is not recommended as it has flammable properties and is also very drying to the skin. The skin should then be wiped over with a tissue to absorb any moisture from the skin. It is important that the skin is sanitised and all oil is removed to ensure the skin is as hygienic as possible, therefore preventing the risk of infection occurring. Oil also attracts dirt and this could cause infection to occur in the area. The skin should also be oil free and feel matt to the touch to ensure the therapists fingers do not slip from the area being worked on. Finally sebum is an excellent insulator, excess sebum covering the follicle opening and needle could prevent the conduction of the current. Psychological Preparation of Client The client should be prepared mentally for how the treatment will feel. This will reassure the client and lessen the anxiety felt when the treatment has never been received before. For most clients it is the fear of the unknown. Depending on the current being used will depend on the sensation felt. An acceptable explanation is that a feeling of warmth will be felt accompanied by a sensation similar to a bee sting. Client Reassurance Due to the nature of the treatment you will find that the clients require additional reassurance to that normally provided. You should reassure the client that: • • • • •
Only the area being treated will be exposed at any one time. The client will feel more relaxed as they become used to their therapist. If the client is uncomfortable at any time they must let you know so that you can adapt the treatment or take a break. You should explain the treatment procedure and encourage the clients to ask any questions. Reassure the client that very strict hygiene procedures are being followed.
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Modesty and Privacy The clients modesty and privacy must be maintained throughout the treatment due to basic ethics and also to ensure client comfort. You must ensure that the client is suitably covered at all times with appropriate towels, and that only the areas being treated are exposed. Whilst the client is changing you must ensure that nobody enters the treatment area. This should also be maintained throughout the treatment with an exception to the therapist. If working in a curtained area the curtained area should be secured around the treatment area. It is best when purchasing an epilator to find out if they service and repair the machines. Some manufacturers offer a loan epilator whilst yours is being repaired or serviced, this is essential as it can save you from having to cancel clients and therefore losing money. Check this out before purchase. TREATMENT CHARGES As blend can be a more effective treatment than diathermy it is usual to increase the treatment charges so you do not lose money. The average increase is 50% more than diathermy, i.e. Diathermy 15 minutes treatment =
£6.00
Blend 15 minutes treatment
£9.00
=
Planning Treatment After studying this section you will be able to: •
Choose the best technique with your client
•
Discuss the treatment plan with your client
•
Prioritise treatment
Blend electrolysis offers a number of treatment choices as you have read. Which modality and which technique is decided by you and your client together. There are many things to discuss: which technique is most comfortable; which is the quickest; which is the most effective. How the client feels during each technique should be thoroughly discussed at the consultation stage and your client’s comments written down for further reference.
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Priority Areas One of the most important parts of treatment planning is to find out which area or areas are giving your client the greatest concern, the treatment plan should revolve around those areas. Never assume at the consultation, that the hairs you can see are the ones the client is most concerned about. For example a woman may have a ‘horrendous’ growth on her bikini line area and won’t thank you for saying she has a problem on her upper lip! Let the client tell you - never assume! If the client has a large area of growth, and one that can be seen, for example a full beard, both of you will have to discuss and agree an area to be concentrated on at each visit, for example sideburn areas on a Monday, neck on first and third Thursday, chin on first and third Saturday, upper lip second and fourth Tuesday, sides of face second and fourth Thursdays etc. This planning will ensure sufficient healing time plus if they have to shave they know which areas to leave so you can treat them. It is ridiculous to expect a client to walk around with a scarf tied around their lower face for the duration of the treatment, the fact is they will probably shave if the area is large and visible, work with them and realise they need your help and support. For some of your clients that have an extensive visible growth, you may decide to treat the area initially with diathermy to clear the area as quickly as possible therefore increasing client motivation but then treat the re-growth with blend, as re-growth hairs come through at different times. When planning and carrying out the treatment, the emphasis should be upon on-going discussion with your client, after all a happy client is a regular client. Planning treatment is about understanding and assurance for the client, along with joint discussion and demonstration of your professional expertise.
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Other Methods of Hair Removal 1.
Shaving
When shaving the hair is cut at the surface of the skin, leaving the hair blunt and making it feel stubbly. It has no effect on future hair growth, but it may cause rashes or other skin irritations. It must be done frequently as the hair grows back quickly. 2.
Depilatory Creams
These type of creams dissolve the hair to just below the surface of the skin. The results are not as stubbly as shaving and it does not have to be done as often. The cream however can cause skin irritation and it is not always effective. 3.
Tweezing
With this method the whole hair is removed, but if technique is incorrect then the hair is sometimes just snapped off. Tweezing may encourage a stronger hair growth, making the hair thicker and darker. This technique is only suitable for the eyebrows where alteration of shape and style are required, professional treatments are recommended to avoid pain or infection. 4.
Depilatory Waxing
This is very similar to tweezing, but on a larger scale and therefore is ideal for rapid results. The hairs take approximately 6 weeks to return. Professional treatments are recommended to avoid blistering or bruising. The same areas as electrolysis, apart from the breast region, can be treated.
After-Care Advice After your electrolysis treatment 1.
Avoid touching the area for 24 - 48 hours. If it is absolutely necessary, hands must be very clean.
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2.
If the area is sore bathe in a saline solution (salt) or in diluted Witch Hazel. A medicated cream may be applied.
3.
Avoid make-up for 24 - 48 hours, but if it is essential to wear make-up apply a medicated cream to the area, then use medicatedmake-up to help the healing process.
4.
If a yellow scab, crust or white pimple appears they must not be picked, as will cause a scar. This is the skin’s natural healing process.
Reasons for Re-growth 1.
Hair germ cells of dermal cord not totally destroyed therefore multiply and reform follicle and hair, each time taking longer to produce a hair and the hair becoming weaker. The stronger the hair the more epilations it is likely to take to totally destroy. Also the papilla and matrix are gradually destroyed therefore bringing less and less nutrients to sustain hair growth. The body will naturally try to repair itself after any damage is done to it. This is the reason for regrowth. However, after so long it is not possible for a follicle to regenerate as the hair germ is totally destroyed. Factors which affect re-growth Probing faults causing unacceptable re-growth
2.
3.
a)
Too shallow
b)
Too deep
c)
Wrong angle
Incorrect Current Intensity a)
Current applied at too low an intensity
b)
Current applied for too short a time
Hormone Imbalance Excessive androgens due to normal or abnormal systematic changes (puberty, pregnancy, menopause, illness or drugs) make re-growth persistent and therefore treatment lengthier than otherwise. Treatment will still be successful eventually, but hairs persistence to re-growth must be explained to client. If necessary seek medical advice.
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4.
Previous Methods of Hair Removal Distorted follicles due to waxing and plucking over long periods make accuracy of probing difficult and therefore may hinder speed of success of treatment. Make clients aware that if they have plucked or waxed constantly for a time that it may take 6-8 weeks for all hairs to be apparent. This can confuse a client when starting treatment, as hairs will keep appearing once plucking/waxing ceases. Clients are often unaware of how extensive their hair growth really is. This should not be confused with re-growth.
5.
Pain Threshold Speed of epilation may be restricted by a client with a low pain threshold and so re-growth will be more than on another comparable client who can tolerate more treatment and a higher intensity.
6.
Sensitive Skin (reaction and healing capacity) A skin which reacts excessively strongly to treatment and so restricts the amount of treatment given at one session and limits the intensity prolonged treatment and re-growth. Also a skin which has poor healing capacity will need modified treatment and so re-growth will be expected to persist and progress slower. Acceptable level of re-growth Once all hair which a client requires treating have been treated (this can take about 8 weeks if a client has been plucking or waxing), you should start to see an improvement – this will take the form of: a)
Hairs gradually becoming finer as they begin to re-grow. Becoming finer and finer after each successive epilation treatment. Bear in mind a hair takes 6-8 weeks on average to re-grow so the same hairs are treated about every 3rd or 4th treatment if fortnightly appointments are kept. Also hairs may begin to be paler in colour and so less obvious.
b)
Hairs will begin to take longer to re-grow so gradually treatment times will become shorter due to less hairs appearing and also after some time a longer gap between treatments will become possible, i.e., 2-3 weeks and then from 3-4 weeks and so on. The speed of this progress depends on the severity of the original problem – extent and coarseness of the growth and its underlying causes. However as long as the above progress is being achieved, gradually this can be seen to be acceptable and will eventually achieve success.
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Treatment of Coloured Skins Prone to:
1.
Hyperpigmentation
2.
Can be slow to heal
3.
May react severely to current
4.
May mark badly if extreme care is not taken (prone to keloid scar tissue - over growth of scar tissue shiny appearance)
Treatment a)
Use minimum current possible
b)
Use insulated needle if possible - reason it prevents spread of
c)
Current upwards - therefore reducing reaction i.e., coloured skins hard to detect erythema.
d)
Take car to insert correctly and accurately
e)
Work slowly to maximise effective treatment
f)
Keep treatments short and well spread out e.g. every 2-3 weeks
g)
Probing should be well spaced out to avoid heat reaction which could cause hyperpigmentation.
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Temporary Scarring •
Blue-black mark or lump This is bruising due to capillary damage in and around the follicle. It appears almost immediately and may be due to too large a needle or needle expansion during current application. This causes pressure on the follicle wall and damages surrounding capillaries.
•
White mark or lump The epidermis has been damaged by too much current, either from too long, too high or too superficial an application. This may result in a permanent scar if excessive current is applied.
•
Blood crusts Damage to the surrounding capillaries where blood has leaked to the skin’s surface causing a crust which may not be apparent for some hours.
•
Lymph crust Due to extensive damage to deeper tissue resulting in lymph crust information.
•
Pustule Infection of the treated follicle due to poor hygiene or poor after-care procedures.
•
Red lump The local blood supply increases to dispense the heat, resulting in redness. Lymph may also increase to prevent further damage causing a lump - this is a normal reaction unless excessive.
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How Laser Treatment Affects the Skins Sensitivity • • • • • • • •
Sensitivity to sunlight causing hyper-pigmentation of skin tissues Thinning of skin tissues Increased sensitivity Erythema and localised swelling Hypo-pigmentation Hyper-pigmentation Bruising in vascular areas Blistering
Permanent Scarring •
Fine lines Occur commonly in the upper lip due to tissue dehydration. This is due to over- treatment of the area, using too high an intensity of current, treating hairs too close together, or insufficient time between treatments.
•
Pitting Resembling small chicken pox scars - due to high intensity of current or picking scabs.
•
Pigmentary irregularity Hyper-pigmentation (increased pigmentation) or hypo-pigmentation (decreased pigmentation) may be due to superficial application of current ultra-violet exposure too soon after treatment.
•
Keloid formation Often occurs on black skins and is due to skin damage from various causes. It appears as a raised, firm, smooth overgrowth of tissue at the area of damage and is always much larger than the original injured site.
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LENGTH OF CURRENT APPLICATION The longer the current is applied the higher up the needles shaft the heating pattern progresses, and at the same time expands widthways. However, the area around the tip will always experience the most intense action. INTENSITY OF CURRENT The amount of current determines where the heating begins. With insufficient current more action takes place near the surface of the skin causing skin damage but having little effect on the lower follicle, whilst with sufficient intensity it is strongest at the needle tip, giving maximum effect to the target area. INSERTION DEPTH A shallow insertion will hinder the development of the ideal pear-shaped heating pattern and result in under-treatment of the follicle as well as damage to the skin. If insertion is too deep, the target structures will be missed and deeper tissues will be destroyed. DIAMETER OF NEEDLE The smaller the diameter of the needle, the hotter its heating pattern will be for a given intensity of current. A larger needle would need a longer application of current to achieve the same effect.
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Principles of Diathermy Needle Epilation The high frequency current used for this treatment is an oscillating type which continually changes its polarity. The force of the attractions and repulsions of the oscillating polarity causes vibration in the atomic structure of the surrounding tissue. The vibration creates fiction resulting in a heating effect that will coagulate cells and destroy them. The High Frequency Field The term ‘high frequency field’ refers to the area of tissue surrounding the conductor, in this case the needle, which is affected by the current. The Heating Pattern The heating pattern refers to the development and shape of the treated tissue around the needle. Heating is most intense at the point of the needle where current is released first. This is ideal, but when current is applied for longer, the heat travels up the needle shaft towards the epidermis and spreads outwards at the same time into the surrounding dermis. Accurate probing is essential to good electrolysis treatment, the needle should enter the follicle easily without any discomfort to the client. The needle should follow the direction of hair growth, a slight resistance should be felt when the needle reaches the base of the follicle. There should be no visible puckering or depression of the skin. The finger switch should be depressed gently and smoothly, if the electrologist is too heavy handed the follicle wall may be pierced. The angle of insertion should follow the direction of hair growth with the needle raised slightly from the skin’s surface. The needle holder should be held very lightly and without tension, the needle should slide smoothly into follicle followed by the application of current. A correctly epilated hair should slide out of the follicle with no pull or traction. Unnecessary hesitation results in poor treatment and time wasting. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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If the skin dimples during insertion this is due to incorrect insertion or probing through a hair follicle. Application Time for High Frequency Epilation The heating pattern starts at the tip of the needle where it expands in width around the tip. If the high frequency is applied for too short a time insufficient heat will be generated. Should application be too long the heating pattern will eventually reach the skin’s surface resulting in scars.
Several factors influence the high frequency heating pattern. • • • • •
Length of current application Intensity of current Insertion depth Diameter of needle Moisture gradient
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Scarring by Needle Diathermy Incorrect epilation by needle diathermy will cause temporary or permanent damage to the skin resulting in recognisable scarring. High Frequency Short Wave Diathermy The high frequency alternating current used for diathermy is several million cycles per second. The precise amount varies from country to country. The frequency is in the same band or range as radio waves. In diathermy the electrons do not move in one direction they move up and down, alternating between the negative and positive poles. The rapid alternating of polarity creates friction heat in the hair follicle molecules by continually attracting and repelling them. This heat builds up rapidly and is very destructive. It is the same type of action found in the microwave oven. The high frequency alternating current passes down the needle and creates most heat in the moist lower part of the follicle. Diathermy Effect Heat production begins at the tip of the needle in a pear to tear drop shape and then travels up the needle to the skin surface. The lower part of the follicle is heated more intensely and for longer than the upper part. This is a very quick way of treating the follicle but has a lot of regrowth.
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The Blend The blend technique uses both direct current and alternating current at the same time. Both currents retain their own characteristics in the treatment of the follicle. The direct current produces lye, the alternating current produces heat. The heating effect is kept very low, it is merely warmth. The reason for the low levels of diathermy is to prevent the follicle from becoming dehydrated which would inhibit or prevent formulation of lye. The warmth makes the lye more active in the follicle, and by warming the lye quickens the process of tissue destruction. Blend Action IT IS A WELL KNOWN SCIENTIFIC FACT THAT A RISE IN TEMPERATURE ACCELERATES THE RATE OF CHEMICAL REACTIONS The follicle is treated very effectively but in less time than with direct current on its own. By combining alternating current with direct current it reduces the treatment time per follicle by a half, that is direct current only = 10 seconds on average, blend = 5 seconds on average. The blend effect in the follicle is wide, deep and takes approximately 5 seconds. The blend method is the most popular way of permanent hair removal throughout the world and is rapidly gaining ground in the U.K. For this reason students of electro-epilation should be familiar with the techniques of blend epilation. Why is Blend Becoming so Popular? The blend method is more effective, has less re-growth, is more comfortable and gives the electrologist and the client far more treatment choices than diathermy. There is less re-growth so client motivation is high and clients invariably go on to have other parts of their body treated because it is much more comfortable. ALL EPILATORS ARE ONLY AS GOOD AT THE ELECTROLOGIST USING THEM. ALL THE NORMAL RULES REGARDING GOOD INSERTIONS AND CORRECT CHOICE OF CURRENT LEVELS APPLY! Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Blend Technical Information In this section you will learn about: •
Direct current effects in the follicle
•
The production of sodium hydroxide
•
How blend or combined current works.
Blend is also known as combined current because the two currents are blended together to destroy the follicle. The two currents are direct current (galvanic) and high frequency (short wave diathermy).
Direct Current (Galvanic Current) With direct current the electrons flow continuously in one direction. The current flows from the epilator through the needle holder to the needle, then into the follicle, through the client, and via the shortest path back to the indifferent electrode where the current returns to the epilator. DIRECT CURRENT ACTION ON THE SKIN TISSUE Salt (Na Cl)
Sodium Hydroxide (Na OH)
Water (H2O)
Hydrogen Gas (H2) & Chlorine Gas (Cl2)
UNITS OF LYE The term ‘Units of Lye’ was devised by the in-ventor of the blend, Arthur Hinkel, as a means of measurement for the minute amounts of lye made in the follicle. Prior to this were the industrial measurements which were in gallons. One unit of lye (U.L) is the amount of lye made when .1 milliampere of direct current flows for 1 second. When direct current is passed through a conducting stainless steel needle into the follicle it causes the water and salt in the follicle to break up into their component parts or ions. These ions reform to make sodium hydroxide, or as it is mainly called ‘lye’. Hydrogen gas and chlorine gas are also formed. The lye’s dissolving action on tissue remains in the follicle to destroy the hair making cells. The amount of lye produced is small and is soon neutralised by the skin’s tissues which are slightly acidic. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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The Blend The blend technique uses both direct current and alternating current at the same time. Both currents retain their own characteristics in the treatment of the follicle. The direct current produces lye, the alternating current produces heat. The heating effect is kept very low, it is merely warmth. The reason for the low levels of diathermy is to prevent the follicle from becoming dehydrated which would inhibit or prevent formulation of lye. The warmth makes the lye more active in the follicle, and by warming the lye quickens the process of tissue destruction. Blend Action IT IS A WELL KNOWN SCIENTIFIC FACT THAT A RISE IN TEMPERATURE ACCELERATES THE RATE OF CHEMICAL REACTIONS The follicle is treated very effectively but in less time than with direct current on its own. By combining alternating current with direct current it reduces the treatment time per follicle by a half, that is direct current only = 10 seconds on average, blend = 5 seconds on average. The blend effect in the follicle is wide, deep and takes approximately 5 seconds. The blend method is the most popular way of permanent hair removal throughout the world and is rapidly gaining ground in the U.K. For this reason students of electro-epilation should be familiar with the techniques of blend epilation. Why is Blend Becoming so Popular? The blend method is more effective, has less re-growth, is more comfortable and gives the electrologist and the client far more treatment choices than diathermy. There is less re-growth so client motivation is high and clients invariably go on to have other parts of their body treated because it is much more comfortable. ALL EPILATORS ARE ONLY AS GOOD AT THE ELECTROLOGIST USING THEM. ALL THE NORMAL RULES REGARDING GOOD INSERTIONS AND CORRECT CHOICE OF CURRENT LEVELS APPLY! Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Typical Blend Epilator
All epilators will have: a mains on/off switch; a control for the diathermy; a control for the direct current; a timer control and meters or digital readouts. There may be other components, such as outlets and accessories for anaphoresis and ataphoresis. The Timer You may not be used to a timer, so check manufacturers instructions to see if the timer actually turns off the current or is just an indicator of time. Also check to see whether you control the current through either the footswitch or finger button. Control Settings Most modern epilators have keypad controls and digital readouts. Some machines do not have any numbers around the intensity dial. For client record purposes the way to record the position of the dial is to liken the dial to a clock face. If the dial is turned straight up you write it down as 12 o’clock, if the dial was only ¼ of the way round you would write it on the record card as 9 o’clock, minimum would be 7 the next 8 and so on. You would also record the meter readings, so the record card entry would read like this: Clock position - meter reading = 10 o/c - .4 Be aware that with some epilators there is hardly any meter reading on the diathermy side when in the blend modality because the amounts used are so low. DIATHERMY IS USED ONLY TO WARM AND QUICKEN THE EFFECT OF THE DIRECT CURRENT.
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Treatment Techniques There are many treatment techniques available within the blend modality, which is one of the reasons for its popularity. Although you will now be studying the main techniques of blend, for techniques specific to your epilator you should consult the manufacturer’s instructions. The traditional technique is where the diathermy is kept on minimum, the timer is set to 5 seconds and the direct current increased an ‘hour’ or 5 to 10 digits after each follicle is treated until the hairs are removed from the follicle without traction.
TECHNIQUE 1 (Higher for Shorter) Method a.
Prepare the area for treatment as diathermy
b.
Choose the needle size as diathermy
c.
Turn the D.C. dial and the diathermy dial to minimum
d.
Turn the timer to 5 seconds
e.
Insert the needle and activate the currents either by footswitch or finger button
f.
Wait for the timer to ‘beep’ and then release the footswitch or finger button, and withdraw the needle
g.
Try the hair to see if it will release without tension
h.
If the hair does not release you will need to increase the D.C. one ‘hour’ to 8 o’clock, or 5 to 10 digits
i.
Treat another follicle in the same way and then try the hair.
Repeat this procedure until the hairs epilate without traction. Client Comfort/Treatment Options If the client finds that traditional technique uncomfortable try the following option.
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Technique 2 (Lower for longer) Method a.
Reduce the D.C. intensity to the level your client finds acceptable
b.
Increase the time, duration of follicle treatment, until the hairs epilate without traction.
What you have done with the second technique is to lower the intensity and to increase the time. The option of the second technique gives your client a more comfortable treatment but as it is slower you will not normally be able to take out as many hairs in their normal treatment session. Point out the drawbacks and ask them to decide which one they would like, both do the same job in the follicle but over different lengths of time. If your client is concerned about facial hair they may be more inclined to have the traditional technique, even though they may prefer the other one, this is because they want to get rid of the hairs as quickly as possible. You will notice erythema and, on some areas, small white circles around the treated follicle, this is quite normal and a typical galvanic current reaction, particularly on the forearms. This reaction goes very quickly and you should not confuse it with the reaction of ‘blanching’ when diathermy is used too high an intensity . Client Differences You will notice on all clients that their hairs come out at different positions on the dial and with different meter readings. This is quite usual when working with galvanic current so there is no such thing as ‘average’, ‘normal’ or ‘recommended’, the golden rule is always: Start low and increase the galvanic an hour at a time until the hairs come out. Remember if the client is uncomfortable turn the intensity down and increase the time. Direct current effectiveness is based on an equation. Intensity = Effect Time
traditional technique uses a higher intensity down and increase the time.
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(5 seconds) and the second technique uses a lower intensity over a longer time (6+ seconds). Think of the two elements intensity and time as a seesaw, if one goes down the other must go up and vice versa.
Technique 3 (Treat and leave) The effect in the follicle caused by the sodium hydroxide carries on working for a brief period of time even though the current is off and the needle is off and the needle is withdrawn. This continuing effect of the lye can be utilised with another technique, one of leaving the hairs in the follicle after you have treated them, going on to treat others then coming back to the original ones with your tweezers to remove. The benefit of this technique, called ‘treat and leave’, is that it is a quicker way of working, as you are not stopping after treating each follicle to remove hair, you remove all the hairs at the end. This technique also allows you to work with either a slightly lower intensity or slightly shorter time because the hairs get extra treatment by the lye whilst they wait for you to remove them. The traditional technique could be combined with the ‘treat and leave’, you could also combine the second technique with the ‘treat and leave’ to quicken to slower treatment. The blend gives you and your client choices; which modality, which treatment techniques, what levels of sensation and finally a combining together of a number of techniques to ‘tailor make’ the treatment to suit each client. To fully appreciate the range of choice start practising on other clients, models and colleagues now!! Technique 4 (Galvanic only) The last technique to try is galvanic only. Turn off the diathermy, set the timer to 10 seconds and put the galvanic intensity where it was from the traditional technique. If there is tension when trying to remove the hair, increase the intensity if your client is comfortable or lower the intensity and increase the time if not. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Even within the galvanic only modality you can work ‘higher for shorter’ or ‘lower for longer’ or even ‘treat and leave’. These techniques greatly increase the choice you can offer your client, experiment and see if you can create other techniques which effectively treat the follicle yet are comfortable to the client. With a blend epilator there is always a technique to suit every client, it takes just a little time to get used to the choices. Hints and Tips If the hairs do not epilate these are the choices: 1.
If your client is comfortable increase the galvanic intensity
2.
If your client is not comfortable decrease the galvanic intensity but increase the time.
3.
Leave intensity and time where they are but ‘treat and leave’.
FROTHING Frothing is something you will see from time to time. It is merely the escaping hydrogen gas which is released when the lye is made. Frothing can be indicative of high levels of follicle moisture.
Testing Procedure All accessories are subject to wear and tear, and it is important to know and understand the testing procedure for your accessories as well as for the epilator. There are more accessories on a blend epilator than on a diathermy one, therefore more to test. Always make sure you have spares of all accessories (needle holder and cables, indifferent electrode cables and footswitches).
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Moisture Gradient Direct current is available along the whole length of the needle but lye is only produced where it encounters moisture. The upper or permanent part of the follicle is much dryer and is also coated with sebum which is a good insulator of current. The lower follicle is more moist and therefore produces a stronger action, that is the production a stronger action, that is the production of lye. ACTION IN THE FOLLICLE
GALVANIC ACTION
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THE HIGHER THE INTENSITY, OR THE LONGER THAT IT IS APPLIED, THE MORE LYE IS PRODUCED. Hydrogen gas can sometimes be seen frothing out of the follicle opening, chlorine gas appears at the positive electrode (indifferent electrode) in the form of extremely mild hydrochloric acid. Direct current is very effective in destroying the follicle but the process is slow. Research the three methods of Electrical Epilation then complete the following chart. Current Type
Advantages
Disadvantages
Short Wave Diathermy
Blend
Galvanic
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Electrolysis in Transsexuals Introduction Transsexualism and Gender Reassignment is a medical condition (a form of gender dysphoria) in which a person is born with their gender, or ‘brain sex, opposite to their physical (genital) sex. So a male –to-female transsexual is a person born with a male body but a female brain and hence a female identity. This condition causes a great deal of emotional pain and suffering, and frequently leads to suicide. People in this situation feel that the only feasible way forward is to undertake treatment to modify their body to bring it inline with ‘brain sex’. Transsexualism is very different to transvestism and homosexuality, and should not be confused with either. Transvestites are men who dress as women for sexual or emotional relief, but do not have female brains and possess a normal male self identity, and have no wish to change their sex Gay men and Lesbians are attracted to people of their own sex and as Transvestites they also have no desire to change their sex. For a person diagnosed as Transsexual by a properly qualified specialist, a process of Gender reassignment take place The steps of the process are: • Diagnosis by appropriate specialist • Counselling and/or psychotherapy as required • Hormones to change the body shape and characteristics • Electrolysis to remove facial (and possibly other) hair • Real life test, living in their chosen gender role • Surgery to change the genitals. Possibly breast augmentation or facial cosmetic surgery too. For successful male to female transsexuals gender reassignment, perhaps the greatest obstacle is the need to work and function in their chosen gender prior to surgery taking place. The patient must undergo a real life test (RLT), living I the new role for at least a year, to demonstrate their ability to function as a woman, as well as obtaining approval from two specialist psychiatrists. Hormone therapy is generally started before RLT, as most patients need the changes that hormones give in order to ‘pass’ in their new role. Male to female hormone treatment causes development of breasts, usually rather small, as well as redistribution of body fat and a general feminisation of the figure, hair and skin. Body hair is often reduced but not removed, hormones seldom have any large effect on facial hair, electrolysis being the only effective method for removing this. Hormones will not alter a male voice( nor will genital surgery), so speech training is also required. Genital surgery involves removal of the male genitals and the construction of female genitals, using materials from the male genitals. Present state of the art surgical techniques produce a very good approximation to natural female genitals, with full sexual sensation. Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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Further information on the reassignment process can be found in the booklet “Transsexualism: A Primer” available from the Looking Glass Society. Electrolysis in Transsexuals Almost all male to female transsexuals require electrolysis to remove unwanted facial hair prior to or shortly after their change of gender role. In rare cases this has been obtained on the NHS, but at present it is hard to obtain any treatment on the NHS for Transsexuals and most clients will pay for their electrolysis privately. The usual standard of good practice, such as sensitivity and confidentiality, apply as strongly to transsexuals as to any other client. Transsexuals are often very self conscious about their facial hair, and indeed about any physical feature that reminds them of their hated masculine past. A sympathetic and skilled electrologist is in a position to make a very positive contribution to the quality of the client’s life, and conversely transsexual clients are usually very co-operative and punctual for their appointments, as the removal of male-type facial hair is very important for them. Furthermore, transsexuals tend to be long term clients requiring a large amount of treatment, so a willingness to treat them makes ‘good business sense’. Treatment timescales A typical transsexual, who has developed to adulthood with a male body, will have deep rooted facial hair. A large amount of treatment will be required to successfully remove the hair permanently, many hundreds of hours may be needed spread over a 2-3 year period and it is not unusual for treatment to take up to 5 years. It is necessary to have approximately 4 hours treatment per week to deal with the rapid re-growth of facial hair in male to female transsexuals. Transsexuals who start electrolysis prior to hormones should be advised that progress may be slow until hormones are started. Re-growth rates will generally diminish further once the testes are removed either as part of Gender reassignment surgery (GRS) or in a separate preliminary procedure (bilateral Orchidectomy) It should also be noted that transsexuals will also need electrolysis for other areas of the body but the facial hair is usually a priority to a transsexual. Which Method – Diathermy v Blend (galvanic far too slow) There is much controversy about which method is the most effective for treatment of male to female transsexuals, the best consensus of opinion from experienced electrologists, and transsexuals themselves is that in general diathermy produces a quicker result, even taking into account that diathermy may give a higher regrowth rate, it should be noted however that most clients find diathermy more painful than the blend method and it generally provokes a greater skin reaction. Therefore it is probably best to use diathermy where possible, provided of course that the client can tolerate it. Some clients have been successfully treated with Production of this material is attributed to Rotherham College of Arts and Technology Revision 1 Creative Studies/Hair & Beauty/0506 6345 Equipment & Probing Techniques - NVQ Level 3
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blend on the most sensitive areas e.g. upper lip and diathermy elsewhere. Many clients have found that with appropriate pain control and aftercare they can tolerate treatment entirely by diathermy. Some clients find diathermy too unpleasant and prefer the generally slower but less painful blend method throughout their treatment. Another criterion may be the presence of badly distorted hair follicles. Most transsexuals are likely to have shaved regularly for several years ( this in itself should not distort the follicles), and some will have used more drastic techniques such as plucking, which may well have caused distorted follicles. Severely distorted follicles cannot be treated by diathermy as it is impossible to place the needle tip at the hair root. In the case of severely distorted follicles it is necessary to use the blend method as the lye produced in this method will be able to effectively reach the hair root where the needle cannot. To Summarise 1. For any distorted follicles choose blend 2. Otherwise, use diathermy to begin with 3. If the client experiences an unacceptable level of pain or skin reaction, switch to blend for the affected areas 4. If the success rate is abnormally low, it may be worth trying blend instead of diathermy. Technique Great care must be taken when treating transsexuals’ facial hair as the power levels required to effectively epilate this type of hair will be very much higher than for other clients and care must be taken to avoid skin damage. The skin may also be made more vulnerable by the effects of high doses of feminising hormones. It is also worth noting that male type ‘virgin growth’ hairs may have particularly large hair bulbs, which may produce friction as they slide through the follicle (which is significantly smaller in diameter than the bulb). This can produce the illusion of traction, which in turn can lead to accidental over-treatment. If there is genuine traction, the hair will not move at all and should be re-treated , if however it move a little and then appears to have traction then this suggests that the hair is in fact adequately treated but jamming in the follicle, and should be simply pulled out. Care must be taken to avoid overtreating any given area, spacing the treated follicles rather widely may be advisable. A degree of pain and skin irritation is inevitable owing to the power levels used in treating male-type hair, but careful preparation and aftercare can minimise these problems. Gold plated needles have also been found to be useful in both reduce pain and skin reaction. There is no hard and fast rule for treating different areas in a particular sequence and it is best to be guided by the client’s personal preference and then taking into account the individual’s recovery and re-growth rates.
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It is also worth mentioning the ‘sideburns’ typical in male facial hair growth. Women have fine hair in this area, similar to scalp hair rather than the thick beardlike hair characteristic of the male. Clearing this area outright gives a result that ‘looks wrong’, but careful application of electrolysis accompanied with the effects of hormones, can actually convert the male type growth to a god facsimile of the female pattern. The method is as follows: The client must first grow her hair in this area to approximately 8-10 mm in length. Then for each hair in the sideburn area, look closely at it and determine whether it is a coarse male-type hair or a finer vellus hair. If it is vellus, it should not be treated. If it is a coarse terminal hair, it should be deliberately under- treated: apply rather less power than normal, and remove the hair even if there is traction. The effect of this is deliberately to fail to kill the follicle outright, but to damage and weaken it. Overtime, this produces the desired effect Pain Control Due to the lengthy treatment times and the pain involved it is important that the client is given advice on pain relief. There are three methods that are regularly used, topical anaesthesia, analgesics and sedatives, generally these are prescription drugs and it will be necessary to liaise closely with the clients GP. Pain relief Topical EMLA creams 5%
Analgesics e.g. co-proxamol Dihydrocodeine
Sedatives e.g. Lorazepam (1-2mg) or other Benzodiazepines
Advantages Can be easily applied Only treats area to be treated
Disadvantages Messy and has limited penetration so not always effective on deep rooted follicles
No mess Greatly reduces sensitivity
Can cause drowsiness And some clients intolerant to drug causing side effects
Does not reduce pain only help deal with pain levels, should only be used extreme cases
Limits activites e.g. driving
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Aftercare Application of a normal aftercare cream is appropriate, typically a witch Hazel based product. •
• • • • •
Some clients experiencing severe inflammation have found improvement by taking a non steroidal anti inflammatory drug e.g. Voltarol 50mg and or antihistamine before commencing treatment. It may also be useful to use topical antihistamine creams. If inflammation is severe and constant GP advice should be sought. Other advice that should be given is as follows: No make-up for 24hrs Do not touch the area No shaving for at least 24hrs (any longer will most likely be ignored) using an electric razor no blade razors as these can tear the small ‘pimples that occur after electrolysis
Genital Electrolysis This needs to take place prior to GRS and is a sensitive subject to both clients and electrologists a like . It can be very difficult for male-to female transsexual to find an electrologist prepared to do this type of epilation. The precise method of surgery used depends upon the surgeon performing the procedure, but all method of GRS place potentially hair bearing tissue from the penis and/or scrotum in locations where hair would be undesirable and problematical( inside the vagina and under the clitoral hood and perhaps inside the labia). For this reason, clients are well advised to seek the advice of their chosen surgeon as to which parts need to be epilated, and then to obtain the necessary electrolysis well in advance of the surgery so the skin can recover and the removal to be at the permanent stage. Genital electrolysis can be extremely painful and have the added problem of maintaining hygiene before and after treatment some clients report that the use of Betadine useful in combating this problem Genital electrolysis is a little different than other parts of the body and are similar to the bikini line and follicle can be extremely shallow. It is safe to use high power level when treating this area as damage to the skin is less important as the area will not be visible after surgery. The ‘flash thermolysis’ technique using insulated needles can be a very effective method. It gives very low re-growth rates and rapid results. It is imperative that the skin is well stretched around the follicle being treated and it can be useful to use a one piece needle as it may be necessary to ‘push’ the needle into the follicle more forcefully than with any other area of the body and a highly flexible two piece needle may be prone to bending.
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Other Epilation Methods Laser Epilation Two methods of hair removal by laser have recently arrived on the market. Both are new technologies and no long-term data is yet available on their safety and efficacy. Some patients have reported good results, however 'horror stories' also abound, and these treatments must, at present, be regarded as experimental and approached with caution, and treatment provided without proper medical supervision (e.g. at certain private clinics) should be avoided under any circumstances. The great advantages claimed for laser treatment are its speed, as each discharge of the laser can treat numerous hairs, and the lack of a needle which some patients find painful or disturbing. Some patients have claimed good results with laser epilation of the genitals prior to surgery, and some laser clinics are certainly willing to treat the genital area. The permanency of laser epilation is uncertain at present; indeed, the US Food and Drug Administration specifically prohibits laser companies from claiming permanency. While this may not be a major problem for facial treatment (re-treatment, or treatment of subsequent regrowth by electrolysis would be possible), it is a cause for concern for genital epilation, as re-treatment of skin that post-operatively forms the interior of the vagina is clearly not possible by any method. In the 'pure laser method', a wavelength of laser light is chosen that is strongly absorbed by melanin. The reasoning is that melanin should be very much more concentrated in hairs than in skin, so the laser light causes selective heating of the hairs, including the root, to a temperature at which protein coagulation occurs, killing the hair follicle. The principal problem with this method relates to pigmentation and the distribution of melanin. Some patients with very dark hair and pale skin report good destruction of hair with no skin damage; conversely there have been problems with darker-skinned patients as the melanin in their skin causes a dangerous degree of general heating of the skin, causing scars and possible destruction of sebaceous glands (leading to intractably dry skin); and pale-coloured (or grey) hair contains little or no melanin and therefore cannot be treated effectively by this method. In the 'dye method', a light-absorbing compound is applied to the face and the surplus is then wiped off. The intention is that some of this compound will remain in the hair follicles, increasing the absorption of laser light. The main problems are that the method is indiscriminate: any pore or indentation in the skin will be filled with the compound and thus heated when the laser is discharged; severe damage to skin has been reported. Furthermore, the compound tends not to penetrate deeply into hair follicles, leading to surface heating which may scar the skin and does little to destroy the hair follicle.
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Tweezer Electrolysis A variety of variations on this theme have been marketed, and new ones appear each year, accompanied by a great deal of marketing 'hype'. The intention is that current is passed down the hair itself from a tweezer-like electrode, and no needle is used. It can readily be demonstrated from electrical theory and some simple bioelectrical measurements, that it is quite impossible to transfer enough energy into the follicle by this method to destroy it, even at the maximum voltage permitted by law. Clinical trials have supported this conclusion, finding that tweezer electrolysis quite simply amounts to nothing more than plucking the hairs, and is a waste of the patient's money. Home Electrolysis Kits These items are widely available on the retail market, and are generally very simple, low-powered, galvanic electrolysis units. In practice the power levels developed are quite insufficient to treat male-type hair, and again these products are quite useless in the treatment of transsexuals. It should be stressed once again that destroying male-type facial hair without causing skin damage is a skilled and delicate process which should only be entrusted to a reputable electrologist with proper equipment and prior experience of treating transsexual clients. Radiation Treatment There have been attempts in the past to use ionising radiation to kill hair follicles. This is now regarded as unworkable and unsafe: at a level that is considered adequately safe, epilation is seldom permanent, while radiation of sufficient intensity to permanently kill facial hair poses an unreasonable high risk of cancer in the future.
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