The electrologist is ethically responsible for the skin before, during, and after treatment. The professional will clean the skin before beginning treatment, and will take care not to burn the epidermis during treatment. It is just as important to consider carefully what aftercare products to use. Whether the electrolysis treatment is a simple 15-minute chin area or a 1-hour abdomen with ingrowns, erythema, edema, and/or eschars can occur. Effective aftercare can speed healing, reduce redness and swelling, and either prevent the formation of eschars or reduce both the size and number of eschars that might form due to the type or duration of electrolysis treatment.

 Benefits of proper aftercare

Electrolysis treatment destroys tissue. The byproduct of this destruction is inflammation. Inflammation is the local reaction of living tissue to injury or trauma. Electrolysis traumatizes the skin and causes inflammation even though no significant amount of bacteria is present. The symptoms of inflammation are heat, redness, swelling and pain. Yet, inflammation is important because it stimulates the body’s immune system to begin the healing process. The wound healing process protects the tissue from bacteria, eliminates damaged tissues, and rebuilds and repairs the damaged epidermis. Effective aftercare can assist this process by preventing infection of the treated area by opportunistic bacteria by blocking access to the weakened tissue – thus protecting the skin while it is healing. It can stimulate the production of collagen and elastin and new skin cells. In addition, effective aftercare keeps the skin moist by either preventing evaporation of moisture or by attracting moisture to the skin. Sometimes it is possible to do both.

Properly applied, aftercare ensures that inflammation will subside quickly, the skin will return to its normal appearance, and clients will be able to resume normal activities sooner – without long-term negative results such as pitting, hypertrophic scarring or post-inflammatory hyperpigmentation.

Selecting products for aftercare

Electrologists today are fortunate to have a number of effective aftercare products available to them. The active ingredients in these therapeutic products are usually naturally derived, and the skin is able to safely absorb them. They are also fragrance free, as a rule, and the amount of preservatives (either naturally occurring or synthesized), is minimal.

Before purchasing any product, we must consider our objective: helping to speed the skin’s healing process. There are basically three major types of skin that electrologists are required to treat: dry, oily, and “normal.” However, combinations of these types seem to be prevalent in hirsute skin. Also, there are a number of other factors that must be taken into consideration before work can begin: Is hyperpigmentation and or pseudofolliculitis present? Are the hairs thick and dense? What modality will be used? Will the area require treatment times that are longer that 30 minutes?

The electrologist must also anticipate the client’s after-treatment concerns. For example: (a) Will clothes cover the treated area and dehydrate the skin? and (b) Is the client going directly home after the treatment session, or returning to work? Situations like these will influence the practitioner’s decision as to what product is best suited to the case at hand. This does not mean that the electrologist has to spend enormous amounts of money on multiple products, but there should be a choice of at least two or three products in stock. If nothing else, this solves the “allergy question.” For instance, if only aloe vera gel is available, and the next client is allergic to that product, that treatment is negatively compromised.

Reading is fundamental

All product labels should be read carefully. Certain substances are able to penetrate the epidermal and dermal layers of the skin and are absorbed into systemic circulation through the hair follicles and sebaceous glands. This mechanism is called the pilo-sebaceous apparatus. Percutaneous absorption is the result. The base ingredients will either encourage percutaneous absorption or they will hinder it. The absorption base should not only allow active ingredients such as vitamins or collagen to penetrate the skin’s surface; it should also act as a humectant, an emollient, a barrier agent or healing agent.

Ointments are greasy protective products. The grease is usually petrolatum or petroleum jelly. It is a barrier agent, highly occlusive and can cause comedones, but it will release active ingredients to the skin more effectively than any other vehicle. It has the added advantage of retaining moisture in the skin.

Creams and or lotions lubricate the skin and hold in some moisture without occlusion. They are greaseless and do not appear shiny on the skin, nor are they sticky to the touch.

Gels are also greaseless but their alcohol content may cause drying.

In the U.S.A., the ingredients in these products are listed on the label in the order of their percentage amounts. In other words, the substance that makes up the greatest part of a formula appears first in the list of ingredients, and the substance appearing last on the list is present in the smallest amount.

Product ingredients to be avoided (because they can cause acne by clogging pores and irritating the skin) are lanolin and lanolin oils, mineral oil, isopropyl myristate, sodium lauryl sulfate (sometimes used as an emulsifying agent), laureth-4 and D&C red dyes. However, if the major ingredients of a product meet an electrologist’s treatment needs, and if the questioned ingredients are listed near the bottom of the list, the product can be used with caution.

Cocoa Butter, mineral oil, petrolatum and lanolin probably should not be used on the face of a person with oily skin, but they may work very well when used on the body. In any event, all products should be tested on a small, inconspicuous area of each person’s skin (to rule out allergies or undesirable reactions) before they are used extensively for the first time.

The labeling on the different products usually contains ingredient information that, while confusing to the uninitiated, can be quite helpful once you have a basic understanding of the nomenclature. Some of the more common terms are as follows:

Humectants – control the moisture exchange between the product and the air. They attract moisture, and also have the ability to release water gradually. Ex: sorbitol, glycerin.

Emollients – lubricate and soften skin tissue, preventing dryness and protecting skin. Ex: coconut oil, olive oil, avocado oil.

Astringents – make organic tissue contract. Ex: witch hazel and pure aloe vera gel.

Antioxidants – inhibit the oxidation process, thereby reducing the number of free radical oxygen molecules that break loose in biochemical reactions. These radical oxygen molecules break down, damage and can mutate other cells. Antioxidants “eat” these free radicals. Ex: Vitamin A, C, and E.

Essential oils – raw materials used as active ingredients in products or alone. They can be natural or synthetic and of plant or animal origin. Ex: Tea tree oil, peppermint oil.

Moisturizers – when used externally, act to raise skin moisture content.

Exfoliants – mechanically or chemically remove dead skin cells. The process is called exfoliation. Ex: Resorcinol, alpha hydroxy acid, loofa, enzyme peels.

Alpha hydroxy acids (AHA) – fruit acids – these products are derived from sugar cane (glycolic acid), apples, grapes, citrus, and buttermilk solids. They loosen the intercellular cement between old and new epidermal cells, and then dissolve the dead surface cells, exposing the newer skin. AHAs also help to loosen blackheads and dry out pores, and assist in combating hyperpigmentation and ingrown hairs.

Beta hydroxy acid – salicylic acid. Works on the surface to dissolve dead skin cells that are loosened by AHAs.

Proteolytic Enzyme – protein digesting enzyme that selectively digest only dead skin cells. Ex: Papaya (papain), pineapple (bromelain). These products are gentle and do not cause microscopic tearing, as crushed fruit pits are prone to do.

What really works?

Immediately after electrolysis, the treatment area should be disinfected before applying ointments, gels, lotions or creams. Hydrogen peroxide 3% works well for this purpose. Below are some of the products and or product ingredients that have been tested in my office, and a review of some suggested products. Remember, to avoid or minimize potential allergic reactions – to any new product, or on any new patient – apply the aftercare product in a small inconspicuous area before beginning electrolysis treatment.

Calamine lotion – in the textbook Electrolysis, Thermolysis and the Blend, the authors refer to calamine lotion as the “old standby.” They also point out that this product is very drying and that it can promote the production of eschars. For these reasons I have never used it as an aftercare product.

A & D ointment/A & D ointment with zinc – many electrologists, some with many years of experience, recommend this product but without the zinc. I was apprehensive because its base is petrolatum. However, I have been pleased with the results on dry skin, body areas such as the bikini line, abdomen, arms, fingers and toes, and as the final layer on the face after multiple hour treatments. It contains the antioxidant, vitamin A, and the skin-soother and healer, vitamin D. The petrolatum acts as a barrier to bacteria and seals in moisture. The formulation with zinc gives it anti-inflammatory properties and may help with the absorption of Vitamin A. It does leave a white film that clients may object to if they are not going home directly after the treatment.

Aloe vera gel – is a natural oxygenator, drawing and holding oxygen in the skin. A natural astringent and antioxidant. It is pH balancing, soothing, and protective. It also has remineralizing properties. There are many brands available. Make sure that aloe gel is one of the first ingredients listed on the label, and that the formulation does not contain lots of waxes or dyes.

Colloidal sulfur – reduces oil gland activity, redness, soreness and swelling.

Vitamin C – now widely available in concentrated serums. Many can be found in magazines that serve the cosmetics and esthetics industries. The serums can be expensive, but the results can be stunning! Skin redness may be reduced in a matter of minutes; soothing and healing begins almost immediately.

Zinc oxide – temporary protection of minor burns. Very heavy and occlusive. Mixed with aloe gel I have used it on the abdomen.

Tea tree oil – long used as a disinfectant for minor cuts, and for its soothing effects. Many electrologists and esthetics practitioners use Australian tea tree oil in their work and highly recommend it for its non-drying, mild antibacterial and antifungal properties. However, it can cause skin problems for some people. A study of tea tree oil conducted at the University of Hawaii School of Medicine, Honolulu, in 1995, found that allergic reactions to concentrations as low as 1-percent were experienced by some people who used it topically. As with many essential oils, it can easily be diluted, but anyone with sensitive skin or eczema is well advised to steer clear of strong solutions of the oil.

Calendula (marigold) gel – I tried the calendula ointment but it was too thick and I found it did not spread over the area easily. Calendula is an emollient, which soothes, and helps promote healing of burns and irritations.

Camphor – is an antiseptic and analgesic that calms the skin and reduces redness.

Bladderwrack extract (seaweed) – rich in trace minerals and amino acids, it helps balance and remineralize the skin. It is soothing, reduces redness and promotes healing.

Allantoin (comfrey) – healing agent and humectant that promotes cellular renewal.

Antibiotic ointments – I prefer those with triple antibiotics and zinc. They usually contain neomycin, polymyxin B sulfate, and zinc bacitracin.

Menthol – acts as a natural disinfectant and is cooling.

From practical experience, and from researching the ingredients found in different formulas, electrologists can select the most appropriate after-treatment product for each client. The client’s personal skin type, and the specific body area being treated with electrolysis, are important factors in this decision-making. Drying products seem to work better on overactive, oily skin, and dry skin seems to respond better to moisturizing products.