The information on this page is written for a transsexual audience.

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How will electrolysis affect my skin?

Contents

Summary

  1. Skin damage is the worst side effect of electrolysis. Choosing an electrologist will be the most important factor in how your skin ends up. Ask the recommendation of local TSs who are done and are happy.
  2. You can count on a certain amount of redness, swelling, welts, tiny blisters, scabs, dryness, and ingrowns between treatments. These temporary side effects must be treated properly to avoid permanent skin damage.
  3. Immediately after treatment, you must stay out of the sun, avoid make-up, and avoid harsh chemicals until your skin has recovered. The less you do to your skin between treatment, the better. A fragrance-free and menthol-free aloe gel (not lotion) can moisturize the skin following treatment and reduce redness. There are also several preparations designed for use after electrolysis which can help reduce and conceal redness and swelling.
  4. If at all possible, avoid shaving immediately after treatment. If you absolutely must, use an electric foil razor.
  5. As you near completion, you may find that weakened hairs are causing more ingrowns. Use a gentle exfoliant to help release them.
  6. If you are having excessive swelling and redness or are seeing skin damage, discuss it with your electrologist to adjust treatment, or consider trying another electrologist. You may also want to consult a dermatologist.

Main factors
 
Your skin type
As mentioned before, everyone's skin has a damage threshold that may even be lower than your pain threshold.
Method of electrolysis used
Some people find a difference in skin condition depending on whether thermolysis, galvanic or blend treatments are used. Also, some feel that stripping an area of all hairs causes more damage than gradually thinning an area. The size of the area treated will also be a factor.
How much treatment and current you need
When you are starting out, this will be at its highest level. The redness and swelling will be at their worst until you're down to clearing your face in one session a week. After that, the side effects will be less and less with each treatment.
Amount of treatment in one area
If too much work is done in a small area, it can lead to significant local swelling. This is most frequently reported on the upper lip, but also can happen anywhere on the face. You can expect mild to severe swelling if you do more than a half an hour on your upper lip.
Thinning versus stripping
If you treat hairs that are less than about one-eighth inch apart, you will probably get more swelling. If you are especially sensitive, you may find that thinning hairs from an area gradually works better then stripping an area all in one session.
Time between treatments
The more often you have to go, the less recovery time between sessions. Again, that means your skin will be affected most early in the process.
Your skin care regimen immediately following and between treatments
This is the most easily-controlled aspect, and possibly the most important. The do's and don'ts listed below can make a big difference in the condition of your skin.

Potential side effects

You can count on the following to some degree or another:

Redness
Depending on all the factors listed above, you can expect the treated area will have redness immediately after, which will last anywhere from half an hour to well into the next day. Common treatments include witch hazel to cleanse and soothe the area just after treatment, followed by a skin soother like Simply Smooth or aloe gel. My electrologist uses a menthol aloe gel, but I advise against any irritants like menthol or astringents like alcohol, even if they feel good right after. I bring my own plain Walgreens Aloe Vera Gel mostly, although I also have an aloe plant I have used at home.
Also, those sensitive to permanent wave solution and other products containing lye may want to test an area of skin with galvanic before face work. Some believe that those suffering excessive redness or discomfort may find a gold-plated probe less irritating.
If the redness gets excessive, you may want to consider thinning hairs gradually instead of clearing a patch on your face. Some clients experiencing severe inflammation have found an improvement by taking a non-steroidal anti-inflammatory drug (e.g. Voltarol 50mg) and/or an antihistamine before commencing treatment. Topical antihistamines may reduce redness and help control itching. Ask a dermatologist if you seem to be having a severe reaction.
Swelling
Depending on all the factors listed above, you will have some overall puffiness on your face, and some raised bumps or welts immediately after. Usually these welts look like insect bite here and there, but sensitive clients sometimes report enough swelling to make them look like "a deformed monster."
This is much more common in those who clear an area instead of thinning the hairs over several sessions. I did a couple of marathon clearing sessions that left me looking like I scraped my chin or swollen enough for co-workers to say I looked like I'd been slapped around, even a day or two after treatment. Too much treatment in a small area can turn skin into a seeping mess that crusts over into a giant scab, especially for those with sensitive skin.
Swelling may start to subside following treatment, or it may increase for several hours following and then take a day or two to go away. Ice is the most common method to reduce swelling, although ice often increases the redness. This is why it's good to schedule your treatment so that the redness and swelling won't be noticeable to others. Besides ice in a bag, some people use froze tissues or washcloths soaked in water, or those gelpacks used in coolers for food storage.
 
Tiny blisters (scabs, crusts, petechiae, or eschars)
Following treatment, you may notice a few tiny raised white blisters that look like acne. When I would get these, they would usually show up the day after. These would sometimes scab over. To people at work, I'm sure it just looked like acne, and most people aren't going to mention that to you. It's best to cleanse the area and leave them alone to minimize scarring. In the process of treatment, there is usually a tiny amount of blood involved. Sometimes there would be a spot where the skin was open from removing an ingrown or from treating a lot of hairs in a small area. These scabs are also best left untouched.
Ingrowns
As mentioned earlier, occasionally a treated hair will grow back in a direction away from the skin's surface. Also, weakened hairs may not push through the skin and remain below the skin's surface. There is a chance an ingrown hair may become infected or cause inflammation. Getting ingrowns out must be done very carefully- trying to "dig them out"can cause scarring. Many electrologists use a sterilized needle to release hairs that can't be gotten out with forceps. However, prevention is your best bet. See the skin care section below for additional tips on fighting ingrowns.
Breakouts/folliculitis (inflammation of follicles)
This is best treated by doing as little to your skin as possible between sessions. Use the mildest cleanser and gentlest moisturizer, and avoid shaving if possible. Avoid drying products like benzoyl peroxide (Oxy 10, etc.), which may make the acne worse.
Dryness/flaking/itching
Many find that the heat and/or chemical reaction from electrolysis leaves their skin very dry. This is often exacerbated by the use of hormones, which can have a similar effect on skin. The dryness can get severe enough to be noticeable to others. The best treatment I've found is aloe gel for a day after treatment, followed by a fragrance-free emollient lotion. I find any lotion with fragrance burns my skin if I use it within 24 hours of electrolysis.
Skin discoloration
People prone to scarring may experience hyperpigmentation (darkening), which can be reduced in some cases with a cream made of alpha-hydroxy acids and hydroquinone. One such brand is Neostrata. Much rarer is hypopigmentation (skin lightening). I know no one personally who has experienced either of these. Blacks are usually more likely to have this happen.
 
Permanent scarring and pitting
These are the most common and most troubling problems. Electrolysis is a rather violent process designed to destroy tissue. Scabs or crusts form when enough tissue damage is caused for the skin to leak fluid or blood. Usually it resolves itself in a few days, but severe scabbing can result in pigmentation change or permanent scarring.
Scars do not show up until 6 months to a year or more later due to the fact that inflammation can take 6-8 months to recede and the scar tissue 2-3 months to contract. So, looking at your face the week after treatment does not tell you if you are being scarred. Turning the currents up really high to compensate for the coarseness of beard hair and the lack of exactness in technique increases your chance of scars. Injury to your subsurface tissues is cumulative.
In people prone to forming thick scars, the scars may be noticeable quickly. Dark-skinned people may develop dark or white areas around the treated hairs. In all clients, there is a chance that overtreatment will damage the collagen below the skin. This connective tissue can be damaged by heat, causing depressions in the skin in some. Collagen damage is most commonly reported at the corners of the mouth. Dealing with scarring and pitting will be discussed in the skin care section.
Ingrown hairs
Occasionally a treated hair will grow back in a direction away from the skin's surface. Also, weakened and curved hairs may not push through the skin and remain below the skin's surface. There is a chance an ingrown hair may become infected or cause inflammation. Getting ingrowns out must be done very carefully- trying to "dig them out" can cause scarring. Dealing with ingrown hairs will be discussed later in the skin care section.
"Tombstones"
Bits of hardened debris sometimes remain in a treated follicle. It can be visible under the skin's surface, because it sometimes contains pigment from the hair that was removed. They often look like blackheads. Eventually, the follicle will push this out with natural action, although sometimes they need to be "helped" out. Methods for doing this will be discussed later in the skin care section.
Bruising
Some people get tiny bruises when the probe is inserted wrong and punctures a capillary. When this happens, it's reported on the chin or eyebrows more frequently.

Skin care

Following electrolysis, take the following steps:

Immediately after treatment:

  • No astringents!
  • No shaving! (but DO shave after redness has subsided)
  • No sun exposure!
  • No makeup!
  • No perfume!
  • No scratching or rubbing!

Treat skin with one or more of the following:

  • Cool water (esp. if witch hazel is irritating)
  • Witch Hazel
  • Aloe leaves or a prepared Aloe Vera Gel (no menthol, and no lotion-- get gel)
  • Simply Smooth (see ordering info above)
  • Sterex Apres Cosmetic Cream
  • calamine lotion
  • Post-Epil
  • Tend Skin to reduce the appearance of razor bumps, ingrown hairs, skin redness after hair removal. To reduce redness, apply immediately after. For ingrowns, apply before sleep and after showering until ingrowns are cleared, then use it several times weekly to keep skin clear. Because it's an exfoliant, be careful using other exfoliating methods and products with Tend Skin. (phone orders: (800) 940-8423)
  • Foille
  • Oatmeal mask
  • Savlon (chlorhexadine gluconate)
  • Hydrocortizone cream (not ointment)- 1/2% or 1%. (This can aggravate acne, though, and is a steroid, so some recommend avoiding it.)
  • Banana Boat "Soothe-a-Caine" for after-treatment burning.
  • Antibiotic ointment, spray, or lotion like Neosporin, Bactine, Bacitracin or generic equivalents
  • Harsher antibiotics like hydrogen peroxide gel and benzoyl peroxide products (like Oxy 10) may be too much for sensitive skin, but some like these.
  • Some suggest preparations made from tea-tree leaves and bark, but many people find this to be an irritant.

Cataphoresis

Some galvanic practitioners claim the reversing the machine's polarity (called cataphoresis) helps reduce temporary side effects. There is no clinical data supporting this, but if you are having severe reactions, you might consider trying it.

At home the evening after treatment:

Cleanse the face with a mild liquid detergent soap like Clean and Clear Sensitive Skin Foaming Facial Wash. Continue to use aloe or Simply Smooth-type products until swelling and redness have subsided. Don't use bar soap, which can be very alkaline (just like lye produced during blend and galvanic treatments), and may make things worse. Once the irritation has subsided, add a non-astringent toner like Neutrogena Alcohol-Free Toner after cleansing, followed by a mild fragrance-free face lotion like Lubriderm Moisture Recovery GelCreme. Some find relief from their itchiness with Dermoplast spray.

From one day after treatment until your next session:

Once the redness and swelling are gone, you should use a daily sunscreen. I find that Lancome SPF 15 spray sun screen and Clinique spf 25 sun screen lotion don't irritate my face.

Try to avoid shaving if at all possible until your redness and swelling have completely subsided. However, it can be good to shave a couple of days before your next appointment. Any hairs that grow out will be in anagen phase, and they will be in more effectively treated. If you can get in often enough to keep up with this new growth, you'll save yourself time in the long run. The longer a hair is allowed to grow after it surfaces through the skin, the stronger the root gets. For me that meant going in 2-3 times a week for a while. This is another reason to try to get done before you go full-time.

If you shave between sessions, you may find an electric foil razor less irritating. If you use a regular razor, make sure it's sharp, and avoid any shaving creams with menthol and other irritants. Some find a non-spirit-based aftershave like Clinique's Post-Shave Healer helps. REMEMBER: Don't shave for 24 hours prior to your session-- your electrologist needs a day's growth to determine a hair's direction and to grasp it with forceps.

Once you're to the point you don't need to shave between sessions, you can start letting your fine vellus hairs grow. Shaving removes the, and this can make your face look waxy and unnatural. The sooner you can let this fine down cover your cheeks the better (yet another reason to start before full-time).

Diet can help your complexion as well. Get plenty of antioxidants by eating fresh fruits and vegetables. Drink lots of water, which can help with skin moisture levels. You may find a humidifier helpful, too. And as if there weren't 500 other reasons to quit smoking, it can affect the health of your skin.

As I have gotten closer to completion, I've had more ingrowns at my jawline. I can see them just under the skin, but I resist the temptation to dig them out. Sometimes you can get them to surface by GENTLY scratching at the skin above them. Your best bet if to do as much exfoliating as you can in that area. This should get many of them out.

Once you're clearing your face in one session a week, you may want to battle ingrowns and tombstones with a gentle skin exfoliant like Physician's Formula Beauty Buffers Exfoliating Scrub the day or two before your next treatment.

There is a product called Tend Skin which some people have claimed helps reduce ingrowns. Tend Skin claims to clear "razor bumps" (a frequent post-shaving problem for African-American men) in 48 hours and to lessen redness. They further claim that if used regularly, it will prevent future ingrown hairs and "razor bumps". Be careful if you have sensitive skin, though-- the active ingredient is acetylsalicylate, in an alcohol/propylene glycol/glycerine solution. A user writes "Don't get it anywhere too sensitive or you'll be sorry."($20-4oz; $50-16oz). In many drug stores, or call 1-800-940-8423 for a store or for ordering info.

For those who want a much stronger alpha-hydroxy type exfoliant, I recommend M.D. Formulations Facial Cream with glycolic acid (despite its $60 price tag for 2 ounces). Keep in mind that any exfoliant can be too much for sensitive skin-- start slowly and use very sparingly at first. I can only use this about once a week.

If the damage is done...

If, despite the best efforts of you and your electrologist, you have some skin damage, you have a few options. You'd probably be best served by speaking with a dermatologist. Some of the options include using Alpha-Hydroxy Acids in prescription strength, the stronger chemical peels such as phenol peels, or laser skin resurfacing. These procedures will be discussed at greater length in an upcoming article.