Anesthetic injections during electrolysis

I underwent my first electrolysis session today for removal of chest and back hair. (These are white hairs remaining after successful laser treatment to remove the dark hairs.) The electrologist used cold ice compresses but still it was painful, and after two hours I couldn’t take any more. The supervising physician recommended anesthetic injections.

He showed me the anesthetic drug, which is Drocanil-A (Lidocaine Hydrochloride with Adrenaline). The insert says the concentrations are:
1% with Adrenaline 1:100,000, 30ml single dose
2% with Adrenaline 1:80,000, 20ml single dose.

Both the physician and the electrologist said that many patients find the electrolysis pain too much to tolerate, especially when large areas are being treated, and that these injections are safe and effective. When I asked about EMLA topical anesthetic cream, he said it was not very effective due to its low depth of penetration.

Question: are these injections safe? Are there any serious risks of adverse effects?

I really want to continue the treatment, but it was getting really tough at the end… I’m not sure I want to repeat that.

I’d appreciate any information or experiences with anesthetic injections … thanks!

Hell yes it’s safe, and consider yourself very fortunate to be able to get treated with it. I’m guessing it was with epinephrine and not adrenaline. Of course there are always risks with any drug being inserted into your body, but it’s a very common numbing agent used by physicians. Your dentist injects a similar agent: novacaine.

Injections are not without risks, but as a whole, if administered by a doctor or dentist or other trained medical person, it can be safe for contained, smaller areas.

There is a vast degree of what people feel and how they tolerate electrolysis treatment on the back area. This is due to personal perception of sensation or it can be due to the electrologist’s set up and skill level.

This guy tolerated 91 minutes of thermolysis (Synchro, to be exact) and 1,356 insertions and wanted to go longer, but I had no more time that day. He had no anesthetic help.

This guy never had any help and at times slept on the table:


This guy was finished in 14 months and his whole back is smooth like a baby. It wasn’t easy, but he is finished and happy.

You can try out other electrologists in your area. There may be vast differences in skill and equipment used … or in the end, you may decide you need anesthetic help.

Dee Dee, I love your “stach” by the way …

Now the Book! (tee hee)

One of my patients was (is) the California State Board Examiner for Anesthesiologists. Yes, that was an interesting person to work on (total upper-body hair removal). I got lots of technical information from him. Additionally, I work with a plastic surgeon. Here are a couple “factoids” from my expert sources (and the literature).

First, nobody uses “Novocain” any more (dentists use Lidocaine) … but the term is still used because it’s what patients know. So I suppose the dentists think, “What the heck!” The term is still widely used and is part of our everyday nomenclature. For most people “Novocaine” just means … that numbing stuff the dentist uses. But it’s an older formulation (trade name) that’s not widely used today

It’s okay to use the term “Novocaine.” It’s a generic term. I use it too.

Your medication Drocanil-A is common in Asia; but is the same formulation as, say, “Xylocaine” (a trade name of “Astra-Zeneca” with the same formulation … a Swedish Corporation), commonly used here in the United States.

The terms Adrenaline and Epinephrine are used interchangeably. (Usually they say “Adrenaline” in Europe and Australia (NZL/Asia). And, usually termed “Lignocaine” in the (former) “British Empire.” With a “G,” not a “D.”

Yeah, it’s needlessly confusing. Don’t worry about it.

Actually, an injected anesthetic is more safe than a topical. WHY? Because the physician knows precisely how much as been administered. And, he/she is computing dose and duration for metabolism “half-life.” With a topical, you do not know how fast the medication is being absorbed … and that can be a problem.

Indeed, there have been problems with the topicals … I have yet to hear of ONE real world problem with “the good stuff.”

I cannot give medical advice, but your doses are extremely safe (as per the literature on Lidocaine 1% with, and without, “epi”). Indeed, if you go “on-line” you will see a plethora of toxicity reports. Please talk to the physician in charge and he/she will easily allay your concerns. The doses you state are safe; I would say “ridiculously safe.” Don’t worry about this!

Let me only say the following: In electrolysis, it’s NOT the anesthetic that’s dangerous … it’s the electrolysis treatment itself that can cause problems! In addition, with anesthetic, the electrolysis treatment becomes VERY different indeed, and your technician knows this (has learned this) and has adjusted her technique accordingly.

If you have the time (or inclination) I would GREATLY appreciate your putting me in contact with your electrologist … (Please use my private email at mikebono@cox.net) I’m looking to refer patients to her/him.

Anesthetic is safe to use on large areas of the body, not just, say, the upper lip. (Here I attentively disagree with my colleague based on my 35+ years of experience working with several plastic surgeons.) It’s all about technique.

Real world example …

A couple weeks ago I had to have a skin graft for a skin cancer I had (not the one you die from … usually).

Dr. Chapple used 1% Lidocaine with epi. He numbed my face AND a large area on my belly (the skin graft). The area he injected was 8 inches by 5 inches (40 square inches), and my face about 3 X 5 … and he used about 20cc of Lidocaine.

I had zero problems and everything went super fine. This is a very common amount and area.

This size area (on my belly) is what can be done in roughly 2 hours doing electrolysis on a man’s hairy back. At the end of the 2 hours, more than 90% of the medication will have been metabolized. Toxicity is infinitely remote.

All good to know, Michael!

Mike, when you complimented me on my lovely “stache” I grabbed my upper lip before I realized you were referring to my avatar. Talk about adrenaline surging through me!

I don’t consider two palm size areas a large area, but I’m thinking of a case where I did 7-9 hours of work at a time, as a large area. Would that scenario increase the risk factor for injecting? I guess I am overly cautious about such things, maybe because we are not even allowed to get close to the gray area when it concerns our license here in the state of Ohio. Heck, in my state, it’s hard to find a dentist or anyone that will inject for electrolysis reasons. They clam up. I think there was some kind of directive distributed warning them not to.

Do you remember these syringes filled with anesthetic? I think they were called something like madajet? My memory is a little foggy, but I think electrologists could order those syringes by the dozen and use them, without medical supervision. If one would hit a blood vessel instead of injecting intradermally, well that would not be good. I remember when my Electrologist ordered a bunch and then chickened out and sent them back. I don’t know what caused her to change her mind. They weren’t ordered for me because I would have never allowed it, but she was going to use them on her transwomen.

I personally don’t want to mess with anesthetics, but I know that there is a need for this kind of help for some people, especially in the genital area. I would prefer that our great manufacturers keep doing research and engineering the best possible products all geared toward reducing the sensation factor. There have been times where I wished that someone was nearby to inject, I have to admit.

I have read about the madajet and seen how it was used by MDs on youtube. The whole point of madajet was that it’s a no-needle injection which uses air pressure to drive in the anasthetic into skin. Since madajet was primarily developed for circumcisions (as far as I understand) its no needle effectiveness relies on the genital skin which has no epidermis and makes absorption fast?

I’m still curious if a madajet is as effective on other body areas? And I think it’s still regulated as a medical device at least in many areas. Some electrologist in Canada uses madajet for pain management with her clients. I think it could be the closest best thing to injection anesthetics. Too bad topical creams have not evolved much in research to make their effectiveness work faster than the hour needed.

Off issue at the moment (sort of), and I will get back to it; promise. (I’m going to offer up some real data in a bit.)

But, at the moment, I’m always astonished that regulators endlessly seem to focus on the wrong details of any procedural issue.

For example, for DECADES in California, the State Board had this BIG issue with people putting a needle in the skin. At one point they went “nuts” when they realized that electrologists put “needles in the skin!” OMG!

The thing is, the needle is NOT the issue. Hell, you can give a monkey a sterile needle and have him poke your skin, and that’s not going to cause a problem (of course the monkey will be wearing latex gloves). The issue is BURNING the tissue with current … not the needle! But they never consider that.

Same thing with “telangiectasia removal.” The whole issue is: “does the needle penetrate the skin!” THAT’S not the issue! The issue is “should non-medical people be allowed to remove “solar telangiectasia?” Again, the focus is on the wrong thing.

Same with local anesthetic. The issue is NOT “how you get the medication in the skin,” it’s the medication itself that’s the issue! The focus is on the wrong part.

Why is a “Madajet” (somewhat) legal? Oh, because it doesn’t have a needle? STUPID! STUPID! Using a 30G needle is WAY more safe (and WAY less painful) then squirting the stuff in under pressure … Geeeeze! Besides, with a needle you have extremely accurate placement. I mean, “spot on,” if you know what you’re doing.

And the poor estheticians. They are not allowed to “poke” a blackhead with a needle … however; they can use pressure to pop the thing (and rupture adjacent capillaries in the process.) It’s not about sticking a needle in the thing … it’s about removing the thing in the first place.

At one point, the manufacturers argued that non-medical people should be allowed to use lasers … because THERE IS NO NEEDLE! Thankfully, most States have figured this one out.

But on average, it’s all the damned “needle phobia” that seems to always be the issue. I think regulators are idiots. You know what? I suppose you could inject cyanide and that would be horrible. Then, you could just swallow it and “that would be okay?”

It’s not the “delivery system” it’s the THING itself. (Yeah, I do like that word “thing.)

Am I the only idiot thinking about this (thing)?

I’ve given this great thought. Here in Canada I canbuy a syringe at my local drug store no muss no fuss. Getting injectables though a different story.
As one of those transwomen and a DIY’er I face a different scenario. I probably could not afford to have someone else do the work before surgery. But how would an anesthetic affect doing your own work? How doable is it without using an anesthetic, when working on yourself? Thankfully these arent questions I’m ready to face for a little while, my face keeps me busy and I’m already biting off more than I can chew for a while.

Seana

Thank you everyone for your replies!

Dee, when you say “injections are not without risks, but as a whole, if administered by a doctor or dentist or other trained medical person, it can be safe for contained, smaller areas”, would you mind expounding on what the risks might be, and what you mean by a “contained, smaller area”?

I want to finish getting rid of all the white hair on my chest and stomach, and back. The laser did a great job of removing the black, but there’s a ton of white still on my front, though very little on the back.

During my first session, the electrologist removed 2,060 hairs in two hours, basically in a palm sized region of my upper left chest. I have a lot more to do. It was pretty pain free near the rib cage, but quite painful nearer the sternum. The ice packs helped at first, but seemed less effective as the time wore on. Near the end it was tough; she wanted to do 2.5 hours to clear a neat area but I called time at 2 hours.

Incidentally, I am in Bangkok, Thailand, and there is only one place for electrolysis, Yanhee Hospital, which specializes in health and beauty treatments. But they seem to have a very well qualified staff including four MDs who supervise the electrology work. My electrologist seemed to be excellent and I have no complaints at all.

The majority opinion here is that the anesthetic injections are perfectly okay, and the doctor and electrologist recommended them . . . I didn’t do them this time because I wanted time to check into it at home. But I think I’ll go for them next time. I was a little concerned when I read that the injection includes adrenalin and, since the area on my chest is right over my heart, I was concerned about having heart trouble on the table . . . !

There are some articles on the internet strongly warning against anesthetic injections, like this one:

http://www.bostonschoolofelectrolysis.com/articlelive/articles/5/1/Boston-Electrolysis-Warning--Consumer-Beware-of-Lidocaine-amp-Marcaine-Injections/Page1.html

Has anyone rebutted or debunked these accusations? The majority opinion certainly seems to be that they are safe.

Again thanks a lot for everyone’s responses! I feel a lot better about going back for more now.

Adrenaline / epinephrine, is a vasoconstrictor. Used in conjunction with the anesthetic, it lessens bleeding at the the injection site. The vasoconstrictor action can help to keep the area numb longer since the blood vessels are constricted. It won’t affect your heart in that quantity, is my guess, but discuss your concern with a doctor.

No comment on the boston school of electrolysis link. Someone else can comment if they want to.

If you are supervised by medical personal and there are doctors willing to inject, that is probably the safer scenario.

As a side note, there are people that need surgery and may not be a good candidate for general anesthesia. They are injected instead with a lot of anesthetic, with expertise and they safely come through the operation.

I’m not a big fan of injecting mainly because I don’t have access to a willing doctor, on the premises to do this. I still go back to depending on our electrolysis manufacturers to provide us with the best engineered epilators and probes and training, so as to reduce sensation for the client, so they dont need medicine to get them through a session. Some people do require some help though. So far, the manufactuer’s are doing a good job.

Just for FUN, ask you physician or EMT person what they administer to a patient (I.V,) that is having a heart attack! Get back to us when you have the answer.

The Boston School of Electrolysis? Actually, everybody is AFRAID of this person. And, that’s why nobody on Hairtell will give you an opinion or evaluation. I hope you “read between the lines” here.

Let me only say that the internet does not filter out lunacy. All of us, myself included, have been (at one time or another) a VICTIM of this person’s unwarranted RAGE. Remember, the internet is “the Wild West.” Not everything you read is TRUE!

Dee, Michael - many thanks again for your helpful advice! I’m well aware of what resides on the internet, that’s why I’m asking questions here. It seems I may be fortunate after all to be living in Bangkok where the electrology clinic at Yanhee Hospital is accustomed and experienced to providing anesthetic relief. Actually I thought I had a pretty good tolerance for discomfort (that’s what my laser practitioner told me) but honestly it was getting rough after two hours around the sternum area. If pain relief is available, I’ll take it . . . I’m looking to remove hair, not experience a rite of passage!

I’ll let you know how it goes in a few weeks when I go back.

Ugh, Boston school of electrolysis ? Really? I still dont understand why no one has sued that fruitcake for damages yet. I suppose the concensus is she is such a raging lunatic that no one will take her seriously, but every so once in a while some new person will post here having read something on that site, showing that’s not the case.She should have been taken out ten years ago and still be paying off the damages.

Seana

Seana, I didn’t mean to stir up a hornet’s nest. I am indeed a newbie - this is the first communication I’ve had with anyone about my hair removal other than the laser clinic I go to, and the electrology clinic I started with last week. This site looks terrific and I’m astounded that so many experienced patients and practitioners are so responsive and generous in sharing information.

The “Boston” site comes up first in a google search (try searching “anesthetic injections electrolysis”), that’s why I asked about it. I subsequently did a search on this site, which provided links to the attack pages on the “Boston” site. And yes it’s pretty clear that the author is not of sound mind and for some reason is selling fear. Sorry I mentioned it! And thanks again to everyone here for your helpful replies!

That is incredible. I’ve had hours of treatment on the same area and could not tolerate it without numbing help, especially on the neck and traps and near the sides of the back. Different for everybody I guess.

Hi, well I went back for my 2nd electrolysis treatment at Yanhee Hospital. This time I asked for the injections. My initial experience was not that good - I fainted while the injections were being given. I think it’s a vasovagal response, it’s happened to me before during blood tests. Also, I stupidly didn’t drink enough water in the morning, and my BP was a little low going in. So they gave me an IV and I needed to wait about 15-20 minutes until I stabilized.

Anyway, the electrolysis was wonderful with my chest numbed up. After two hours, they gave me some more shots - well, actually seven shots. It’s not THAT bad really, but, well, I really don’t like being stuck 14 times in a morning! Anyway I did another hour. Three hours, 3,241 hairs. They cleaned up my chest pretty well this time. It still hurt a lot when they probed into areas that weren’t numbed, but I survived it. I would NEVER survive this without an anesthetic, I don’t know how people can. Could be me - I’m thin and bony and there’s no fat on my chest.

I guess I’ll go back in two months, which they recommended, for more. I don’t enjoy the treatment, but I like the result.

Interestingly, the anesthetic injections are completely free of charge (not that money plays any role in my decision making about hair removal, it doesn’t) - they charge $130 an hour, period, whether you opt for only ice compression or shots. Even the IV was free, the only charged me $10 for the saline bag. Hospitals in Thailand are great, and the level of care is excellent.

If I would charge $130 per hour i would also be able to offer my clients any comfort up to and including golden door knobs without extra charge.

Just today i did a 3 hour job on a man’s belly which was successfully numbed with just EMLA (under plastic cover). He puts it on at home and arrives already numbed and ready to go.

Other clients do 4 hours ore more without numbing.

Due to regulations (translation: government interference. Translation : psychopathic narcissists bent on control and hindrance of others lives) people in the US are likely to spend anywhere from $50 to $400 extra for pain medication if they choose to have it in conjunction with electrolysis… that is assuming that it is available at all.

Here’s a photo of yesterday’s electrolysis. I am really happy with the result. I’ll go back in two months for them to do some more work.

Beate, I mentioned EMLA cream to my doctor when I first had a consultation, and he said that it was not very effective since it only numbed the surface. I suppose I could try it next time. Is there a general consensus that it’s as effective as numbing injections?

I really had/have no idea what electrolysis should cost. In Bangkok there is only one reputable provider (Yanhee Hospital) so I don’t have a choice. It sounds like I’m paying a premium price, although the lidocaine injections at no cost seem to make up for that.

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