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Dear Bette: In my early years of electrolysis practice, which began in 1969, bruising in the eyebrow area happened more often than I would have liked, but with experience and many years of continuing education, bruising is almost a thing of the past for me now. Nevertheless, knowing that bruising can occur when treatment is given under the eyebrows, electrologists must strive to stack the odds in their favor, and I always instruct brides-to-be to get their brows treated at least a week before the wedding day. Treatment protocol for us begins with the Client Health History Assessment, which is completed prior to treatment. Firstly, the electrologist should always list the medications the client is currently taking, or that have recently been taken. Drugs like aspirin, arthritis medications, and blood thinners, (prescribed to avoid strokes), can lead to excess bruising. That is why physicians ask clients to discontinue these for a few days prior to surgery. It is wise to check the side-effects and precautions pertaining to each of the medications the client is taking. This can be done online, free, at sites like www.pdrhealth.com or with a current copy of Physician’s Desk Reference (available at most book stores). Each medication the client is taking should be checked to see if it is contraindicated for persons with ulcers, intestinal bleeding, etc. If it is, the client will possibly be more prone to bruising. The “side effects” section should also be checked for precautions involving bruising. I always ask clients if they have a tendency to bruise easily, or if they have ever had a problem with blood clotting slowly. If they have, I explain that bruising is possible in areas where the skin is thin, and advise them that plans for upcoming special occasions should allow for such an eventuality. When drug research reveals that a certain medication might pose a problem, I ask them to speak with their physician about the possibility of substituting another drug, that would not have that effect, or if that is not possible, have them ask the prescribing physician if it would be OK to omit taking the medication the day before treatment and on the actual day of treatment. Age is another important item of client health history. Most clients over the age of 55 have skin that is beginning to become thinner. Special precautions must be taken when working in the eyebrow area of these clients. Also at some risk, are the very young clients, aged 12 to 18; their skin is more delicate than mature skin. As to the question about acupuncture: I’ve treated the brow area of many persons who have had the acupuncture apparatuses in their ears, without ever observing any adverse effect on the eyebrow treatment. In fact, when my own eyebrows were being treated, I was using the ear acupuncture at that time and had no bruising. That said, it is always wise to check with the client’s provider of any type of medical treatment if you are in doubt. The dermis and epidermis are typically very thin in the eyebrow area, and the follicles are quite shallow. And while it is important to stretch the skin for a proper insertion, care must be taken not to place too much downward pressure on this thin tissue. The follicles here are typically shallower than those in other treatment areas, so care must be taken to not insert too deeply, and to make forward insertions, which are more easily controlled than backward insertions: We must move around the client’s head until we can make a comfortable, well-controlled insertion. If a client presents with a flushed face caused by recent exercise or time in the sauna or steam room, the blood vessels will be more dilated, and therefore, more easily penetrated. In Southern states, where the summers are very hot, just riding in a non air-conditioned vehicle can cause this dilation of blood vessels. If this happens, I give the client an ice pack to cool the skin prior to treating the brow area. If the client presents with sunburned skin, we don’t give treatment until the redness has subsided. Also, attempting to lift ingrown hairs in the brow area (I know it is tempting at times), should be avoided – it’s very difficult to accomplish without bruising. Work in the eyebrow area calls for a .002 needle (or a size no greater than .003) with a smooth rounded tip, rather than a sharp pointed tip that is more apt to puncture the papilla and cause bleeding. Furthermore, we must ensure that enough milliamps of current are available to properly cauterize the follicle. If bleeding does take place, and the epilator intensity setting is not high enough to immediately cauterize the treated follicle, bruising will occur. Should a bruise occur, the electrologist must immediately apply enough pressure – with a gauze pad or cotton ball – to prevent additional bleeding/bruising. An astringent substance, such as witch hazel, will help to close the follicle opening faster; and the client will appreciate an ice pack (easily made with a 3 inch by 3 inch plastic bag with a couple of ice cubes or crushed ice in it) to put on the bruise for five minutes or so. I always advise clients to avoid saunas, hot tubs, Jacuzzi’s and hot showers on the treated area for the first 24 hours to reduce post-treatment erythema. These measures will help minimize the size of the bruise. |
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