TO PLUCK OR NOT TO PLUCK? HOW TWEEZING HAIR CAN DAMAGE YOUR SKIN AND WORSEN YOUR HAIR PROBLEM

10 Sep

In the 1980s, when I was a new electrologist, a client came to me who had horrible acne – but only on her chin – the only place on her face she was tweezing hairs every day. This client had been to a dermatologist multiple times for her “acne”.  She never volunteered and the physician never asked if she had been tweezing hair or picking at the area.  Before electrolysis she always had scabs from the digging she had done to extract a hair and her chin was bumpy and deeply pitted. She doubted electrolysis would work but was desperate enough to try it.  She promised to stop tweezing, and within a few months her acne disappeared.  I could not repair the damage the tweezing and picking had done to her skin, but after electrolysis she was left with unblemished, hairless skin.  No more scabs and acne sores.

Not everyone has such bad results from tweezing, but electrologists see it often enough.  The damage occurs when the client picks and digs at ingrown hairs resulting in broken skin that bacteria can infect and damage further.

The first rule to follow when choosing electrolysis treatments is to STOP ALL TWEEZING.  This is very hard for some people.  If hair is visible, or even if it is not visible to anyone else, to let it grow feels like the worst thing that could ever happen.  Clients often relate the nighttime dreams (nightmares!) where they go somewhere with visible hair.  It is horrifying for them.  Shaving feels wrong – women feel masculinized by face shaving, and some believe the myth that shaving makes the hair become worse. However, shaving is not the evil it is thought to be.  Shaving simply cuts hair at the surface of your skin.  Shaving does NOT stimulate more hair to grow, nor does it cause hair to become larger in diameter. 

TWEEZING:  THE GOOD, THE BAD, AND THE UGLY

There are two good things that can be said about tweezing. The first is that it is inexpensive – all it costs is a pair of tweezers.  The second is that the plucked skin is cleared of hair – for the moment. 

The bad and the ugly of tweezing takes much longer to describe. The BAD includes the fact that tweezing must be done from now on – even beyond the age where you can see and grasp the hair; and the UGLY is:  YES, tweezing can damage your skin.

In the book ELECTROLYSIS, THERMOLYSIS AND THE BLEND: THE PRINCIPLES AND PRACTICE OF PERMANENT HAIR REMOVAL the authors Arthur Hinkel and Richard Lind write that “repeated epilations (tweezing) eventually cause most hairs to regrow more quickly and to become darker, coarser, and more firmly rooted.”  They go on to state, “Only a fraction of all tweezed hairs are ever permanently eliminated.  Thus, a woman who tweezes is simply letting herself in for greater hair problems than she had before she tweezed; rather than solving her problem she is worsening it.” 

Hinkel and Lind list two negative results from tweezing.  The first is that an “increased blood supply is the cause of the accelerated growth of tweezed hair. Each time a hair is tweezed out of its follicle, a good portion of the bottom half of the follicle is torn out.  The damage is not sufficient to prohibit future growth, but it is enough to cause the follicle to reconstruct itself a little sturdier with a better developed capillary system each time.  The difference from one tweezed hair to the next may be imperceptible, but eventually what may have been a few annoying lanugo hairs will have become full-growth terminal hairs, bristling in defiance of their owner’s attempts to evict them.”  (Vellus is the term that should have been used here. Lanugo hair is the downy, unpigmented hair that grows on a fetus around the fourth or fifth month of pregnancy.)

The hair follicle regulates hair growth. The follicle is lined with stem cells whose only job is to divide and become a hair.  The ripping out of the stem cells by tweezing only causes the remaining stem cells to divide more so they can build a bigger hair. Some people’s skin contains an enzyme that acts as a magnet to the hormones that regulate hair growth. Injury to the skin from tweezing will cause an increased blood flow bringing those hormones to feed the dividing stem cells.

The second negative effect of tweezing that Hinkel and Lind lists is infection which can occur when the entire sheath of the follicle comes out after a hair is plucked from a soft sensitive skin.  They write, “The resulting cavity quickly becomes infected with the organisms, usually yellow staphylococci, which normally inhabit the follicular pore.  Deep pustules that result leave a whitish scar or pit.” 

Hinkel and Lind go on to call waxing “as a specialized tweezing method”, with the same issues as tweezing causing increased hair growth, especially because ALL hair is ripped out of the skin, not just the larger diameter ones.  They discuss the fact that some people will have hair loss from waxing in areas like the eyebrows, and women who wax in their 40s and 50s during a time of “glandular changes, which would ordinarily result in a diminishing of hair regardless of hair-removal practices.”

The most disastrous consequences waxing can produce occur on the face.  While there are some fine vellus and accelerated vellus hairs on the face that will respond favorably to waxing most other hairs in the same area will be stimulated to greater depth and coarseness.  Face waxing will often lead to a superfluous hair problem that never existed previously – a face full of scattered, large diameter and terminal hairs.

In 1981, Julius Shapiro published ELECTROLYSIS BEAUTY AND CONFIDENCE THROUGH PERMANENT HAIR REMOVAL.  In his chapter on Temporary Methods of Hair Removal he describes tweezing in this manner: “Success:  you have plucked a hair.  But, at the same time, you have also set into motion the wheels that will perpetuate this sequence of events. You have begun a never-ending cycle which will tend to hasten the rate of regrowth.  It will also build the thickness, strengthen and deepen the regrowing hair, thus making it darker as well; it will also increase the possibility of irritations and infections of the follicle which result in pitting and scarring.  Finally, you will undoubtedly have made permanent hair removal by electrolysis more difficult to accomplish by creating distorted follicles with the additional possibility of ingrown hair.  And all this from just one simple, innocent pull of the tweezer.”  While “I” love his descriptive writing, I disagree about “one simple, innocent pull of the tweezer” but I do agree that repeated extractions of the hair via tweezing will result in the list of problems he described.

In 1985, Dr. Robert B. Greenblatt wrote UNWANTED HAIR – ITS CAUSE AND TREATMENT – ANCESTRAL CURSE OR GLANDULAR DISORDER?  Greenblatt does not discuss tweezing, but he does remind us that there is a thing called “multiple follicular hair units”, which means where you see one hair, there are often multiples appearing to come from one follicle.  He also states that deep and coarse hair on women can be brought about “by personal tampering through plucking, shaving, waxing, and depilatories.”  I disagree with shaving and depilatories being on this list since they remove hair at the surface of the skin and there is no follicular extraction. Keep in mind that depilatories work to dissolve the hair, which can be very irritating to the skin.

I mention Dr. Greenblatt’s book because another thing can occur when women tweeze frequently.  Women who tweeze daily often believe that they are tweezing the same hairs every day when there exists multiple follicular hair units.  The only time this could be true is when the tweezing technique results in breaking the hair off under the skin.  This can be seen in very large diameter hairs – you know them by the “plink” sound they make when you unsuccessfully extract them.

In Fino Gior’s 1987 book MODERN ELECTROLOGY: EXCESS HAIR, ITS CAUSES AND TREATMENTS, we are warned that “follicles can become distorted and thickened from constant tweezing or waxing.” Gior writes, “Ingrown hairs can be another drawback of waxing.  This happens when the hair is pulled apart inside the hair follicle.  Instead of growing up and out of the follicle, the hair curls under the skin causing a cyst-like projection.”

In the Richards and Meharg 1991 book on COSMETIC AND MEDICAL ELECTROLYSIS AND TEMPORARY HAIR REMOVAL, A PRACTICE MANUAL AND REFERENCE GUIDE, it is stated that “Plucking experiments have shown that repeated plucking can damage some hair follicles. Some react by producing a thinner hair, others develop a coarser hair.” And they tell us tweezing “can lead to distorted follicles, pigmentation, folliculitis, ingrown hairs, and scarring.”  I am certain we have all known someone who tweezed their eyebrows to the point they have little or no brows.  Eyebrow hair is a different because eyebrows are not influenced by hormones like chin hairs are.  In my own practice I have had clients whose prior waxing resulted in loss of hair. 

In the 1992 book PRINCIPLES AND PRACTICE OF ELECTRICAL EPILATION, Sheila Godfrey writes, “The tweezing of individual hairs tears out the lower follicle.  The reconstructed follicle is usually stronger, with a better blood supply.  Vellus and fine hairs are frequently removed at the same time, so aggravating the condition.  Hairs that have been waxed or tweezed invariably leave behind distorted follicles, so hindering electro-epilation.”

In the 1993 I had a 67-year-old client who had been waxing her upper lip since she was 16.  She had been waxing for over 50 years!  The center of her upper lip had no hair.  The reason she came to me was that the large diameter hairs now growing at the corners of her upper lip were so stubborn she could no long pull them out!  My conclusion was that the waxing worked on her center upper lip but made the outside corners of her upper lip worse.  This client was willing to contribute to this article in the OLDER KANSAN TIMES.

In 2004, Helen R. Bickmore writes in Milady’s HAIR REMOVAL TECHNIQUES, A COMPREHENSIVE MANUAL, that after tweezing, “the hair may grow back thicker, more pigmented, and faster the more it is tweezed.  Tweezing hair also causes hair follicles to become distorted.  These distortions make it difficult for an electrologist to remove hair permanently later.”  Under the pros and cons (the only pro is minimal cost) she lists that tweezing “can be painful, can be time consuming in areas of heavy growth, and may cause hair below the skin to break, in turn causing bumps to occur in those follicles as blunt edges try to push their way through small follicles.”

SUMMARY

Tweezing facial hair becomes a never-ending cycle of self-grooming.  Hairs become larger in diameter over time which makes them more difficult to tweeze and more difficult to extract during an electrology appointment.  Tweezing also contributes to skin damage from picking skin with ingrown hairs and infection from non-sterile tweezers. 

If you are reading this while looking for information on electrolysis, know that your electrologist can tell when you’ve been tweezing.  If you do tweeze then your first goal will be to stop tweezing.  My retired colleague, Jeannie M. Bush, CPE from Wisconsin, was the first person I heard say, “Tweeze only the hairs you want to keep!” 

FDA Consumer Health Information Bulletin

3 May

The United States Food and Drug Administration through its Center for Devices and Radiological Health regulates electrolysis equipment, lasers and other medical equipment. Amid the growing popularity of laser hair removal and the extravagant claims of manufacturers and clinics, the FDA reiterated its position that only electrolysis can permanently remove hair and warned laser clinics against making such claims.

The FDA Consumer Health Information Bulletin of 27 June 2007 states:

“The U.S. Food and Drug Administration (FDA) recognizes electrology as providing permanent hair removal. The FDA identification in Title 21, CFR, Sec. 878.5350 for needle-type epilators is: “a device intended to remove the hair by destroying the dermal papilla of a hair”. As no other device for hair removal has the unique identification of “destroying the dermal papilla of a hair”, only electrologists are allowed to claim permanent hair removal in their advertising”.

Consultation: Evaluation of Hair Growth

3 May

Presented to the Kansas Association of Professional Electrologists on April 14, 2019 by Barbara Greathouse, CPE

This presentation provides electrologists a method to evaluate the treatments they provide and gives clients essential information needed to recognize the signs of progress by the electrologist they have selected.   Using information gathered during the consultation for electrolysis treatments the electrologist will have asked the client specific questions about the methods and frequency of their previous hair removal.  Documentation of this information provides a quantitative comparison of hair growth before, during, and after the required series to reach permanent hair removal goals. 

According to a survey presented to three professional electrolysis groups on social media, more than 85% of first appointment consultations for electrolysis are requesting treatment on the face.  Since clients rarely remove body hair with frequent tweezing, the questions are in reference to what has been done on the face, but hair growth on body areas can be documented with all but the Pre-Treatment Tweezing information.  Knowledge of the nature of other methods of hair removal and the physiology of hair growth allows the electrologist to better explain how and why the electrolysis treatment takes time; to reinforce to the client that the hair did not develop overnight and therefore completing electrolysis will take a series of treatment to reach permanent results.    

DOCUMENTING THE CONDITION OF SKIN AND HAIR

Written and photographic documentation will provide the electrologist and client with before, during, and after comparisons thus showing the results of treatment. 

  1. In what condition is the skin? (healthy, smooth, rough, oily, dry, irritated, pitted, broken skin, pustules)
  2. What type of hair is present?  (diameter and texture of hair – vellus, accelerated vellus, terminal)
  3. How much space is between the hairs?  (sparse, intermediate, dense)
  4. What methods of hair removal have been used most recently? (tweezing, waxing, threading, shaving, depilatories, laser or other light based, electrolysis)

The old wives tale that shaving makes hair grow in heavier is probably why so many women started tweezing their unsightly facial hair.  The fact is that shaving does nothing to produce more or larger hair is hard for people to get past, however, electrologists report they see many clients with hair diameters larger than average after the client reports they have tweezed for many years.   

PRE-TREATMENT TWEEZING  (PTT)   

Questions about tweezing before beginning electrolysis treatments:

  • How often do you tweeze the area?
    1. Every day (raises PTT number)
    2. Once a week 
    3. Once a month (lowers PTT number)
  • How much time did you spend tweezing each time?
    1. 1 – 2 minutes (lowers PTT number)
    2. 5-10 minutes
    3. more than 10 minutes (raises PTT number)
  • When was the last time you tweezed the area?
    1. Today (reevaluate when they return next)
    2. Yesterday (shows how much hair grows in 24 hours)
    3. Last week (first clearing helps determine how long to schedule for weekly treatments)
    4. Last month (probably very few hairs, see you in a month)

DOCUMENTING PTT 

PTT+1     Occasional tweezing of a few hairs or electrolysis more than 90 days ago

PTT+2     Tweezing in the past 10 to 20 days or electrolysis 30 to 90 days ago

PTT+ 3     Tweezing within the past 10 days; removed 50% of growth or electrolysis about 20 to 30 days ago

PTT+4     Most of the hair tweezed within the last 10 days or electrolysis within the last 20 days

DETERMINING LETTER CODE

The letter code is determined from observing hair diameter.  A fine hair is less apparent than a large diameter hair and a long hair is more obvious than a short hair.  Larger diameter hairs grow faster than smaller diameter hairs.  The electrologist should select a probe size close to the diameter of the hair to allow for the treatment energy to effectively treat all the stem cells in the follicle.  Too small a probe with larger hairs will not reach all of the stem cells, contributing to regrowth of the hair from that follicle.   

Determine the ratio of the various types of hair.  For example:  90% fine hairs with a few large diameter hairs scattered.  OR:  Mostly large diameter hairs with a few fine hairs.

A  is a vellus hair with less than 1 mm depth and a diameter of less than .001 inch

B is a vellus, accelerated vellus, or terminal hair with a depth of 1 mm and a diameter of less than .001 inch

C is a vellus, accelerated vellus, or terminal hair with a depth of 1 to 3 mm and a diameter of less than .003 of an inch

D is a terminal hair with a depth of 3 to 5 mm and a diameter of more than .003 of an inch

DETERMINING DENSITY RATING

Select one or more areas to measure using a one centimeter cut-out to photograph or count the hairs.  

  1. Are hairs close together or is there much space between hairs?
  2. How many hairs per square centimeter? 
  3. Does there appear to be more than one hair growing out of the same follicular unit?

DENSITY RATING

+1 Very sparse; only a few hairs present

+2 Sparse – 2mm to 15mm between hairs

+3 Moderate crowding – 1mm to 3mm between hairs

+4 Very dense growth – 1mm between hairs

+5 Unusually high density; most of the follicles have more than one hair and these follicle units are less than 1mm apart (less than 1% of clients will fall into this category – less than 1mm apart; 2-3 hairs growing in each follicular unit

EVALUATING THE INFORMATION

Clients may give inaccurate information about recent electrolysis or laser treatments.  They may not admit to using self-administered hair removal treatments such as tweezing, waxing or threading.  Learn to recognize the signs of recent tweezing, laser treatments, or faulty electrolysis treatment. 

The following signs will help you recognize regrowth from the various forms of epilation: 

  1. Ingrown hairs; with or without active lesions.  Ingrown hairs may need to be carefully lifted from the skin with sterile forceps or a sterile lancet.  Frequent picking by the client can also contribute to acne in the area of the hair growth.  When a client insists they cannot stop tweezing between treatments their first goal will be to stop the tweezing, with the knowledge that continued tweezing will delay completion of the treatments.
  2. Hair fragments protruding through the surface of the skin.  This can be from tweezing, poorly executed electrolysis or an indication of recent laser treatment.  
  3. Follicles reverting to premature telogen, expelling distorted and/or corkscrew hairs.  Follicles that have been tweezed or under-treated with electrolysis may result in a hair with a clumpy root sheath.  The corkscrew hair (not a naturally curly hair) will often be seen with the whole root so close to the surface of the skin that you can see where the hair is attached to the papilla. Some electrologists believe these hair follicles are essentially dead and can be tweezed out without regrowth or causing more problems, but treating the visible follicle is a good exercise in checking insertions and current application.
  4. Dark spots (black dots) embedded in the skin. These will show up as if there is pepper under the skin.  They are a remnant of the hair root. They will expel from the follicle on their own.
  5. Hair growing from pitted follicles.  Most pitting is caused by the client picking the skin.  Over-treatment resulting in large diameter and deep scabs or high-frequency blowout may result in some pitting. 

As treatments progress the Density Rating will lower and the Letter Code will change as evidence of permanency. As treatments progress the length of each treatment will become shorter while the time between treatments will become longer. All signs of regrowth will disappear and the skin condition usually improves.  The electrologist can evaluate their work by comparing clients with similar hair problems to see if results are similar.  K. Lasker, the source of this information, recommends evaluating every 15-20 hours of treatment.  While it is not necessary to document progress at every appointment, reviewing hair growth every 2 to 3 months will provide evidence of the decrease in hair growth.  

Collecting and documenting this information provides evidence of the success of the electrology treatments.  Providing a new client with quantitative results gives them confidence in the knowledge and experience of the electrologist and shows measurable proof that electrology works.

Adapted from the Manual for Epilation Charting System, 2nd Edition by K. Lasker, B.S.

4 Reasons Electrolysis IS Mainstream

28 Jan
  1. Electrolysis is Permanent.  Waxing, shaving, threading and tweezing are all temporary and hair begins growing back immediately.  Laser and light-based methods may reduce hair, but not ALL hair.  Electrolysis is the only permanent method of hair removal for every color of hair and skin.
  2. Electrolysis is Low Maintenance. After completing a series of treatments you may need an occasional touch up in the event of physiological changes, but previously treated follicles will never produce another hair.
  3. Electrolysis Requires a Short Recovery. Electrolysis is considered non-invasive and gives you fast results.  The best part is that most clients fully recover from the procedure in just a few hours.
  4. Electrolysis is Customizable. After a one-on-one consultation, the electrologist will work to help you complete your hair removal goals – whether it be a few stragglers or a full coverage of unwanted hair.

Hair Gone: Permanently

21 Jan

Fed up with excess hair on your face or body? Did you know there is a permanent solution to unwanted hair? Have a look at these facts about hair removal.

The most common body areas for hair removal are – all areas!  Humans have been using all manner of hair removal methods since ancient times.  Until the 1870s, shaving, tweezing, and chemical depilatories were the only options. Then came electrolysis!  Also known as electrology or electroepilation.

Electrolysis was developed by a Civil War physician who treated eyelashes which curved inward and chronically irritated the eyeball. A skin doctor recognized the value for his hirsute female clients and history was made. The science of electrolysis treatments has undergone countless improvements since it was discovered.  Computerized epilators and pre-sterilized disposable instruments have made it comfortable and safe as well as improved its permanence.

Electrolysis treatments have always been appropriate for each type of skin and hair.  It gives you great results on white, red, blond, and gray hair and is safe for pigmented skin.

In the late 20th century electrolysis was surpassed in advertising by lasers and light-based methods, which are not all appropriate for non-pigmented hair and pigmented skin. The term “permanent removal” was given to the practice of electrolysis and “permanent reduction” was given to laser and light-based methods, confusing consumers, advertisers, and the media.

Prior to the introduction of laser hair removal, women with unwanted hair were embarrassed and secretive about having excess hair.  They didn’t know where to turn or who to ask about their problem. Since laser hair removal was often provided in physician practices, advertising often included billboards and full-page spreads in newspapers and magazines. This was something electrologists could not do due to the cost of advertising, BUT, the resulting awareness helped consumers discover electrolysis.

In most U.S. states, Canada, and Europe, electrolysis is a regulated practice.  The electrologist will provide you with a thorough consultation.  This consultation will explain the procedure, the aftercare, and provide you with appropriate expectations. Questions about your health will be asked, as excess hair growth can be a side effect of certain medical conditions or medications. The consultation may also include the treatment of a few hairs so you can decide whether or not you wish to proceed. There are two major side effects from electrolysis treatments.  The first one is permanently gone hair.  The treatment energy is focused on the specific hair growing cells and not to other tissues in the skin. The second side effect is an immediate

There are two major side effects from electrolysis treatments.  The first one is permanence.  The treatment energy is focused on the specific hair growing cells and not to other tissues in the skin. After the follicle is treated it cannot grow another hair. The second side effect is an immediate pinking up of the skin. This is caused by increased blood flow to the treated follicle and lasts a few minutes to a few hours. Other side effects are rare but may include swelling, a tiny scab, or the development of a small pustule or pimple at the follicle opening.

Electrolysis takes a series of treatments to complete because of the nature of hair growth.  Hair grows in cycles which are unsynchronized and are affected by your hormones, your genetics, your health, and your weight. Hair growth is much like looking at a giant iceberg.  What you see above the surface is only a small portion of the amount of active hair your body currently grows.

Before and after an electrolysis treatment, you need to take care of your skin and stop all tweezing and picking of the hair and skin. Hair can be shaved, but the length must be at least one-quarter of an inch prior to treatment. Skin must be kept clean. Avoid touching the skin after treatment.  Avoid unsanitary practices such as resting the phone on your freshly treated chin, applying lotions or creams for massage or facials, lying on gym equipment, or swimming and hot-tubbing – as these actions can introduce bacteria onto the freshly treated area.

Electrolysis is a time-tested method and is the most permanent method for hair removal.  You will love the results.

Infectious Diseases: TAPE 2015

16 May
DISEASE # OF NEW INFECTIONS PER YEAR IN THE U.S. OTHER INFORMATION
COMMON COLD 200-400% (People average 2 to 4 colds per year) Colds are contagious, but most electrologists will continue to work.  Handwashing, facemasks and over-the-counter medicine are helpful.
INFLUENZA 62 MILLION Vaccines are available but not always adequate in prevention.Electrologists must take time off.  Rest and fluids are important for a quick recovery.
HSV-2 (GENITAL)HSV-1 (ORAL) 24 MILLION UNKNOWN More than half a million people worldwide have HSV-2.  90% of all people have one or the other of HSV.
HBV 10 TO 30 MILLION .7% transmission from occupational exposures to blood.   (not from needlesticks)
MRSA 1.2 MILLION                                       94 THOUSAND INVASIVE 1 in 3 people carry the staph bacteria.                 2 in 100 people carry MRSA.
C. DIFF 450 THOUSAND Almost all cases are caused by the overuse of antibiotics.
HIV 50 THOUSAND Numbers are stable to decreasing.
HCV 17 THOUSAND Numbers are decreasing.
TB 10 THOUSAND TB is curable, but kills 5000 people every day.
MEASLES UNDER 500 So contagious that 90% of unvaccinated people exposed will get it.

True Tales from the Electrology Treatment Room

1 Mar

Today, a new client came in. She’s young, she’s very attractive, and she’s so very thrilled there is a solution to what she feels is a horrible problem. You see, she almost has a whole face beard. If comparing to the Ferriman-Gallwey rating scale, she’s a 3.  (0=no visible hair; 4=full face terminal hair)  It’s bad enough that she gets worried someone will see this hair. She’s afraid of intimacy because of what a guy might think about her if she reveals the fact she has to shave beard-like hairs every day. She’s afraid her friends might see the shadow that appears by 5 o’clock. She’s afraid that someone at work will say something about the hair on her face. She cries because it is so personal and so painful.

She cried in my office because she is so happy to see the solution to her problem. 

A consultation in my office includes a short, sample treatment so one can see how it feels and how their skin reacts. She says, “Is that all it is?  I can do that.” We discuss the plan and she says, “Yes.”

It’s about hope. It’s about confidence. It’s about permanent hair removal. Electrology treatments have performed permanently for any hair color and any skin tone since its inception, circa 1870s.

Tags: , ,

2014 in Review

30 Dec

The WordPress.com prepared a 2014 annual report for this blog.

Here’s an excerpt:

A New York City subway train holds 1,200 people. This blog was viewed about 4,200 times in 2014. If it were a NYC subway train, it would take about 4 trips to carry that many people.

Click here to see the complete report.

Ethical Behavior in a We-Kill-Hair World

3 Nov

Many people face ethical issues every day without consideration of it being “ethical” or “unethical.”  An example would be when you drive in your car:  Do you never speed?  Do you speed a little or speed a lot?  One person would never, ever consider breaking the speeding law, while another thinks nothing of speeding “a little” – but would consider speeding “a lot” as wrong.  This collection of ethical situations stems from many years of watching, listening, and reading what others do or say about ethical behavior in the hair removal industry. 

Ethics is a system of beliefs which allow us to determine the right and wrong actions in our everyday lives. The word “ethics” comes from a Greek word meaning “custom” or “habit.”  The habits we practice influence our own perception of ethics, and we view other’s behavior by comparing them to ourselves. For many, the level of “wrongness” is the determining factor in their feeling bad or good about their own behavior while sometimes judging others harshly for similar ethical actions.

Spend a little time on Facebook and you will be asked to take a survey to discover your hippie name, your animal spirit guide, which ancient philosopher best represents you or which character are you in the Hunger Games movies?  The survey for this article provided none of the fun results but provided an interesting story on the perceived ethical behavior and self-reported ethics of 100 hair removal professionals.  The breakdown of respondents is as follows:  44% practice only electroepilation (electrolysis, thermolysis, blend with needle/probe); 44% perform waxing; 4% perform IPL hair removal; 3% perform laser hair removal; 1% performed threading; and 4% practice equal amounts of electroepilation and one other method of hair removal.   

beauty

Hair removal services are a booming business in most cities. An article in Entrepreneur Press names ELECTROLOGIST in the list of “employees you’re likely to need for the day-to-day functioning of your new business.”  Salons, spas, and hair removal clinics offer various methods of hair removal.  These small businesses rely on advertising to bring in the clients and as a result they hire employees and pay taxes.  When consumers interact with a hair removal business, their first question might be about the cost, but they should want to know if this individual is providing excellent work and if they are being honest about their credentials and the results of their offered services.  Consumers might not care to learn if their service provider is a gossip or if they are cheating on their taxes.   

Four questions were at the core of this survey on ethics in the hair removal industry.  1.  How important is it to practice good techniques and skills?  2. Are respondents promoting themselves, their skills and businesses in an ethical manner?  3.  Is gossip and disparaging speech a problem within the profession?  4. Are respondents honest when claiming income and paying taxes?

For this survey, respondents were first asked if choices they make should be considered a measurement of professional ethics.  Over 90% of respondents considered the choices they make in performing services (94.95%); advertising and promoting services (93.94%); and dealing with or speaking of colleagues or competition (96.00%) as a measurement of their professional ethics. 13.27% said that choices made in reporting income and expenses should NOT be considered a measurement of professional ethics and 7.14% were not sure about this subject.  (Note that 79.59% of respondents considered choices made in reporting income and expenses were a measurement of professional ethics.)

When asked their opinion about the action of other hair removal professionals, 79% of respondents stated practicing poor techniques and skills reflected negatively for the whole profession. The survey allowed respondents to comment on behaviors they witness, and practicing poor techniques and skills was frequently mentioned as a problem.  Word-of-mouth reviews can make or break a business, and often, the negative word-of-mouth for a service offered in one business can cross-over to other similar businesses.  Twenty percent of respondents answered that practicing poor techniques and skills reflects negatively for the individual, and one percent were not sure.  Two-thirds (66.33%) of respondents answered that other’s misrepresentation of themselves reflected negatively for the whole profession and over half (55.56%) answered it reflects negatively for the individual when speaking negatively about colleagues or competition. When it came to under-reporting income, 49% answered that it reflected negatively for the individual and 19% answered, “I’m not sure.”

When asked which types of unethical behavior they believe exists in the hair removal industry, a long list was provided for respondents to select from.  The most commonly chosen answer was “Using unacceptable infection prevention practices such as double dipping and lack of sterilization/decontamination.” Other selections included a list of other poor skill practices; types of misrepresentation of education and training; speaking negatively about others; and stealing product, equipment or business from others. Respondents were not asked how often these actions occurred. One respondent wrote, “I know of all the above I’ve checked, but I don’t think it’s an industry standard.”  Another answered, “I think some of these things are done out of ignorance rather than maliciousness.” 

The survey asked, “Which of the following best represents you?”  Respondents were asked if they were more, just as, or less ethical than others. Sixty-two answered they were more ethical than others and four of those respondents answered NO to the first question of the survey: “Do you consider the choices [you] make in reporting income and expenses as a measurement of professional ethics?”  According to NOLO.com the most common way people cheat on their taxes is by deliberately under-reporting income.  Oscar Vela, Ph.D. concluded in his 2008 dissertation on “Tax Compliance and Social Values” that taxpayers stay honest in reporting income largely since that honesty keeps them from losing income, and professions which place the greatest significance on integrity are the least likely to cheat on their taxes. 

The writers of Freakonomics featured theft of wood from the Petrified Forest in several of their podcasts. It seems four times as many visitors stole wood from the forest when there were signs stating “Many past visitors have removed petrified wood from the park, changing the natural state of the Petrified Forest” than when the sign said “Please don’t remove the petrified wood from the park in order to preserve the natural state of the Petrified Forest.”  Amazingly, less wood was stolen when there were no signs.  Robert B. Caldini concluded in his article “Crafting Normative Messages to Protect the Environment” that public service communicators should avoid sending messages that a targeted activity is socially unacceptable but widespread because it causes people to believe that “a lot of people do it, so I can too.”

This article is not written to change the behavior of hair removal professionals, but to propose the definition of an ethical member of the hair removal profession would be one who has character traits that foster the principles of integrity, fairness, compassion, honesty and kindness.  It is a privilege and obligation as a member of this industry to obtain the best education we can and to continue learning – even when licensing and training does not always exist where we live.  It is a privilege for us to speak honestly and fairly about ourselves and others – even though it may be a tough habit to change.  It is an obligation for us to follow the laws of our local, state, and federal government – especially since we are not populated with law breakers.

How do we define our own ethical boundaries?  How do we perceive levels of ethical behavior in other people?  Anyone who has watched Les Miserables can see the “crime” in sending the starving Jean Valjean to prison for stealing a loaf of bread. After prison, he can only live by stealing, but once shown the compassion from a good man becomes a good man himself.  In Breaking Bad, Walter White decides to make and sell meth in order to secure his family’s financial future after a cancer diagnosis.  While both of these men are considered criminals, we sympathize with Jean Valjean, and while we might root for Walter White in some ways, his choices should make us uncomfortable.  In the end, Walter White admits his crimes made him “feel alive.”   Are ethical behaviors simply a way to feel good about ourselves, i.e. not cause ourselves guilt, to feel superior to others, or are ethics a gray area?

If you think ethics is bunk, but perhaps wisdom is your bag, visit this TED Talk where Barry Schwartz talks about using wisdom but not teaching ethics or watch this PhilosophyBasics video on YouTube. 

There’s No Business In No-Shows

16 Jun

INTRODUCTION

This article provides a snapshot of statistics, attitudes and policies on the subject of appointment no-shows reported by a sample population of electrologists from around the world.  The survey was available to electrology professionals in several social media settings.  The problem of no-shows is a universal problem – it does not just happen in the hair removal industry.  Most consumers respect their electrologist enough to provide appropriate notification if they cannot come to an appointment.  It’s only a small percentage of consumers who seem to be disrespectful and cause financial loss to their hair removal provider.  The biggest problem with no-shows is that lost revenue can result in an increase of overhead which contributes to increased prices for all clients to cover that loss.

NO-SHOW DEFINED

A NO-SHOW is a person who makes an appointment and neither shows up nor cancels.  Appointments are made upon the request of the consumer and it is the consumer’s responsibility to show up or cancel with appropriate notice.  Many personal service providers, including electrologists, make a living from appointment driven businesses.  These scheduled appointments establish an agreement or contract for purchasing time, which if missed by the client is time that cannot be sold again. As a result, the service provider experiences a loss of income that cannot be made up.

OFFICE POLICIES     

An appointment no-show policy is one of many boundaries a business must establish.  These boundaries should be clearly communicated to each client before they receive their first treatment.     Electrologists were asked if they had a written policy on no-shows and how their clients learned about these policies.  Nearly 30% of respondents reported they did not have a written policy for no-shows.  However, those respondents were not lenient when clients failed to show up for appointments  – the client paid for the missed appointment or they were not given future appointments. More than 70% of respondents reporting having a written policy for no-shows. Half of all respondents utilize several methods of communicating their no-show policy.  59.9% provide consumers a written copy at the first appointment; 31.82% display it on their website; 27.27% have it on their business card; 18.18% explain it during a phone consultation; 13.64% include a link to their policy in each email confirming the appointment; and 4.55% provide a written copy at each appointment. Generally, clients are considered a no-show after 10 to 15 minutes.  Most electrologists (77.27%) will try calling the client within this time.  Here are some of the messages electrologists reported to send a client upon a missed appointment:    

Watching the Watch

Missed You!

“I tell them I was sorry that they missed their appointment…”

“Want to make sure you are ok since you missed your appt.”

“We were expecting you in for an appointment at … time. We would like to remind you of our cancellation policy. Please contact us when you get this message in order that we can reschedule your appointment.”

“Hi… , I have u booked with us today at… and it is now….  I was wondering if you are on your way, or are experiencing difficulty attending your appointment. Pls call me back on… to let me know.”

“I wanted to make sure we had an appointment today. I had you down for 11am, but perhaps there was a misunderstanding. Just wanted to make sure you were not thinking of coming another day, as I may have a client already scheduled. Please let me know that you are okay.”

LOST REVENUE

There is a difference between the client who misses one appointment out of many and the client who has repeated difficulties getting to their appointment.  We all make mistakes, but the client who repeatedly fails to show up causes a financial burden to the business.  The frequent no-show client should probably reconsider their priorities when it comes to making that appointment. A few respondents take a hard-line when clients fail to show from the beginning.  Nearly 5% require that after one no-show clients are expected to pre-pay for all future appointments.  One electrologist wrote, “They are warned about my lost income and told they will pay for any missed appointments in the future.”  Nearly 15% require that clients will pay for every missed appointment from the beginning; over 18% warn the client about the lost income and expect to be paid for any missed appointments in the future; nearly 14% allow a certain number of no-shows before firing the client; over 27% allow a certain number of no-shows before charging the client; and under 5% do not consider no shows a problem, so the client is not penalized or fired.

ADVICE FOR THE PROFESSIONAL

Here are some tips gathered from your colleagues: 

  1. Consider letting the first missed appointment go without charging the client.   Make it clear in your written policy that “events can occur unexpectedly and, therefore, a one-time missed appointment will not be charged.”
  2. Consider implementing a “three strikes you’re out,” rule and terminate clients who are chronic no-shows.
  3. Excuse missed appointments if the client has a true emergency.
  4. State that future visits may not be scheduled until the missed appointment fee is paid.
  5. Make sure your clients know your office policy on no-shows and late cancellations. 
  6. Confirm, confirm, confirm.  Give clients the chance to give you notice. Confirmation can be in the form of a reminder call, an email, or text message. 
  7. Reward the good client.  They get priority over the “bad” client. 
  8. Train your clients into behaving better.  Ask that client who is always late or is habitually standing you up, “Are you making me a promise you’ll show up at that time?” You’d be surprised how that stops people in their tracks.
  9. Gift your clients with a calendar.

DEALING WITH THE NO-SHOW CLIENT

One respondent shared her message to clients who become habitual no-shows:  “As an electrologist my livelihood is made by making and keeping appointments for my clients. When a client repeatedly fails to keep their appointment then the time and income are lost forever unless they agree to pay for each missed appointment.  For that reason, some clients will be declined future appointments.”

  1. Have the client call on the day they wish to come to see if there is an opening. (No pre-booking.)
  2. Make this client the last appointment of the day.  If they fail to show, the evening starts sooner.
  3. Fire them.  Be firm and polite in letting them know their needs might be better met by a different electrologist.  This client isn’t just wasting time – they are costing money.

ADVICE FOR THE CONSUMER

Remember that most electrology practices are owned by women who help support their family.  These businesses require a significant amount of training and the maintenance of expensive equipment.  The relationship between client and electrologist must be one of trust.  The client trusts that the electrologist will use their best skills to provide permanent results in the shortest time possible and the electrologist trusts that the client will follow the recommendations for treatment, which includes showing up for every scheduled appointment. The “rules” for clients are simple:

  1.  Know the office policy on no shows and late cancellations.  If you can’t live with the stated policy, select another provider.
  2. If you aren’t sure, confirm or decline the appointment.  Permanent hair removal takes a commitment on your part, but remember that postponing treatments will postpone completion of your treatments.
  3. Keep it or cancel it.

CONCLUSION

During the time I’ve taken to put this blog together I have had some very significant no-show losses, which almost made it seem like my focus on the subject made it happen! (I know, I know…it was simply a coincidence.)  Then a colleague wrote she was so embarrassed – she’d slept late and missed an appointment with her eye doctor.  She was thinking she wouldn’t call and could never go see them again.  For me, this was the moment of clarity, as the day before I had two no-shows.  My clients receive an email reminder 48 hours in advance of each appointment so they have no reason to give me less than 24 hours’ notice to cancel.  One client had two four-hour appointments a week apart and 36 hours before the first appointment she responded to my email reminder, “I have to cancel.  I am very sorry.” My response was, “See you next time,” but a week later she did not show, so I called to ask, “Are you on your way?” as she still had time to come.  No response.  I then emailed “missed you,” (which sets the appointment as a no-show in my scheduling system). No response. The other client received the “missed you” email and she immediately texted back, “I’m so sorry!”  The clarity came to me when I realized that an apology for missing an appointment goes a long way in my feeling charitable towards the client who misses.  Did the first client mean to say she was cancelling both week’s appointments?  It certainly wasn’t clear to me, and because of her failure to communicate I don’t want this client to return, as she does not respect me or my  business.  The amount of time lost doesn’t help me forgive this client, but an apology would have gone a long way.

← Older Entries