Unwanted facial hair is a common problem that is seldom discussed in the primary care setting. Although men occasionally request removal of unwanted facial hair, women most often seek help with this condition. Physicians generally neglect to address the problem if the patient does not first request help. The condition may be caused by androgen overproduction, increased sensitivity to circulating androgens, or other metabolic and endocrine disorders, and should be properly evaluated. Options for hair removal vary in efficacy, degree of discomfort, and cost. Clinical studies on the efficacy of many therapies are lacking. Short of surgical removal of the hair follicle, the only permanent treatment is electrolysis. However, the practice of electrolysis lacks standardization, and regulation of the procedure varies from state to state. Shaving, epilation, and depilation are the most commonly attempted initial options for facial hair removal. Although these methods are less expensive, they are only temporary. Laser hair removal, although better studied than most methods and more strictly regulated, has yet to be proved permanent in all patients. Eflornithine, a topical treatment, is simple to apply and has minimal side effects. By the time most patients consult a physician, they have tried several methods of hair removal. Family physicians can properly educate patients and recommend treatment for this common condition if they are armed with basic knowledge about the treatment options. (+info)
Shaving, coronary heart disease, and stroke: the Caerphilly Study.
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The relation between frequency of shaving and all-cause and cardiovascular disease mortality, coronary heart disease, and stroke events was investigated in a cohort of 2,438 men aged 45-59 years. The one fifth (n = 521, 21.4%) of men who shaved less frequently than daily were shorter, were less likely to be married, had a lower frequency of orgasm, and were more likely to smoke, to have angina, and to work in manual occupations than other men. Over the 20-year follow-up period from 1979-1983 to December 31, 2000, 835 men (34.3%) died. Of those who shaved less frequently than daily, 45.1% died, as compared with 31.3% among those who shaved at least daily. Men who shaved less frequently had fully adjusted hazard ratios (adjusted for testosterone, markers of insulin resistance, social factors, lifestyle, and baseline coronary heart disease) of 1.24 (95% confidence interval (CI): 1.03, 1.50) for all-cause mortality, 1.30 (95% CI: 0.99, 1.71) for cardiovascular disease mortality, 1.08 (95% CI: 0.61, 1.92) for lung cancer mortality, 1.16 (95% CI: 0.90, 1.48) for coronary heart disease events, and 1.68 (95% CI: 1.16, 2.44) for stroke events. The association between infrequent shaving and all-cause and cardiovascular disease mortality is probably due to confounding by smoking and social factors, but a small hormonal effect may exist. The relation with stroke events remains unexplained by smoking or social factors. (+info)
Expression patterns of the transcription factor AP-2alpha during hair follicle morphogenesis and cycling.
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AP-2alpha is a member of a family of transcription factors expressed in cells of the epithelial and neural crest lineage. AP-2alpha plays an essential role in embryonic development and in regulation of epithelial gene transcription. To further characterize the role of AP-2alpha in skin biology, we assessed its expression in the skin of C57BL/6J mice during defined stages of hair follicle morphogenesis and cycling. During early hair follicle morphogenesis, AP-2alpha was upregulated in the epidermal placode, in the basal keratinocytes of the hair follicle bud, and then in the inner root sheath. The follicular papilla cells underwent a brief upregulation of AP-2alpha expression during the initiation of hair shaft formation and active hair follicle downward growth. Completion of hair follicle morphogenesis was associated with a marked reduction of AP-2alpha immunoreactivity in the lower portion of the hair follicle including both epithelial and mesenchymal compartments. In adolescent mouse skin, consistently strong AP-2alpha expression was found in the basal keratinocytes of the epidermis, in the hair follicle infundibulum, and in the sebocytes. In the follicular papilla, AP-2alpha was weakly expressed in telogen, significantly upregulated in early anagen, then gradually declined, and reappeared again in middle catagen. In the inner root sheaths, AP-2alpha expression was detected during early and middle anagen and during middle catagen stages. Prominent AP-2alpha expression was also seen in the zone of club hair formation. Therefore, AP-2alpha upregulation in both epithelial and mesenchymal hair follicle compartments was coordinated with initiation of major remodeling processes. Our findings support the use of the hair follicle as a model to explore the role of AP-2alpha in physiologic remodeling of developing organs and in reciprocal ectodermal-mesenchymal interactions. (+info)
Histological and morphometric analysis of the effects of argon laser epilation.
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AIM: To analyse the location and extent of tissue damage induced after argon laser epilation. METHODS: Laser burns were applied to the lid margins of four patients before excision for entropion ("live tissue") and the lid margin of one patient was lasered after an excision for ectropion ("dead tissue"). The laser burns were directed towards the lash follicle and between 10 and 50 burns were applied with an argon blue-green laser set at power 0.9-1.0 W, at 0.1-0.2 second duration and a 100 micro m spot size. The tissues were processed for conventional histology. Serial sections were obtained and used for area measurements and three dimensional reconstructions of the burns to determine the volume and location of tissue destruction. RESULTS: The laser created a cone-shaped region of tissue ablation with surrounding coagulative necroses. Maximum burn depth was 1.2 mm in dead tissue and 0.8 mm in live tissue. Maximum necrosis depth was 1.4 mm in dead tissue and 0.9 mm in live tissue. Follicle depth ranged from 0.8 mm to 1.9 mm. Some of the burns had been misdirected in the dermis leaving target hair follicles intact, despite being of adequate depth. CONCLUSIONS: The argon laser has some potential for ablation of lash follicles, but accurate placement of the burn is essential and energy levels greater than those currently recommended should be applied. The treatment is ineffective in patients unable to remain immobile. (+info)
Mechanical treatment of phthiriasis palpebrarum.
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Phthiriasis palpebrarum is a rare disease in which crab lice infest the eyelashes. It can cause pruritic lid margins or unusual blepharoconjunctivitis and is difficult to diagnose and treat. We diagnosed and managed a case of phthiriasis palpebrarum in both upper eyelids, accompanied by nits, on the scalp of a 6 year-old female child. We removed the eyelashes, including lice and nits, by pulling with fine forceps without sedation. On the second month after treatment, all lice and nits were eradicated without recurrence and the eyelashes grew back. In conclusion, phthiriasis palpebrarum can be diagnosed by close examination of the eyelashes and eyelid margins with slit lamp and can be managed mechanically. (+info)
Expression profiling and cellular localization of genes associated with the hair cycle induced by wax depilation.
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The hair cycle is a highly regulated process controlled by multiple factors. Systematic analysis of gene expression patterns in each stage of the hair cycle would provide information useful for understanding this complicated process. To identify genes associated with the hair cycle, we used DNA microarray hybridization to analyze sequential gene expression patterns in mouse skin following hair cycle synchronization by wax depilation. Messenger RNA levels in mouse skin at various times after depilation were compared with those prior to depilation (resting phase). According to their expression patterns, upregulated genes were categorized into four groups: early anagen, middle anagen, late anagen/early catagen, and middle/late catagen, and processes that take place in each stage were evaluated. We identified 12 new components that are specifically expressed in the hair follicle, 11 genes in anagen including carbonic anhydrase 6, cytokeratin 12, and matrix metalloproteinase-11 in catagen that were confirmed using in situ hybridization. The strategy used here allowed us to identify unknown genes or process previously not suspected to have a role in hair biology. These analyses will contribute to elucidating the mechanisms of hair cycle regulation and should lead to the identification of novel molecular targets for hair growth and/or depilation agents. (+info)
High prevalence of Demodex in eyelashes with cylindrical dandruff.
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PURPOSE: To determine the prevalence of Demodex in eyelashes with cylindrical dandruff (CD). METHODS: A modified sampling and counting method was applied to 55 clinical cases. Patients were divided in to group A (n = 20) with diffuse CD, group B (n = 12) with sporadic CD, and group C (n = 23) with clean lashes or greasy scales, of which the latter was divided into subgroup C1 (n = 15) without lid hygiene and subgroup C2 (n = 8) using daily lid hygiene for the past year. Each patient underwent a routine complete eye examination and modified counts of Demodex. RESULTS: Demodex was found in all group A and B patients (n = 32) with CD, which was significantly higher than the 22% of group C patients (n = 23) without CD (P < 0.001). The Demodex counts were 4.1 +/- 1.0 and 2.0 +/- 1.2 per epilated lash with retained CD, significantly higher than the 0.2 +/- 0.5 and 0.2 +/- 0.4 per lash without retained CD in groups A and B, respectively (each P < 0.001) and than the 0.01 +/- 0.09 and 0.12 +/- 0.41 per lash in subgroups C1 and C2, respectively (each P < 0.001). Demodex was still found in CD fragments left on the lid skin after epilation. Five Demodex brevis mites were found among the 422 Demodex specimens. CONCLUSIONS: The modified sampling and counting method showed that the prior controversy regarding Demodex has resulted from miscounting and confirmed that lashes with CD are pathognomonic for ocular Demodex infestation. Lid hygiene with shampoo reduces Demodex counts but does not eradicate the mites. (+info)
Epilation today: physiology of the hair follicle and clinical photo-epilation.
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Despite the variations of length and type of hair (vellus or terminal), the growth of human hair in all body sites is cyclic. Phases of active hair growth, or anagen, are separated by periods of quiescence, or telogen. The duration of both phases varies greatly depending on the body site. Whether hairs are in anagen/telogen at the time of hair removal is important because only anagen hairs are particularly sensible to physical insults. Photo-epilation is a technique for long-term removal of unwanted hair by thermal destruction of the hair follicle and its reproductive system (stems cells). As melanin is the main chromophor existing in hair follicles the corresponding wavelength spectrum would range from ultraviolet up to infrared light. Furthermore longer wavelengths are preferred as the cromophor lies deep in the skin and the penetration of light is increasing with the wavelength. Thus, in the range of 600-1100 nm melanin absorption may be used for selective photothermolysis of hair follicles. Yet to be resolved questions for permanent destruction are the location of the key follicular target and the possible influence of the hair growth cycle on photothermolysis-induced hair removal. An overview on the individual physiology of the hair follicle is given to discuss the latest strategies for photo-epilation. (+info)