Thermolysis on thick facial hair (+Photos)

Good morning Hairtell members!

First, let me introduce myself. I’m a 28 years old MTF transgender person from central Europe and I’m currently undergoing thermolysis treatment to remove facial hair. Unfortunately, this form of permament hair removal is not very popular in my country and therefore my electrologist choice is limited. As a consequence, I have to stick to the electrologist located 2 hours away from my home (I really cannot afford to drive even further and search for another one). I’ve been reading Hairtell forums for hours before registering but every case is slightly different and I finally decided to join and ask the experienced people here about my progress / concerns. Your help would be greatly appreciated.

Let’s begin with some general facts:

  • My facial hair is very coarse and the color ranges from mid-brown to blonde (there are also some with ginger-ish tint). It is basically a fully developed male-type beard. [photo link removed per request] (this was my starting point)

  • I have fair skin color (something between type I and type II on Fitzpatrick scale). My skin is also quite oily.

  • I’m on hormone replacement therapy (Estradiol) since June 2017.

  • My electrologist uses Apilus Junior and feels most comfortable (I believe) with flash thermolysis.

  • So far, I had around 10 hours of thermolysis spread over the period of 3 months. Every 2 or 3 weeks I’m having a 2 hour long session.

  • Because the single session time is quite long (2 hours) we decided to thin the hairs in selected regions instead of clearing one particular spot. At the same time, we are trying to alternate between treated areas so that each spot has at least a month of time to heal before we attempt to work on it again.

  • Prior to thermolysis, I had 4 laser hair removal sessions in the first months of 2017 with Vectus laser but saw no real improvement in hair texture or density. Obviously the laser did nothing to blonde / ginger hairs but also almost all of the mid-brown ones, that seemed to be good candidates for laser, have regrown after several months since initial treatment. I’ve also noticed that laser probably stimulated some of the thinner blonde hairs and they became thicker and somehow darker. At that point, I decided to wait 2 months and switched to electrolysis / thermolysis.

  • Prior to both treatments described above, I’ve been plucking / tweezing all the beard hairs for 3 years (yes, tweezing is not a good thing but I didn’t know that back then and could not afford laser nor elecrolysis). Plucking them was very painful because they are very thick and deeply-rooted.

During the thermolysis session:

  • I feel some pain when the zapping takes place but it’s not unbearable (upper lip area is the worst though).

  • She usually does 2 or 3 zaps for the thicker hairs and 1 zap for the moderate ones.

  • I feel slight traction when the hair is being removed but this is different from the plucking sensation (it is not painful). My elecrologist explained that some traction may indeed be experiended as the hair bulb is very large.

  • I sometimes hear the sizzling sound (more on that below in the “concerns” section)

After a single thermolysis session:

  • My face skin is usually quite red, tender and somehow swollen. Redness starts receding after 3-6 hours but the swelling remains for at least 2-3 days after the treatment.

  • Some areas (especially the upper lip) feel a bit stiff for 3-4 days after the treatment.

  • I didn’t notice any scabbing nor fluid oozing.

  • During the first week after a session usually some acne-like pustules are appearing.

  • I use witch hazel, pure aloe vera and, sometimes, a dab of tea tree oil here and there for 1 week after the treatment. I also apply SPF-50 sunscreen when the weather is sunny.

  • This is how my skin looks like 2 hours after a single treatment (thinning) on the upper / lower lip and around the chin area (photos taken with flash on to emphasize all the little details): [photo link removed per request]

  • And this is how my skin looks like 10 days after the same session (hairs remaining from the session were shaved off to provide better skin visibility on the photo): [photo link removed per request]

  • This photo was taken 2 hours after another session - this time treatment on the cheeks and under the jaw line: [photo link removed per request] (* marks the old acne scar that was there before)

  • The following photos were taken 5 days after the same cheek / jawline session (again, remaining hairs shaved off for better visibility): [photo links removed per request]

  • Finally, this is how the skin looks now (these were taken 1 week after last session on the upper / lower lip and chin area):
    Photos in daylight: [photo links removed per request]
    Photos with flash on: [photo link removed per request]

Now, what concerns me is that:

  • I did notice some residual redness / pigmentation change / bruising in some areas that is fading really slowly . I still have some slight marks from 3 months ago. Yes, I know that hyperpigmentation can take over a year to fade but I don’t even know for sure if that’s that or something else (see photos above).

  • I did notice some minor skin unevenness (?) which is observable on the high-contrast photos (the ones taken in dark environment with flash on). I’ve watched Michael’s great video on healing process and myofibroblasts’ role and this seems normal to certain extent. Nevertheless, I thought it is worth mentioning here.

  • During the treatments, I sometimes (actually quite often) hear a short sizzling or popping sound. Sometimes it’s quiet, other times louder. From what I’ve read on the forum, it’s not a good sign as it may indicate incorrect insertions or too high energy level. I asked the electrologist about it and she told me that it may happen when there is a lot of moisture in and around the follicle and that’s nothing to worry about. Could it be that in my case this is normal? As I have mentioned, I have giant hairs, quite oily skin and I also drink a lot of water 2 days before the session.

  • There was one spot on the upper lip which seems to be healing rather poorly. 1,5 months after treatment it still looked like a raised bump filled with some matter. I thought it might be an ingrown hair that got trapped under healing skin so I recently asked my electrologist to have a look at it. She pierced it gently with a sterile needle and tried to look for any debris but found nothing. She also said that it is not recommended to dig any deeper now because some scarring may follow. Since then, the bump got somehow smaller but the spot is still visible.

I would be very grateful if any of the experienced electrologists on the board could voice their opinion about mentioned issues. Am I receiving decent thermolysis treatment? How am I healing? Is there anything I should be worried about?

Please let me know,
Best Regards,
Kate

Hello Kate,
Welcome to the forum !

I would like to comment some points about your testimony :

First, you should not feel any traction at all. We can treat big coarse hair with big root without any traction at all. If the hair is pulled, it will grow again.

Secondly, for treating a male patterned beard, you should need around 100 hours of electrolysis, so with 10 hours, you just began the treatment.

You don’t have to drink a lot of water just before the session. This is just a myth… if you are alive,with normal consumption of water, we can perform electrolysis without any problem…

The skin will heal, do not worry. Some bumps are normal after electrolysis.

I have a question please, do you use any kind of anesthesia ? Like Emla cream for example ?

Hello! And thanks for the reply!

Well, I’m not sure if I used the right word. I mean, I can certainly feel “something” when the hair is being removed but it’s definitely not the plucking sensation. It’s very mild and not painful at all. My electrologist told me that the hairs are coming out smoothly so it may as well just be me being oversensitive.

Yes, I’m aware of that. I was just curious if everything seems ok so far…

Thanks for explaining. I didn’t know that.

No. I don’t use anything.

Hi Kate!

I’d like to touch on a few points I havent seen addressed yet.

First, no I see absolutely nothing of concern in any of the photographs, actually, maybe one thing, and that is it seems like too mild a skin reaction for the size of hairs i see in similar areas on the face.the hairs left on your chin give me a good estimation on what lays underneath the skin, and I would bet they are thick course and DEEP hair roots. If I was treating the hairs on your chin flash, would NOT be my first choice. I would be seeking more current than flash could provide to get those course hairs out. It would explain however why she is using multiple pulses, and what I think may be a variable depth technique to get a smoothish release of the hair. The lack of surfaceskin reaction is likely due to the use of an insulataed probe.

I think your electrologist is doing a FINE job with one limiting resource, her apilus junior, which if I’m not mistaken only does flash in thermolysis but if she hasbeen using it a while she would be more than comfortabe with going beyong the presets and setting the timing and intensity necessary to get these thick hairs killed. The variable depth technique would target the various parts of the large root ( bulge and papillae) and also loosen the bulb itself so the hair .
Before I did any DIY, or professional electrolysis for that matter, I had about 12 hours performed over a month at a school. My results were far from fantastic ( expected, I was treated by students) but yours are better than mine.
I do treat a lot of transpeople, and I watch the differences in their facial hair during electrolysis as they progress with HRT. I’m also trans myself. I do note that while hair growth itself does not change with HRT he courseness of the hair bulb and the depth at which hair grows changed considerablythe longer on HRT. Whether this is because of progressive electrolysis or HRT at work I could not definitively say, but I do believe HRT is at least partially responsible. This is al to ay as your treatment progresses, the hair removal will become easier as well. I note you indicated you were on estridiol, but didnt mention an antiandrogen such as spironolactone or Androcur (cyproterone) or finestride . These drugs are used in conjunction with estridiol to reduce the amount of dihaydratestosterone which is affecting your hair growth and are usually a standard part of HRT regimen (though perhaps not in some European countries).

Dont sweat some hyperpigmentation. It’s going to fade.This is not a concern. Your electrologist is doing a fine job.She could maybe benefit from a more robust modality such as Synchro,but that isnt available on the junior. I’m going to say that with flash, it may take more than 100 hours, but it looks like your electrologist is doing things right so I could be wrong.

The next issue I’d like to address is the issue of the sizzling sound, or “snap” that we have come to know as high frequency blowout.With insulated needles ( which looking at your results I’m 99% certain your electrologist is using) and insertions of the correct depth to treat your thick deep beard hairs this should not be happening, unless of course the energy is a bit high. Its possible also your electrologst could be using a isoblend probe with has insulation along half its length rather than the 3/4 of the length by all other insulated probes. If they are using an isoblend and their insertion is not deep enough, you will hear the snap.Other times too much energy is used and steam vents from the follicle . If the electrologist is using a variable depth technique ( and by this I mean they are altering the depth of insertion with each successive pulse ( Papillae bulb bulge!) then often if their depth is a little too high in the follicle, you will get the high frequency blowback. It’s not ideal, but it’s also not the end of the world if it’s only occasional, every follicle means adjustments should be made. The solution is to adjust energy levels, adjust depth of insertion, and presto chango the issue will be resolved.I’m betting you hear it more frequently on areas like the upper lip than on the chin, and if that is the case it’s most likely a depth issue.

You’re right that it’s difficult for us to recommend electrologists in europe. In some countries its not done, in some not done well, and in others there are some fantastic electrologists who are top of the world class. If yours would be willing to pass on contacts for yours ( with her permission) it would help us to build a list of skilled electrologists.

TL;DR I think your treatments are fine. Some minor adjustments could be made to relieve your concerns, but you should not have any problem with getting rid of your beard as is with no after-effects.

Seana

Hi Seana! And thank you very much for elaborating on the topic.

Do you mean that the face skin should initially look more red or swollen after such treatment?
If that’s the case, right after a single session it looks more red than on the posted photos but, as I’ve mentioned before, that starts to fade after like 3 hours.

Yes, currently I’m on Estradiol only as I was experiencing adverse reaction to even minimal dose of Androcur (severe depression, insomnia, high blood pressure, nose bleeds). There are research that strongly support the theory that, in some individuals, given time, Estradiol alone can reduce Testosterone and DHT levels to feminine range. I’ve already noticed some positive changes regarding feminization (no random erections, slight breast development) so I know that it is doing something. That being said, if my T/DHT levels are far from feminine range after say 6-8 months of theraphy I will consider trying Spironolactone.

Thank you! You gave me some hope.

Well, I’ve asked my electrologist about possible issues with insertions or energy levels but she started explaining that these are both OK (she gave me some justification). She attributes the sizzling to excessive moisture/oil in the follicle.

If I were to put a figure on it, I would say quiet sizzling (or “snap”) happens every 4th hair treated and is more common on the second or third zap in the same follicle. Occasionally, a louder pop or sizzle can be heard but this happens only 5 or 6 times a session (that is, per 2 hours).

As for the place, it happens everywhere on the face but I’ve noticed that the thicker the hair is, the more noticeable the sound (e.g. I don’t hear this a lot on the upper cheeks where the hairs are finer but I hear it frequently under the jaw line and on the sides where the hairs are the thickest).

I’ll try to ask her about that.

Again, thank you very much for your response.
Kate.

I too had severe depression/anxiety/suicidal tendancies due to cyproterone. Spiro has always been just fine.I’ve never used finestride.

that the “snap” is heardon the second, or third pulse is more evidence of a variable depth technique. I think shes either lifting the probe too high in the follicle, using a isoblend probe or using too much energy.

Yesterday I had my next thermolysis session. While my electrologist was taking a small break from working on my upper lip, I noticted the parameters on the display of her Apilus Junior Plus machine. They were as follows:

THERMO FLASH
.05s
86%
UPPER LIP 7

As I have mentioend in the previous posts, each hair is zapped once, twice, or thrice (depending on the hair’s coarseness).

Anyone would like to comment on these settings?

a standard preset for the upper lip, in about the same range as I use to treat upper lip hair. I use an xcell, often with a pico -7 which is a flash modality on new apilus machines. If the hairs are not releasing in one or two pulses, you operaator has the ability to adjust these settings upwards or for longer timing to correct the issue.I try for one pulse in just the right depth , but sometimes hairs on the upper lip can vary widely as to insertion depth, and I wouldnt fault someone who takes 2 and gets a good release of the hair.

I would not do pulses shorter than 0.1 secs - longer pulses usually heal better and the danger of local overheating becomes smaller.

The same energy would be delivered with 0.1 sec 61% (energy is proportional to the square of the intensity).

And with Your beard hair i would not go any shorter than 0.17 secs. I would probably use a size 0.06 probe or at least a 0.05. Again in order to avoid local overheating.

Just today i did flash thermolysis (synchro) on a male upper lip beard and used that timing, but at levels between 34% and 37% on a platinum using a size 0.06 probe. That killed most hairs with one single shot. On the junior i would use a bit more.

Beautiful work, in my opinion.

My own Estradiol levels actually increased while i was fading out CPA. Actually Estradiol alone should completely suffice, if the dosis is large enough to suppress the LH level (which simply indicates the body that there is simply enough “sexual hormone” and there is no need to produce more; LH reacts both on Estradiol and Testosterone and controls the production).

Thank you! You gave me some hope.

Well, I’ve asked my electrologist about possible issues with insertions or energy levels but she started explaining that these are both OK (she gave me some justification). She attributes the sizzling to excessive moisture/oil in the follicle.

If I were to put a figure on it, I would say quiet sizzling (or “snap”) happens every 4th hair treated and is more common on the second or third zap in the same follicle. Occasionally, a louder pop or sizzle can be heard but this happens only 5 or 6 times a session (that is, per 2 hours).

As for the place, it happens everywhere on the face but I’ve noticed that the thicker the hair is, the more noticeable the sound (e.g. I don’t hear this a lot on the upper cheeks where the hairs are finer but I hear it frequently under the jaw line and on the sides where the hairs are the thickest).

I’ll try to ask her about that.

Again, thank you very much for your response.
Kate. [/quote]

Thank you all for the comments. :slight_smile:

OK, I’m back again with one more question.

Is that how hyperpigmentation looks like? (places marked with red arrows) [photo link removed per request]
It is even more noticeable when you look at it from a distance [photo link removed per request]
These areas have no visible hair on the surface but still have grey’ish / blue’ish tint.

I know you have already told me before not to worry too much about any darker areas but I’m curious if this is just a pigmentation issue or something else?
I’ve read some horror stories about people ending up with permament beard shadow from elecrolysis and it scared me a bit (don’t know what to think about it).

As always, every response would be greatly appreciated.

I have those spots too! How do we get rid of those???

it’s a bit hard to tell ( or maybeI’m tired this morning) but yes those look like hyperpigmentation.

hyperpigmentation is a symptom/part of the healing process of the skin. When the inflamation that causes it is no longer taling place, the hyperpigmentation starts to fade. Often within a month or two, 90 percet of the time within 12 or so months ( severe cases) and always within 18 months.
watch the "healing skin " series shown here:

for more information. If you get a mosquito bite, or waxed, or lasered, or anything which causes inflamation to the skin like a scab or cut, then all of these can cause hyperpigmentation. In some extremely severe cases, such as is the case with deep surgical scars, hyperpigmentation can be more long lasting, but with an electrolysis treatment there is not enough inflamation for it to be long lasting at all.

So , nothing to worry about, will definitely fade away with no trace. Definitely not causing “permanent shadow” or any other manifestation.

Seana

Thank you Seana for your contribution to the topic again.

Today I took a closer look at those darkened spots on my face and I would say they look more like Melasma rather than ordinary PIH (they have highly irregular shapes and have grey-ish tint to them) but maybe I’m wrong.
I did a little bit of online research (e.g. this movie) and it turns out Melasma is often caused/aggravated by oestrogen, which I am constantly taking as a TG person.

Could it be that my thermolysis treatment interferes with the estradiol I’m on?
Should I worry about it being more long-lasting than PIH? What do you think?

If you go through the video you referenced, it mentions thatthis is common on women with darker skin tones ( asian, phillipine, indian) . You do not havea dark skin tone.
I dont believe that what I’m seeing in your pictures is malasma.
Thermolysis does not interfere with estridiol.

Seana

Well, I have also looked it up in a bunch of different sources and it seems that Melasma is just more common on the darker skin types but can sometimes happen on the white ones as well. Another thing is that my mother has something similar on her cheeks so maybe it’s partially hereditary (I mean, the tendency).

But maybe you’re right and this is just PIH.
Anyway, thanks for the reply. :slight_smile:

Ok, here’s a little update on my treatment.

So far I’ve had 17 hours of total treatment time spread across 5 months (usually 2-hour session per 2 weeks). This is how my skin looks like 1 hour after my last 2-hour thermolysis treatment session on the cheeks, upper lip, lower lip, chin and surrounding areas:

[photo links removed per request]

The skin looks more shiny/oily than it normally is because my electrologist uses some collagen / bepanthenol cream right after the treatment.

Does it all look ok? What do you guys think?

Next thing is that I still continue to hear the sizzling / snap sound (although quiet) mentioned in the first post. I’ve mentioned that a couple of times to my electrologist asking her to evaluate insertions (she uses insulated probes by the way), energy levels etc. but she says everything is ok with these and that I should not worry about the sound. Not sure what to think about it…

As always, I will appreciate feedback from Hairtell professionals.

Ok, nevermind…

Today, that is exactly 7 days after my last thermolysis session, I woke up to see THIS, that is, 2 large pustules on my upper lip.
Yesterday I took a warm bath (involved some sweating) and my skin got quite red afterwards. Usually, I try not to sweat or take warm baths for 3-4 days after a session but I thought that doing that after 7 days is safe. Am I wrong?

BTW. I wiped the areas with Witch Hazel and put a dab of Tea Tree Oil in there. Do you think it will heal quickly?