Hair Removal (Waxing and Related Methods)
Hair removal tests the hair-growth cycle, product technique, and contraindications. Waxing, sugaring, threading, and depilatories all remove hair temporarily; the exam asks which method fits the area and when you must refuse.
Hair growth
Anagen is active growth, catagen is transition, and telogen is rest. Waxing works best in anagen, when the hair is attached and the follicle is most vulnerable. Hair should be about 6 mm (1/4 inch) long for wax; longer hair can be trimmed. Vellus hair is fine and soft; terminal hair is coarse and pigmented.
Technique and methods
- Soft wax is spread thinly in the direction of hair growth and removed with a strip against the growth. Hard wax is applied thicker, allowed to set, and lifted without a strip. Hold skin taut, remove parallel to the skin, and apply pressure afterward.
- Sugaring and threading are alternatives; depilatories dissolve hair chemically and require a patch test.
- Never double-dip a spatula, reuse a strip, or wax over moles, irritated skin, or varicose veins.
Contraindications
Isotretinoin (typically wait 6 months after stopping), topical retinoids (about 7 days), blood thinners, uncontrolled diabetes, active infection, sunburn, recent peel or laser, and a history of keloids are reasons to postpone or refer. Pregnancy and sensitive skin warrant caution and a patch test for chemical products.
Aftercare
No heat, sun, swimming, tight clothing, or friction for 24 hours; exfoliate after about 48 hours; use sunscreen; advise on ingrown hairs.
Worked example
A client used tretinoin on the upper lip last night and wants a lip wax. The reasoning: retinoids thin the stratum corneum and increase fragility, so waxing can strip skin and cause bleeding or hyperpigmentation. Reschedule, advise stopping the retinoid for about 7 days before the next appointment, and document the advice. Do not simply wax 'gently.'
Traps
- Double-dipping or reusing wax.
- Waxing over a mole or broken skin.
- Ignoring isotretinoin or topical retinoid use.
- Removing soft wax in the direction of growth.
- Skipping aftercare instructions.
- Using wax that is too hot.