"scab" management

Hair Removal Methods Professional Electrolysis
#1

My current patient was a total pleasure to work with. Nicely, he followed my post-treatment instructions to the letter (most guys don’t). The point I’m illustrating is how to mitigate post-treatment “scabs” even with heavy body hair and maximum treatment. First step, is to understand what a “scab” actually is! (The photos are before and a few days afterward … the exact time when scabs should have been seen in their "full glory.”)

When the follicle is treated (burned), chemical mediators are released from the mast cells that initiate the healing process. Blood vessels in the area become swollen and, consequently, white cells “leak out” into the area to start “cleaning up the job.”

Along with the white cells, blood serum leaks out (carrying with it clotting factors). In a deep follicle, the serum fills the follicle and collects at the skin’s surface … quickly forming a “scab.” Indeed a scab can, and usually, forms from a perfectly treated deep follicle. (The notion of “overtreatment of the epidermis is incorrect: but that’s another lengthy explanation). So, how to mitigate scabs? It’s all about water and keeping the area moist! A “scab” is “junk” … so wash off the junk!

Yes, we have all been taught to never wash with soap and water after a treatment. This goes against common treatment for burns. Anyway, I simply had this patient take a long warm bath every day after the treatment; he complied.

What happens here is that the “scab material” was washed (soaked) away and was unable to form. All of this speeds the ability for the epidermis to bridge the wound gap quickly. The bathing also allows accumulated “junk” (dead white cells and dead material) to NOT fill the follicle: so not pustules. At the appropriate time, I also had him scrum with a soft body brush. (After the bath, he takes a very light shower and washes with Hibiclens … or other similar detergent … to guard against infection.)

So, this patient got almost no pustules (even though he’s only 20-year-old) and scabs never formed at all. The bathing also helped in post-treatment pain. Ideally, the client would also use an oily material afterward (he did not). (Emu oil is excellent, but so is common Vaseline!) I suspect that the success of “Tea Tree Oil” is largely due to it’s oily nature. By keeping the wound moist, a “hard scab” will not form. It’s very difficult to “beat” good old “soap and water! (At the second “clearance, in 3 months, the client will see 50% reduction of the hair.)

I hope this helps!

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#2

Superb work, Michael! mmmmm! Mmmmm! mmmm!

This is not as easy as it looks, folks, but just look at what the hands of master electrologist (and teacher) can do. This young man has got to be walking in the clouds everyday. Fantastic pictures that I know everybody loves seeing.

Thank you also for the wound healing explanation. It is always good to detail that part along with aftercare. My back guys tell me that they only use soap and water and the heal perfectly fine. They can’t reach part of their back to apply anything, so they have to basically leave it alone. By the way, I love the smell of Hibiclens…

Do you care to reveal how many hours it took to achieve this miracle transformation? I suspect you used a Hinkel probe, as well?

#3

Hi Dee Dee …

We’re done (and so am I!). It took a total of 50 hours for full clearance of shoulders and back. This was an extreme case of super dense hair (I will post a photo of the upper back. I’ve never seen this density on the upper back … ever!).

I charged him $70 per hour, so it was $3,500 (I reduce the rate for out-of-towners). The next clearance will cost him about $1,800 and the final about $900. Not exactly cheap … but electrolysis always works and that’s the beauty of it! Yes, “electrology rules!” he he he

Normally, it takes 40 hours for the average guy.

Yes, I used a standard “C” Hinkel tapered needle. (I only have a few dozen left of my “favorite” tapered. I’m beginning to panic!) I have a trip planned in a couple weeks and I’m hoping to get this company to make tapered needles … in the right sizes! A taper does no good if the taper is riding high above the follicle! And, as I have see, that’s now most people use the tapered needle. (I need to make a video of the proper useage … I think I will.)

#4

I would like to see that video.

#5

Michael, I’m not surprised that this 20 year old has so much dense body hair. I had friends in high school from Caucuses and “Greater Middle East” backgrounds. These guys had upper back, shoulder, upper arm hair development at 18!
At least this guy doesn’t have to worry about needing much “touch up” work later in his adult years, because there is no way you can expect more hair development with dense hair present already. :slight_smile:

Amazing job!

#6

BEAUTIFUL WORK! Man, I hope YOUR back is doing well after working so hard on the clients back . Your description to keep the area moist confirms what my skin always seems to ache for following treatment! Good to know. A video from you would be fabulous!

One question related to scabs…the last session on my face , (with the new electrolysist I found here ,who I really like :)) , she tried an insulated probe for the first time and it was more comfortable and I had way less reaction, and NO scabs. Does no scabs mean that it wasn’t strong enough to have the “kill” one is aiming for ? By the way I dont ask these questions in any way to “mico manage” my sessions. In fact I get along very well with my Electrolysists . We may talk about some of this info. IF they are interested, and generally we have some great, far ranging discussions. I ask simply because I enjoy learning more about this area and i am interested…enquiring mind i guess…

#7

Good question, Danika. I’m wondering that too. I had my first long facial appointment on Tuesday, and I still have red marks all over, though the scabs are not developing as I thought they would. I’ve been keeping it moisturized with coconut oil, and maybe that’s helping? Between the moisture factor and the fact that coconut oil has so many lovely healing and anti-bacterial functions for skin application . . . Still, wondering if putting up with some noticeable skin reaction in the days following treatment may mean that the treatment is more effective. I know Dee isn’t on board with lasting visible facial reactions, and I didn’t know if that was for any other reason besides the fact that it doesn’t look good. But I’ve been looking bad for years with facial hair. I’m used to looking bad. :frowning: If some scabbing/redness means that effective treatment is going on, I can put up with it in the short term.

#8

I say this with all honesty, a skin reaction without scabbing is not a worthless treatment. Keeping the current action at the proper depth in the follicle and limiting the amount of energy that comes to the surface of the skin is possible. I do not have highly visible scabbing as a side effect on my facial cases, no matter how long I work on the face or how large or small the hair structures are. Sometimes there are a few pinpoint scabs, but they are hardly noticeable. For long first clearances, swelling is the main side effect, not scabs, but the swelling disappears in about three days or less.

For body work, sometimes there is no scabbing, but most of the time, there are pinpoint scabs to medium size scabs. Again, no big deal. Scabs are okay. When there are no scabs, gosh, I must be doing something right because I am finishing people within that 9-12-14-18 month timeframe. So, the degree of scabbing does not relate to kill rate.

I mainly use Laurier IBP probes now, but before that, I was, am still am, a big fan of Ballet Gold probes. Either way, with either probe, I can keep scabbing to a bare minimum or not at all. I have talked to other electrologists that report the same thing in their practices. They don’t get much scabbing either.

Scabbing is not a red flag, grab your heart situation. When scabbing occurs, it will heal fine. I prefer to make it my personal goal, not to cause unsightly scabbing if I possibly can and I usually can. Probe choice helps. Understanding what your epilator can do helps. Careful insertions along with choosing the right balance of intensity and timing levels helps. Good magnification helps. Aftercare choices and aftercare behaviors help. If you have a lot of scabbing, that does not equate with a better “kill” rate. It just doesn’t! I say that with total and passionate honesty.

Now about that coconut oil. I am nuts over coconut oil! I bought a beautiful jar from Trader Joe’s last week and I use it on my skin. MY GOD! What a gem of nature ! I may be trying some as aftercare on my clients skin. I am now rubbing it on my over washed winter hands before I don my gloves before a treatment. My skin is lovely. I eat it as well, just a teaspoon a day, thanks to my food guru friend in Buffalo :grin: I am so glad you mentioned coconut oil. It’s all I can talk about these days!

#9

Boy, I wish I lived closer to one of you experts. I have so much anxiety about finding someone who will be able to do an effective job with the least amount of appointments. I keep hearing how important it is to find a good practitioner, and it scares me because I don’t know how to tell when I’ve found a good one!

I love coconut oil so much. For about a billion things. It seems like the perfect aftercare item. I’m kinda surprised it hasn’t come up before. It’s kinda my answer to everything these days. :wink:

#10

Would an electrologist take offense to me asking what probes they used? I mean, I’d hate to sound like a “I read about it on the internet, so I know everything now” sort of person. And is a suggestion of a probe change a faux pas?

#11

That’s how a lot of practioners find out about us :wink:

#12

We all have different personalities, gp. Personally, I would be delighted if someone asked me that question or any question about what concerns them. I would be open to try anything that may help me discover new things. Go for it.

#13

The two subjects that garner the most “heated” discussions among electrologists are “scabs” and “what to put on for aftercare.” (Also which modality is better; although that discussion is much less heated these days.)

My purpose in bringing up this never-ending scab discussion is to say that I feel the average electrologists thinks that ANY scab reveals an overtreatment, and that scabs indicate that something went wrong. Because of this, too many “rank and file” continue to undertreat their patients and not get the job done. Results of undertreatment can mean many wasted treatment hours, and actual permanent skin damage in the long-run (I will have some startling photos for you at the end of March.)

I don’t like scabs either! Repeat: I don’t like scabs! I am not the “SCAB MASTER” (as I have been called). But I consider what scabs are physically: an upwelling of blood plasma; usually from a deep follicle. I don’t think that measuring scabs or grading them is productive. However, an expert electrologist instantly recognizes when a post-treatment scab is, in fact, indicative of overtreatment (it’s not just about the “size” of the thing). I know that my excellent colleagues (e.g., Dee Dee and Jossie) can simply look at the work they’ve done and determine whether the scabbing is “acceptable and not a problem.” (I do, by the way, agree 100% with Dee Dee’s posts … as always, i.e., I too almost never create a scab on the face. Male beards are a different story)*

Over the years, I have taken care of many of Dr. Chapple’s plastic surgery patients. (Actually, I love caring for people: fixing food and pampering them. Talking all night when they get post-surgery depression … it’s common.) With these surgeries, the issue is always bruising and swelling. Some people are so swollen that they look like monsters; others get almost no swelling at all. Some people bruise like they were beaten with clubs, and others have virtually no bruising. All of this is “normal” in the world of surgery.

However, then there is the dreaded “hematoma” which is a bruise requiring immediate surgical intervention. When I have any patient, that’s what I’m looking for. Yes, this too is “bruising” but not acceptable (and usually damaging to the tissue if not treated). All of this pretty much depends on the patient’s physical nature itself (or if Chapple didn’t properly zap a blood vessel). Some people naturally bruise easier and swell easier.

Just like (scabs and swelling) in our field, bruising and swelling from plastic surgery is okay … but not all the time. It’s all about recognizing the “bad boys.”

Actually, this last patient of mine (from England, by the way), was amazing because he had almost no swelling. And, this is simply part of his body mechanics. The fact that I didn’t get any scabs is also the result of his own body chemistry (so I really can’t take credit for this): less swelling produces much less “blood plasma” oozing and, consequently, minimal scabs. Combining his particular chemistry with good aftercare produced pretty amazing post-treatment results. I will have more to share on this patient, (more photos), but this sucker is already too long … as usual!

(* Note: I also get scabs with insulated needles … all types; and gold, Ballet, Laurier and tapered too. It’s what I do to the follicle; not the needle.)

#14

A few more hints:

This patient presented me with an interesting situation. His hair density on the upper back was as dense as I’ve ever seen (look closely at the post-treatment marks to see the density). Were this a local patient, I would NOT have cleared-off the area. Instead, I would have clipped the hairs and removed about half the hair. However, this guy is from England, and needed to see results! He could not return in, say, 4 or 5 weeks. My strategy, in this case, was to “sneak up on it.”

I did the back in patches, and surrounded those patches with untreated pathways. He looked pretty odd for a few days because I left untreated strips of hair all over his back. I did this, to ensure a good blood supply to the area and to minimize swelling. The untreated skin (blood supply) was “supporting” the electrolysis/damaged skin. If you look at the left shoulder, you can see a strip of hair that I left between the front and back of his shoulders. Yeah, he did look like a “bad hair day!”

Once the treated areas looked stable, I zapped off the “pathways.” Now, the calm skin had a somewhat stable blood supply to support the newly damaged areas. This patient did not develop scabs. If you look at the right front shoulder, you will see what the area looked like in a week. The skin was “flakey” but no scabs.

I already explained how I mitigated scabbing, but it’s a good idea to make “islands of treatment” if you have an extremely dense-hair case (well, that’s my strategy anyway). By the end of his two weeks here, everything had been cleared off. The second clearance will be easy, because the density will be much less than 50%. No need to make “pathways.” With three clearances he will be 99% done. I’m hoping to send him to Darren (Follizap), 4 to 6 months after the last clearance, for the 2 or 3 hours of “clean-up” (my missed/poorly treated hairs, you know “true regrowth”).

I hope this helps and gives you some ideas for clearing big jobs. There are other ways to do this, but this is my way.

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#15

This a lot of hair for a 20 year old. I, too, have never seen this much hair on any man of any age. Did he have any laser sessions before this?

I think it is great that you shared your strategy with this case. Yes, it is difficult to do out of town clients because sometimes the plan has to be changed from what we normally would do because we have them for a limited time.

I like that striping idea and it makes much sense in relation to blood supply issues. Thanks for sharing that, Mike and congrats on doing such a nice job for this young man. He will enjoy his smooth back for many years.

I hope this teaching module encourages other electrologists not to be afraid of tackling large jobs. May I stress again that what Michael has done here is NO EASY TASK.

#16

Dee Dee you are WAY too kind. Between you and Jossie I usually feel like I’m “walking on clouds” whenever I speak to you. I barely deserve your friendship. What I don’t see, sometimes, is the gratitude that several manufacturers should give both of you for all your incredibly kind and beneficial efforts.

Funny, but the “English patient” told me (a couple days ago) that he’s only 19! He didn’t think I would take him at that age. Actually, I might not have, because I would have assumed that all the hairs had not yet grown in. It had! (He also said that he wants to move here! Yep, that is a common wish. See below.)

This boy started developing body hair at 13 and was fully grown-in at the time I saw him. He’s also “ethnically” 100% English. The excellent part of this, is that because the hairs were “all grown in” he will get spectacular results … his skin will be totally denuded of hairs and he will never grow new ones because they have ALL grown in already! (Well, there is some fluff at the lower neck; you can see this.)

If my fellow zappers encounter such a “massive” case, don’t be frightened! Actually, your efforts will be much better than you think! The really difficult (male body) cases are the young guys that only show 30% or so of terminal hairs with LOTS of accelerating vellus hairs (we usually call these “shooters.”) I will say: “You have a bunch of ‘shooters’ on the shoulders.”* And, the guys understand the idea that these little hairs are “shooting up.”

You know, we can generalize, but the interesting thing is that lots of people don’t fit our well-thought-out “program.” Just when I think I’ve “got it right,” good old Mother Nature throws me a curve ball! I don’t think I’ll ever really have this “electrolysis thing” figured out … but I do keep trying! I have learned SO MUCH here on Hairtell … I love this place!

(*Actually, shooters are typically found on the shoulders of young men, but not on this English guy: hairs were ALL grown in. The two patches on his back looked exactly like angle’s wings. I didn’t take a photo because he was too ashamed by the appearance.)

Here’s a tiny look at Santa Barbara. This is a project I’m doing in a few months; not exactly sure what it will entail … this was a video we did to outline what the area looks like here. Yeah, that’s me in the video: all old and creepy looking! I flattened out my toupee with gel (bad idea) and it looks horrible! If I were a patient, I wouldn’t go to me. He he he … (These two kids are actual patients and will be in a new TV series next year. I love these kids!)

#17
  • I already gave Michael my comments on this clip, but just wanted to tell those with iPads that I needed to view the link on my laptop as my iPad did not support this format.
#18

I am an black male who has started electrolysis on my chin area. In the area treated, I see hyperpigmentation. Looks like bruising under the skin and I have dark spots all over the treated chin area. I also have one part of my chin area that has always been sensitive and and prone to ingrown hairs showing either scabs or ingrown hairs. Most of the bumps have gone down, but I m concerned about continuous treatment of the area since the hair there grows very slowly and does not seem to push out like the rest of the chin area. Also there is an issue of hair curled at the root on other places on my chin.

I am having second thoughts abut the whole thing. Should I be worried or hang in there? My electrologist is very experienced and highly recommended, even right here on Hairtell.

#19

I would say … hang in there!

I have only completed maybe 15 “African/American”* beards and this is the “Olympics” of beard removal. This is a big difficult job for your “zapper.” Hyperpigmentation is a certainty with your skin-type. It is going to happen … guaranteed. The chin is going to be a “mess” for a while: bumps, lumps and ingrown hairs. Your electrologist is seeing bleeding too, but, well, why brings up the subject. (I’ll bet you notice him/her dabbing the area with dry cotton? Yeah, releasing an ingown hair and then drying the area so the HF does not dissipate in the surface blood. It’s a nuisance. Don’t think about it! Sorry I said anything, mate!)

I promise you this is going to be okay. In every case your skin is going to turn out so smooth and perfectly pigmented you are going to be, well, “thrilled.” Your skin-tone will be 100% better than anything you can achieve from shaving: I mean perfect! I’m not kidding. One young guy went from looking a mess to almost having a “movie star complexion!” His skin was so beautiful, it almost looked like he was wearing make-up. So, hang in there!

Your “curved” hairs are actually REAL curved hairs (not some lame “excuse” for not killing-off the follicle). They are really fun to treat because they “pop out” like no other hairs I’ve ever seen. They just suddenly “jump out” of the follicle. Weird.

Recommendation: Even if the patient is unhappy with my beard strategy, on the chin I never clear the whole thing off: I only thin, and thin again, and then clear (same with the upper lip). These areas are tricky because (as my doc tells me) they are densely populated with myofibroblasts (these cells pull in the healing tissue). Even though the chin is easy to clear, I don’t. Those pesky “myos” can have a “field day” and the result can be irregular looking skin. Not horrible, mind you, but why not take the safe road on the chin and upper lip?

*Yeah, I prefer “black man” too. But somehow it’s now politically incorrect. I remember when I was writing my book. I couldn’t say, “black beard hairs,” (that didn’t specify “race”), and saying “African American beard hairs” hairs was silly, because a LOT of Africans are white? This PC stuff is bloody silly!

I hope this helps you “stay the course.”

#20

Thanks. That really helped. The part about thinning out is very important because I was thinking about trying to clear the entire chin in the shortest possible time. My electrologist advised me not to try that, but I still went ahead with a couple of lengthy sessions, which she advised against again. She could not get most of the hair out because she said it was taking longer to treat each hair. I am therefore assuming that total clearance for the chin area of a man, and certainly a black man is a bad idea.

By the way the reason why I used black male is because I am not African-American. I am black from another country. It does not bother me at all and it gets straight to the point.

I hope I do end up with smooth skin as well. I have suffered from ingrown hairs for years and decided enough is enough. Laser has taken most of the dark hairs off (90%), but there are a few white and dark hairs left. The white hairs are coarser than the dark hairs because the laser sessions have made the dark hairs left very light. The coarse white hairs are what is slowing everything down.