30. Rapid definitive removal of white hairs with the Timed apparatus
KEYWORDS: definitive epilation, white hairs, Timed, programmed HF current
To remove facial hair, we prefer to use the Timed apparatus, on account of its selectivity and great efficacy. A single treatment session is enough to eliminate hair permanently. Unlike lasers and pulsed light, Timed is also able to remove white, red or light hair effectively.
The Timed apparatus is programmed in the specific pulsed function for hair removal: Direct, Pulsed 25/68 hundredths of a second, Coag.; the power is set from 2 Watts to 5 Watts. The EM 10 Green electromaniple (0.10 mm in diameter) is the electrode most commonly used. Its triangular conical tip concentrates the diathermic energy at the point required. The return electrode is placed on the patient's chest or under the belt.
To remove hair permanently in a single treatment session, it is necessary to eliminate the germinative cells of each individual hair follicle. While the germinative cells are concentrated in the hair bulb, they are also present in the deep portion of the hair follicle, which extends from the outlet of the sebaceous glands to the hair bulb. If the hair bulb is surgically removed, the germinative cells in the deep portion of the follicle regenerate the hair. This is what happens after laser and pulsed light treatments, which, as is known, require numerous sessions to eliminate hair. Light energy acts on the color of the hair, which must be black. In the bulb, however, the melanocytes are light; they therefore do not absorb light energy. Rapid definitive hair removal (Capurro. Cronica dermatologica, 1986) uses a specific high-frequency current that enables all terminal hairs present in an area and any down to be eliminated permanently, regardless of their color. With rapid definitive hair removal, all the regenerative cells of the hair are destroyed. Before the advent of this timedsurgical treatment, complete definitive hair removal was not possible, as the lesions resulting from the electrosurgical treatment of two contiguous hairs merged, giving rise to a visible scar. The duration of the Timed pulsed emission is 25 hundredths of a second. Rapid definitive hair removal was one of the first techniques of Timedsurgery: Technique for the Implementation of Measured Electrosurgical Data.
Rapid definitive hair removal requires greater manual skill than that needed to use lasers. However, the Timed apparatus is a programmable device and is based on electrical conductivity, which is very similar from one individual to another. This means that the operator does not have to evaluate the color of the hair, skin and pigmented formations in the area to be treated. The Timed apparatus is based on real values. The specific pulsed function for hair removal allows the operator to concentrate only on the manual aspects of hair removal.
The Timed apparatus generates a series of high-frequency pulsed emissions, which is interrupted when the operator lifts his foot off the pedal. Two emissions are generally carried out, but if a hair is larger, a higher number may be used.
Rapid definitive hair removal is performed by inserting the tip of the electromaniple into the ostium of the follicle. The tip is inserted in the same direction as the first section of hair that emerges from the ostium.
When the tip of the electromaniple reaches a zone of resistance, which corresponds to the outlet of the sebaceous glands of the follicle, the skin introflects; the operator then presses the pedal and simultaneously sinks the electrode by a few millimeters. A single emission is sufficient to permanently eliminate down and fine hairs; to eliminate terminal hairs, a second emission is necessary, which is generated after withdrawing the tip of the electromaniple inside the follicle to a position between the bulb and the outlet of the sebaceous glands. The treated hair is removed with the fingers (the operator must always wear gloves), or with tweezers for hair removal; the hair must not offer resistance to extraction. If it does offer resistance, the tip of the electromaniple must be reinserted and the emission repeated. If a drop of blood comes out, it means that the electrode is not in the follicle but in the venous plexus that surrounds it; again, the electrode must be reinserted and the emissions repeated. Once the session is over, the operator applies a cortisone lotion. On impure skin, we recommend applying an antibiotic and cortisone cream for a few days.
The patient should use a sunscreen until the redness disappears.
Rapid definitive hair removal is able to remove all the hair present without leaving any visible marks. A hair that is correctly treated is permanently eliminated. In pulsed timedsurgical hair removal, the electrode tip moves downward from the surface, eliminating all the germinative cells. All types of black, white, red and light terminal hairs and down are permanently removed. Even if the hair follicle is in the resting phase (telogen) its germinative cells are destroyed.
Capurro S. (2024): Rapid definitive removal of white hairs with the Timed apparatus. Timedsurgery section. https://www.crpub.org
What are the differences between the various hair removal methods and what are the indications?
The ideal patient for laser and pulsed light treatment has thick dark terminal hair, white skin and a normal hormonal status. Methods that use a light beam are not definitive and require multiple treatment sessions. Each technique has advantages and disadvantages in terms of effectiveness and adverse events. Hair removal with lasers and pulsed light is normally performed by non-medical personnel. Another technique once used by beauticians is hydrolysis, which creates a chemical lesion in the follicle. Electrolysis is slow and painful and has been abandoned. The most effective technique is the use of a programmed diathermic current. Using conical electrodes with triangular tips allows such precise selectivity of action that two hairs situated side by side must be treated individually. Laser and pulsed light techniques require particularly precise adjustment of the equipment, while little manual skill is needed. By contrast, the Timed technique of rapid definitive hair removal requires greater manual skill. Regarding indications, we carry out rapid definitive hair removal mainly on the face, where the deep terminal hairs can be reached with extreme precision by the electrode, and where no visible marks remain after the treatment. To remove groin hair, we carry out three or four sessions, so as to also eliminate hairs in the telogen phase. In the remaining regions of the body, our technique is uneconomical. We therefore send our patients for laser epilation of these regions.
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