Waxing is an excellent and inexpensive way to deal with most hair removal. Waxing leaves the area smoother than shaving does because it pulls the hair out from below the top layer of skin. You can wax at home, and beauty supply stores sell all the equipment you will need. This is the easiest and most convenient way to go about removing hair from large areas. For smaller areas like the upper lip, a wax that is melted in the microwave and applied with a small spatula offers the most control.

In hot waxing, a thin layer of heated wax is applied to the skin in the direction of the hair growth. The hair becomes embedded in the wax as it cools. The wax is then pulled off quickly in the opposite direction of the hair growth, taking the hair with it. Cold waxes work similarly. Strips are pre-coated with wax or a sugar-based substance and pressed onto the skin in the direction of the hair growth and pulled off in the opposite direction.

Before you consider doing this yourself, visit an aesthetician with experience in waxing. It's hard to get the technique right, and getting it wrong can mean a sticky mess. It also smarts when the hair is ripped off.

Sugar Forms of Waxing
The best known "sugaring" method of hair removal is Nad's Gel Hair Removal ($29.95 for one kit). What makes this different is that it literally uses sugar instead of wax. Having a thick, caramel-like consistency, it works exactly like waxing, but instead of spreading a wax substance over the skin, you're spreading caramel.

This is one of the first products I've ever run into where the claim of being 100% natural and organic is 100% true. Nad's ingredients are honey, molasses, fructose, vinegar, lemon juice, water, alcohol, and food dye. Now that's what I call natural. But does that make it better than waxing, as the company claims? As far as hair removal is concerned the effect is identical. You spread Nad's gel over the hair you want removed, then you rip it off and out comes the hair.

Sugaring has two things going for it. First, sugaring's mess washes away while wax has to be peeled or scratched off. Second, sugar doesn't have to be heated while wax often does, and that is much less damaging to skin! Easy cleanup and a relatively easier application are the benefits of sugaring.

But before you jump on the sugaring bandwagon, you should know a few details about some of the untrue claims that accompany Nad's. Nad's states, "when you use Nad's, the hair is extracted, including the roots so re-growth is softer, finer and slower." That isn't true. Hormones and genetics determine hair growth and hair thickness. Anytime you pull hair out it is removed closer to the root so the new hair takes longer to grow back to the surface.

Nad's also claims sugaring will prevent ingrown hairs. Ingrown hairs occur because a hair that has been removed sometimes has trouble finding its way back to the surface. That applies to hair removal in general, regardless of whether you shave, tweeze, sugar, or wax.

Another claim: "Because of the natural substances in Nad's, there is little chance of irritation." Natural or not, ripping out hair hurts, and for some skin types that can be a problem.

Tweezing
Tweezing is not only a painful option, it is extremely time-consuming. It works almost the same way waxing does—pulling the hair out from the root. Some women worry that tweezing will increase growth or make the texture of the hair heavier, but if plucking altered hair growth, we would all have bushy eyebrows! Actually, tweezing hair can eventually shut down the hair follicle by causing repeated shock and injury, although this can take a long time.

Bleaching
Bleaching is a great, inexpensive option if the hair is dark but not dense. It is especially effective for the upper lip or other parts of the face, neck, and arms. There are many options for facial bleach products at the drugstore or on the Internet. One of the best Internet sources for a range of inexpensive options is www.folica.com. (Please note that this site also sells an array of products that have misleading and exaggerated claims.)

Electrolysis
Electrolysis is the only permanent form of hair removal, but it takes repeated treatments and can be pricey. You must find an extremely skilled technician in order to achieve satisfactory results. Before you make an appointment, check out the clients who have had permanent success with this method of hair removal.

There are two types of devices that use electric current to remove hair: the needle epilator and the tweezer epilator. Needle epilators introduce a very fine wire under the skin, and into the hair follicle. An electric current travels down the wire and destroys the hair root at the bottom of the follicle. The loosened hair is then removed with regular tweezers. Every hair is treated individually. This is considered a permanent hair-removal method because this technique destroys the hair follicle. The hair root may persist, however, if the needle misses the mark or if insufficient electricity is used to destroy it. Unfortunately, you can't control hormonal changes that may cause new growth (Source: FDA Consumer magazine, September 1996).

The major risks of using electrolysis include electrical shock (which can occur if the needle is not properly insulated); infection from a non-sterile needle; and scarring caused by improper technique. In addition, there are no uniform licensing standards regulating the practice of electrolysis. Only 32 states require electrologists to be licensed, and among those the requirements vary from as few as 120 hours to 1,100 hours, which means that many electrologists only need a machine and little else.

The American Electrology Association and the Society of Clinical and Medical Electrologists have certification programs, based on a written exam. A list of licensed and certified electrologists is available from the International Guild of Professional Electrologists, 803 North Main Street, Suite 3A, High Point, NC 27262; (800) 830-3247 or on the Web at www.igpe.org.

Home Electrolysis
Technically, these devices work the same way as those for professional usage do (they also carry the same health risks). However, the risks for the home machines are not very great because the voltage is fairly low, which means they also aren't as effective. We've all seen the machines you can buy via mail order (for about $100) that claim to remove hair painlessly and permanently. The chances of operating these devices successfully are at best slim. You would probably end up just tweezing instead of zapping the hair because getting the device to work right is extremely tricky. Given the time it takes for a hair to grow back, it could take months before you knew if it was really working (Source: FDA Consumer magazine, September 1996).

Perhaps the most advertised at-home product is IGIA's Hair Removal System ($119). It is supposed to be a "painless home electrolysis system that helps keep hair from growing back! Unlike common [tweezing] and depilatory devices that can cause skin irritation, this system uses mild radio frequency pulses that is absolutely safe and is delivered through the tweezers to remove hair without touching the skin." Well that much is true. This overpriced machine delivers low-voltage radio waves through the hair shaft. Does that kill a hair follicle? There is no research indicating that these machines do anything but tweeze the hair. The low voltage makes these machines extremely low risk, but also ineffective. Still, in comparison to the other IGIA products, this one is the safest in the bunch.

Shaving
Shaving is fine, but we all know the problems associated with it. Shaving is the method most of us use for our legs and bikini line, but the hair grows back too fast and the stubble or redness it can cause on the thigh and crotch is obnoxious. There are ways to deal with the redness, like using a hair conditioner or non-irritating shave gel (such as my Close Comfort Shave Gel) to shave with, and applying a non-fragranced moisturizer afterward or a solution containing stabilized acetyl salicylic acid (aspirin), such as my Skin Relief Treatment. This is a great options for preventing red bumps because aspirin has potent anti-inflammatory properties even when applied to the surface of skin. You can also try this simple remedy at home: take one or two aspirins and dissolve them in about ¼ cup water and then apply the solution with a cotton ball to the area you just shaved! This works on any part of the body. You will be impressed by the results.

On the legs, an AHA product can help keep flaky skin at a minimum, which means you can get a closer shave. Skin should never be shaved while dry; wet hair is soft, pliable and easier to cut. Contrary to what many believe, shaving does not change the texture, color, or rate of hair growth. Hair density is genetically and hormonally determined; it has nothing to do with what you do topically to the skin.

Laser Hair Removal
Since the advent of the first FDA approved laser hair-removal system in 1995, its popularity has made laser hair removal a financial cornerstone for many dermatologists and plastic surgeons. The original laser hair-removal machine was The Soft Light Hair Removal System developed by the Thermolase Corporation. Since then the growing popularity of this treatment has prompted many laser manufacturers to seek FDA clearance for their laser hair-removal machines. The market is growing so quickly that the FDA cannot maintain an up-to-date list of all laser manufacturers whose devices have been cleared for hair removal. However, to learn if a specific manufacturer has received FDA clearance, you can check the FDA Web site, www.fda.gov. You will need to know the manufacturer or device name of the laser. You can also call FDA's Center for Devices and Radiological Health, Consumer Staff, at 1-888-INFO-FDA or (301) 827-3990, or fax your request to (301) 443-9535 (source: FDA Center for Devices and Radiological Health, Laser Facts, May 2001, online).

One of the most significant FDA regulations regarding companies that promote approved laser hair-removal systems is that "…manufacturers may not claim that laser hair removal is either painless or permanent. The specific claim granted is "intended to effect stable, long-term, or permanent reduction." Permanent hair reduction is defined as the long-term, stable reduction in the number of hairs regrowing after a treatment regime, which may include several sessions. The number of hairs regrowing must be stable over time?greater than the duration of the complete growth cycle of hair follicles, which varies from four to twelve months according to body location. Permanent hair reduction does not necessarily imply the elimination of all hairs in the treatment area." That is a very convoluted way of saying that laser hair removal is not permanent and there are no studies showing it to be so. Unfortunately, the FDA's regulation is usually not what the consumer is told.

When laser hair removal arrived on the scene, many exaggerated, unsubstantiated claims about its efficacy, risks, side effects, and long-term effects were asserted (Source: Journal of Cutaneous Laser Therapy, March 2000, pages 49–50). More research has taken place since then and there's more data (both clearer and more precise) regarding statistical analysis of performance and adverse outcomes. For example, a study reported in the November 2001 issue of Dermatologic Surgery, pages 920–924, used a "755 [nanometer] alexandrite laser equipped with a cryogen cooling…. Eighty-nine untanned patients… in the study underwent a minimum of three treatment sessions spaced 4-6 weeks apart [each patient had an average of 5 treatments]. Treatment sites included the [armpit], bikini, extremities, face, and trunk. RESULTS: The patients had a mean 74% hair reduction.… The best results are achieved in untanned patients." Several studies have looked at various other laser systems, including some showing more promise for darker skin tones (Source: Annals of Plastic Surgery, October 2001, pages 404–411).

The risks in laser hair removal can include skin discoloration (either darkening or lightening of skin); swelling; inflammation; and infected hair follicles. Laser hair removal is particularly problematic for those with tans or darker skin colors (Source: Cosmetic Dermatology, November 2001, pages 45–50). One study found that “Both long-pulsed alexandrite and long-pulsed diode laser systems are effective in the treatment of unwanted hair, and they are more efficacious than [the] Nd:YAG laser” (Source: Dermatologic Surgery, April 2004, 498-502).

More recent research confirms early information that laser hair removal, while superior to other forms of hair removal, is still not permanent and there can be complications (Source: Journal of Dermatologic Treatment, April 2004, 72-83).

Because of the potential for complications and the plethora of hair-removal machines available, it is essential to have this procedure performed by a physician who is familiar with the research and able to make the correct choice about which procedure is best for you.

Vaniqa
Manufactured by Bristol-Meyers Squibb, Vaniqa ($44.99 for 1.05 ounces), is approved by the FDA as a prescription-only topical cream for reducing and inhibiting the growth of unwanted facial hair (it has not been studied for its effect on hair for other parts of the body). On the surface, Vaniqa might sound like a depilatory (those nonprescription, drugstore products that topically "eat" hair away), but Vaniqa performs very differently from the way a depilatory works.

The active ingredient in Vaniqa is eflornithine hydrochloride, which has been used as an oral medication for certain cancers and to treat African Sleeping Sickness. Many disconcerting side effects are associated with taking this drug, ranging from anemia to diarrhea, vomiting, and hair loss. The notion that topical application of eflornithine hydrochloride can also reduce hair growth probably stems from the hair-loss side effect from this drug, when it is taken orally.

As the insert for Vaniqa explains, eflornithine hydrochloride affects skin when it "interferes with an enzyme found in the hair follicle of the skin needed for hair growth. This results in slower hair growth. [However] Vaniqa does not permanently remove hair or ‘cure' unwanted facial hair. Your treatment program should include continuation of any hair removal technique you are currently using. [Further] Improvement in the condition occurs gradually. Don't be discouraged if you see no immediate improvement. Improvement may be seen as early as 4 to 8 weeks of treatment… [and] may take longer in some individuals. If no improvement is seen after 6 months of use, discontinue use. Clinical studies show that in about 8 weeks after stopping treatment with Vaniqa, the hair will return to the same condition as before beginning treatment."

The insert that accompanies this cream warns, "You should not use Vaniqa if you are less than 12 years of age…." and there are animal studies that showed definite fetal problems. That means this drug is not to be used by pregnant women, and probably not for lactating women, though there is no research about that risk. Also, "Vaniqa may cause temporary redness, stinging, burning, tingling or rash on areas of the skin where it is applied. Folliculitis (hair bumps) may also occur" as well as acne.

So, should you consider Vaniqa? Well, that depends on how you look at the statistics, because for some women it may work well to reduce the amount of facial hair. And it sure beats the expense of having laser hair-removal treatments.

What about those statistics? Vaniqa does not work for everyone. "In two randomized double-blind studies involving 594 female patients, approximately 32% of patients showed marked improvement or greater after 24 weeks of treatment compared to 8% [with a placebo]." It is important to note that 42% to 66% of those women in the study showed no improvement or actually felt their condition got worse. If you think it's worth the risk, give it a try. Just keep in mind that this isn't a slam dunk. More than half of those who use it won't be happy with the results.

Hair Removal Warning!
Any and all treatments for hair removal are contraindicated after any facial peel or laser procedure. It can take six to eight weeks for the skin to completely heal after a peel. Any trauma to the skin during the recovery period can cause discoloration or even scarring.

Hair removal is also extremely problematic if you are using AHAs, BHA, topical retinoids, azelaic acid, or taking Accutane. These treatments can make skin more susceptible to tears, wounds, and irritation. This can all prove damaging and uncomfortable.