by Lori A. Wood
Like any ambulatory woman, those of us with disabilities know that maintaining a beauty regimen is hard work. The only difference is, we’re sometimes not the ones who actually do the work. The act of eliminating unwanted hair is part of this routine and is often done in private. Excess body hair, it seems, is regarded as a shameful and unclean characteristic, best dealt with in the solitary confines of one’s own home. Physical disability often necessitates a lack of modesty. Many of us who live with it require assistance in meeting our dressing, bathing and toileting needs. Just the thought of another person holding a razor to our body parts can be somewhat nerve-wracking. If his or her hand were to accidentally slip, or if the woman being shaven were to have a spasm in her arm or leg, she could be cut easily, an eventuality that she cannot control.
This concern is undoubtedly compounded by the fact that disabled women with paralysis in their legs may not even feel the cut, requiring attendants to be especially vigilant. Even for those of us that can grasp a razor, dexterity issues may make it difficult to operate and manipulate. Therefore, for women with disabilities, gentle hair removal techniques may seem like a far more practical option.
At http://www.epilight.net, the EpiLight Laser Hair Removal and Skin Treatment is presented as a viable solution for disabled women, claiming that it can improve our quality of life. In the course of the treatment provided by the Superfast EpiLight, one square inch of light covered an area of about one hundred and fifty hairs. Light flashed every 1.5 seconds, and each flash was a second long. In older incarnations of the technology, the light was much slower, flashing every three seconds. This fact made the treatment half as fast. The website boasts that the procedure used today is virtually painless, and that recovery from it is immediate.
Unfortunately, quick fixes like this are sometimes accompanied by unpleasant side effects. Many hair removal procedures can trigger autonomic dysreflexia (AD), a condition that can be characterized by several symptoms, including: significant elevations in blood pressure, headaches, sweating, stuffy nose, flushing of the skin and blurred vision. These symptoms can be triggered by painful stimulus. “Anything that can be interpreted by your body as painful [can trigger dysreflexia],” says Kathleen Dunn, a Clinical Nurse Specialist and Rehabilitation Case Manager at the Spinal Cord Injury Center of the VA San Diego Healthcare System. “The source of the pain has to be below the level of the injury for dysreflexia to occur.” As stated at http://www.emedicine.com/pmr/topic217.htm, generally reported statistics show that forty-eight to ninety percent of those with SCI who are injured at level T6 or higher get dysreflexia. Those with cervical injuries are at highest risk for the condition. At a four to one male-to-female ratio, the website calls AD a primarily male phenomenon, but women are at risk, as well. “It’s your body’s way of warning you that something is wrong,” Kathleen states.
Laser hair removal sends a beam of light to hair follicles; this beam is powerful enough to destroy the root. For women with SCI who are considering laser hair removal, Kathleen recommends discussing it first with those in the know at the location where the procedure will take place. “If it were uncomfortable at all for somebody who was able-bodied, then there would be a risk of AD,” she points out. “Find out if you can anticipate whether whatever hair removal method being done is painful for able-bodied people. If it is, talk to your doctor and have a plan for how you’re going to manage AD, should it occur.”
A plan may entail taking medication, such as nifedipine, either prior to the treatment, or as symptoms arise during it. One must proceed with caution when taking medications, though, because as soon as the source of the pain is removed, blood pressure decreases. If this occurrence is supplemented by medication, it can plummet to dangerously low levels.
In these types of situations, nitroglycerin paste may be a more convenient option, because it can be wiped off of the skin after a hair removal treatment. Unfortunately, it may not take effect as fast as nifedipine, so it might not work as well once dysreflexic symptoms appear. Conversely, ephedrine, which is often prescribed for low blood pressure and found in many over-the-counter cold remedies, can trigger the condition, as well. “It would probably be best to get a laser treatment the first time on a small area, and see what happens,” Kathleen suggests. Dysreflexia is not necessarily a forgone conclusion with hair removal methods, however. Some people may not have any trouble with it at all.
With this procedure, a patient is also at risk of serious burns to the treated areas of skin. At http://www.hairfacts.com/medpubs/lasergen/laser-burns.html, pictures are shown of one woman’s leg burns, taken one day after her laser treatment. Since many people with SCI lack sensation in their legs, this could be considered a red flag for those considering this option. If you don’t have a lot of sensation, be sure that the person conducting the procedure knows that, just because you can’t feel the laser working doesn’t mean that they should automatically operate it at its highest intensity.
“You have to turn it down,” says Stella, a laser and electrolysis technician in Miami. “Even if [women with disabilities] aren’t feeling it, if you don’t know your parameters, you can burn somebody. You have to be very careful.” Hair removal makes up ninety-five percent of Stella’s business. Only about one percent of her clientele is disabled, so, she says, “It has not been my experience [to see side effects in disabled women.]”
Following a hair removal procedure, age and lifestyle may have more to do with your rate of healing than your disability. For example, as they grow older, people with SCI have a greater risk of developing diabetes than the able-bodied. “People with diabetes have poor wound healing, because of changes in their capillaries,” Kathleen explains. Other factors, such as smoking, excessive exposure to the sun and unhealthy eating habits can affect healing, as well.
Much like these medical considerations, the costs of the procedure vary, according to such factors as area covered, length of treatment time, and session frequency. According to http://www.hairfactz.com, treatments can range from $150 to $250 per session. Also, the process can be time-consuming, requiring several treatments to be considered fully effective.
Before seeking laser treatment, though, Sue, a woman who had a spinal stroke and who has had laser hair treatments concurs with Kathleen, in the recommendation that you visit your primary care physician. He or she can conduct a blood test to check testosterone levels and for signs of Cushing’s disease, a condition caused by excess levels of the hormone cortisol in the blood. More information about the disease can be found at http://www.medhelp.org. Both of these factors can contribute to unwanted hair growth, and laser treatment for its removal may not be as effective in these instances.
Chesapeake Plastic Surgery and Aesthetics, located in Baltimore, Maryland, http://www.cpsaesthetics.com, is the hair removal facility of choice for Sue. “They’re board certified in plastic surgery,” she explains. “I had a serious problem with the side effects of Solumedrol (methyprednisilone). In huge doses, it works on spinal infarcts like mine.” It is given for acute traumatic spinal cord injury due to trauma and for multiple sclerosis exacerbations, as well. Upon hospitalization, she was receiving thirty milligrams per kilo of body weight, the steroid promoted hair growth. Steroids, particularly the anabolic variety, are more male than female-oriented, and can function like testosterone, which facilitates hair growth. “The hairs were just a little darker than peach fuzz, but I had hairs growing out on my chin that were stiff,” remembers Sue. “After the steroid treatments, even with a good plucking, I could still see a shadowy or hyperpigmented area on my chin and high neck area. The follicles were very dark and large and I often had ingrown hairs,” she recalls. “I actually waited nine years before seeking hair removal treatment, hoping that the excess hair would just go away.”
Sue was plucking daily, which was a difficult task for her, because of dexterity problems. Therefore, she decided to try laser hair removal. “It’s fast, but you do have to go back for repeats. A lot of people have tried to say that it’s permanent hair removal, but it’s not,” she cautions.
“When the first round of laser treatment was done on me, the laser light technician used a lower setting, since I was on prophylactic antibiotics that led to photosensitivity, which can cause splotchiness after the treatment. If you’re on drugs that do this, let the laser technician know. We saw how the lower laser setting did, and I had no bad reaction to it. With the old lasers, the technician did it hair by hair with a small laser point. The old ones hurt a touch more; it’s like putting a rubber band on your wrist and snapping it. Afterward, technicians would typically get you an ice pack. By filling a regular rubber glove with ice, I reduced redness and swelling immediately. With newer lasers, if you have to go out, do a one-time hit with a razor [following the procedure], you have to let hair grow out and fall out.” Actually pulling the hair out may stimulate its growth.
The second time Sue had the procedure, the laser was turned up, and the areas of hair that grew back were lighter and smaller in diameter. “After the first two laser treatments, I had a few hairs that came back darker than most of the rest, but each time even those were lighter and than what I started out with,” she explains.
The next time, she learned of the Aurora Hair Removal System, shown at http://www.miamiplasticsurgery.com/procedures/hairremoval.htm. “Unless you’re going in for your primary to show where it [the hair] is, shave it off first. It covers a two-by-one inch swath of hair at a time, and it can be used on paler skin and hair,” she explains. “They smear on chilling gel, and with the Aurora, they can use a higher setting.”
In the process of electrolysis, slender probes are inserted into a hair follicle. Then, electric current is applied, in order to burn the follicle. This process serves to retard its growth.
Improperly performed electrolysis can lead to lasting skin damage and the spread of infection. Swelling and redness in the treated area is considered normal following a session, however, these symptoms typically disappear within an hour. Scabs may also appear within two to four days after treatment.
The procedure of electrolysis requires patients to lie on a bed. If the patient in question is unable to transfer herself onto that bed, it can be difficult for her to undergo the treatment independently, especially if muscle spasms and spasticity are an issue. In addition to dysreflexia, those with muscle spasms and spasticity may encounter problems with “Spasticity is increased abnormal tone that makes it difficult to move the joint, so it feels like it’s fighting against you.” says Kathleen. “Spasms are involuntary muscle movements. People call them the same thing, but, technically, there’s a difference.”
Also, it can be quite expensive. Sessions can cost up to $250 an hour. Unfortunately, medical insurance won’t usually cover these costs, because hair removal is largely considered a cosmetic procedure. “It would have to be because of a medical condition that causes abnormal hair growth,” declares Kathleen. “You would probably have to go through quite a bit of work, such as obtaining letters of justification from your doctor, [to get it covered].”
For those that find those costs prohibitive, http://www.painless-hair-removal-machines.com/Removing_Unwanted_Hair.htm offers a chart of various hair removal options and their characteristics. As for which hair removal type is safest, Stella says, “I think you’re better off doing both [laser hair removal and electrolysis]. It depends on how much hair you have, and what type of hair you have. It doesn’t have to do with whether you’re disabled or not.”
Buying your own hair removal equipment is another option, to eliminate the costs of repetitive treatments. For a one-time expense of anywhere from $400 to $900, http://www.global-electrolysis-supply.com/Electrolysis_Equipment_Packages.htm displays a wide array of home electrolysis equipment.
For women who prefer to avoid any medical procedures in their quest to conquer unwanted body hair, scissor tweezers may be an option for those with limited dexterity. This type can be used by hooking your thumbs through the holes, to get an easier grip. “They actually work really well,” she enthuses. An example of them is found at http://www.folica.com/Rubis_Tweezers_d114.html.
Unwanted hair is a problem for many women, and our desire for its permanent removal is a fact of life that unites us. Women with SCI share this desire, and it’s encouraging to know that, upon careful consideration of their physical needs, it doesn’t have to go unfulfilled.