10 replies to this topic

[~Chris~]

I'm wondering if laser hair removal, or electrolysis, or any other hair removal method could permanently get rid of Trichostasis Spinulosa. It really bothers me. I'm using Retin-A but it doesn't really make it disappear, it just... helps.

I asked my dermatologist this question, and he gave me half an answer. He seemed to think laser hair removal would cause scarring, and I would be less happy after then before...

[fivetotenyears]

Can I ask how were you diagnosed with TS? Biopsy?

If the TS looks like small blackheads then fraxel would probably clear the plugs, though they may return depending on the cause.

As for Laser Hair Removal it is likey to exacerbate things:

-Laser only works on terminal hair. It would do nothing for laguno hairs which cause TS.

-The laser would cause irritation and increased sebum production on your face (LHR
removal on my face gave me such bad acne I went on accutane).

-Even if the LHR somehow magically worked on laguno hairs they wouldn't be able to shed since the pore is blocked with a keratin plug = infection and irritation.

-If you do laser hair removal on any of your beard area (I assume you are male and old enough to have terminal beard hair) you WILL experience patchy hair loss. The regrowth is likely to be grid-like. It will look like you shaved notches in your beard hair. It will even be apparent when you are clean shaven.

I speak from experience. I had laser hair removal done on my beard. It did not work well at all. I had no acne problems before the procedure. I endured more than a dozen treatments over the course of two years. In that time I experienced horrible acne breakouts and clogging of my pores. My oil production went crazy. I started getting huge blackheads. I used to squeeze beads of hard sebum out of my pores with burnt hairs embedded in the middle.

The worst part is:

1. The hair grows back. Go to the FDA website and see how they define the word "permanent". Permanent simply means a period of time equal to or greater than one growth cycle of hair (2 months to 2 years depending on area of the body).

You'll notice no laser company guarantees any longer than 2 years. Because they now it will grow back. My laser company got sneaky and said "Well then we will give you a 3 year guarantee". However that 3 year guarantee started at the beginning of my treatment. And they new that it would take two years to complete the treatment. So it ended up being only a 1 year guarantee! Keep in mind there are NO clinical studies that show laser hair removal is truly permanent.

Nor are there any clinical studies which show that laser hair removal produces 100 percent clearance. In other words you will always have A LOT of hair in the area where you get treatment. Which brings me to my second point:

2. The hair loss is patchy and not uniform. All laser hair removal devices use a stamping technique. Which means the laser shoots out a circular spot and it is the technician's job to move it across your face. There is supposed to be slight overlapping to ensure there are no missed spots.

However there will always be missed spots! It's impossible to be that careful. And not even a doctor who draws a grid on your face will give you 100 percent coverage. Even after several treatments.

The other factor is that even if an area is zapped by the laser hair removal beam that doesn't guarantee all the hairs in that area will fall out and not grow back. Only some of them will fall out. And even less will not grow back.

If you are able to put up with extended treatment you are likely to end up like me with patchy hair all over your face. People will look at you like you shaved notches in your beard or are just some kind of freak. You will curse the day you ever got laser to begin with.

Here's my picture if you still don't believe me

Attached Thumbnails

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[~Chris~]

Can I ask how were you diagnosed with TS? Biopsy?

If the TS looks like small blackheads then fraxel would probably clear the plugs, though they may return depending on the cause.

As for Laser Hair Removal it is likey to exacerbate things:
-Laser only works on terminal hair. It would do nothing for laguno hairs which cause TS.
-The laser would cause irritation and increased sebum production on your face (LHR removal on my face gave me such bad acne I went on accutane).
-Even if the LHR somehow magically worked on laguno hairs they wouldn't be able to shed since the pore is blocked with a keratin plug = infection and irritation.

That's really disappointing... =\ I still can't believe there's something as seemingly simple as TS that can't be removed in the year 2007.

Well I was diagnosed with TS by my dermatologist. He looked at my nose through a large magnifying lens. The black dots are very small, but it still makes the skin on my nose look uneven, and its not pretty up close.

*looks up what "fraxel" is*

Thanks for the reply btw, I appreciate it.

~

Reply to edit.

Well I'm not having the beard area treated, it would be my nose only. So you think I would probably have results on my nose like you have on your chin? That sucks... Man I'm so depressed about this, I wish I could just get rid of it.

[fivetotenyears]

The problem is not so much that you have laguno hairs in the pores of your nose. In fact everyone has this. The issue is that your pores are blocked.

I read a clinical study of sebaceous filaments in peoples' noses, along with another study on Biore pore strips and what they actually remove. Both studies showed that the pores on people's face, esp. nose are filled with several tiny vellus hairs. That is unless the person has a thick terminal hair growing out of the pore (in which case there is only one and occasionally two per pore).

Both studies showed biopsies of pores and pictures w/ magnification of the extracted sebum plugs. Mind you these where all from healthy volunteers. And these people all had sebum plugs with vellus hair in them.

(Laguno is really a term that only refers to the fine hair that is sometimes present on newborns due to increased hormones in the womb. It's a visible body hair with pigment and the hair can sometimes be quite long. It sheds n the weeks after the babies are delivered. I'm not sure why all definitions of TS call it Laguno hair when what they really mean is vellus hair.)

[fivetotenyears]

How bad is your condition? Is it confined to your nose? T-zone?

If you surf this board you will see that most everyone gets those sebum build-up in the pores of their nose. How bad it is (and how much it bothers you) depends on a number of things. Sometimes it improves with age, although if it is a genetic issue it may get worse!

People due various things to treat it:
-Exfoliation
-Pore Strips
-Picking
-Medication (Acids, Retin-A, Tazorac, etc.)
-Make-up
-Lasers (Ablative, Non-ablative, Fractional)
-Moisturizing
-Diet restriction (No Milk, Less Oils)
-Vitamin restriction (No Fish Oil or Flax Oil supplements)
-Vitamin Supplementation (Vitamin A, B5, Accutane)

I include Accutane as a vitamin because it is essentially a chemically modified form of Vitamin A which makes it less toxic. I had a round of Accutane and it completely stopped the sebum plugs I was getting on my face, chest, and back. The only place I still got them was on my nose and upper cheeks (although greatly reduced).

After some experimenting I found that Fish oil and Flax oil capsules I was taking with my vitamins were causing granular (sand like) sebum plugs on my nose. I stopped the oil capsules and the sebum stopped immediately and has been completely gone for months. My pores are closed and my nose has not been this smooth since before puberty.

I was also still getting acne and eczema after Accutane. So I experimented with cow milk and dairy exclusion from my diet. Sure enough I found that dairy was giving me both. I stopped cow dairy several months ago and drink soy milk now. I haven't had one pimple since then. Not one! I also feel much better physically. The milk was absolutely contributing to skin inflammation and I suspect digestive too.

As an added bonus I now only have to wash with tepid water and the only product I use on my face is Cetaphil cream every morning and night. Moisturizing is essential. If your skin dries out then you get easily irritated. Your body also starts producing more oil to try and compensate. I never go more than a min after washing my face without applying some moisturizer.

The only problem I have with my skin is the patchy hair from laser hair removal. Although over the many months the hair has been slowly growing back.

As I pointed out laser hair removal is not permanent in any way. Anyone who tells you different is a snake oil salesman even your dermatologist. Although some individuals may claim to have prolonged hair loss from it, there are no clinical studies showing it to be permanent. And again, for your face area you have to consider the patchy effect.

I wouldnt do Accutane for TS unless your skin is otherwise oily and you have acne problems (although maybe a super low dose might be safe).

I hope you read all this and try at least diet restriction and some topicals. I hate to see you go through what I did with laser hair removal.

[fivetotenyears]

Like I said, Laser Hair Removal will do nothing for your nose. It only works on terminal hair (thick dark course hairs like the one's on your head). The laser is attracted to the pigment in the hair, which is why it doesn't work well for blond haired people. That's also the reason it doesn't work on vellus hairs.

SINCE YOU HAVE VELLUS HAIRS IN UR NOSE LASER HAIR REMOVAL CAN ONLY MAKE IT WORSE!

In fact, studies have shown that when laser hair removal is done on vellus hairs it can have a paradoxical effect, stimulating them to grow into terminal hairs.

Personally, I am Italian descent and have terminal hairs which grow out of the pores of my nose. My father has it quite bad and has to shave his nose. When I went through puberty it started with me too. I plucked them for years. Then decided to try laser hair removal.

These were thick black hairs growing out of the pores on the front of my nose mind you! And Laser Hair Removal was a big mistake. The laser caused a really bad reaction. I believe it was because it made my skin dry in combination with the philosebaceous unit (hair follicle and sebaceous gland) being stimulated by the laser.

I started get to thick yellow sebum plugs that dilated the pores on my nose. I could squeeze out large amounts from each pore about the size of ballpoint pen tip. Some had thick terminal hairs embedded in them. It was really nasty. It lasted for a year until I had enough and went on Accutane.

*Some* of the hairs on my nose did fall out. But several months later most of them have grown back completely. And remember I had over 12 treatments over two years!

I now how you feel when you said "TS that can't be removed in the year 2007". But you have to understand that often times the treatment is worse than the condition. The best thing to do is try some of the things I've mentioned in my above post.

If nothing works and you are really being upset then I would recommend Accutane. Accutane does two things:

1. Normalize the flaking of skin cells within the follicle so it's not hyperactive. And also modulates them so they don't clump and stick together causing a comedone.

2. Reduces the production of sebum (oil) within the pore. Reduces the viscosity of the oil so its less sticky. (The oil is formed when the sebaceous gland cells that produce them explode and die releasing the oil. So the less cells you have producing and exploding, the less cell wall material you get clogging the oil and causing comedones.)

Therefore I really think a low dose, short term course of Accutane may in fact solve your problem.

Another thing that happens on Accutane is that your skin naturally exfoliates itself because the oil production has stopped. All you have to do is keep it moisturized.

I myself and many others on here have experienced the "sand-paper nose" while on tane. Basically after a few weeks to a month, all the crap in the pores of your nose will come to the surface and your skin will feel like sandpaper. Leave it alone and in a few weeks it flakes off effortlessly and your pores close back up.

Hopefully after you stop Accutane, the oil production stays reduced for months to years until your an adult--by which time it will be low naturally.

I'm no expert on TS so you may find that you need a laser to get the plugs out of your pores. In which case I'd think Fraxel would be your choice. Many people on the Fraxel thread report that it caused their blackheads to go away completely especially on their nose. Also some report it makes their pores smaller and skin drier.

The only downside is that you have to choose either Accutane or Fraxel. Because your skin is so sensitive on Accutane you can't do any laser while on it and for an entire year after stopping.

Although I guess you could try Fraxel first then go on Accutane if the TS persists. It's just that insurance covers Accutane and not Fraxel (which is way expensive). So I'd want to try the medication first. The medication would also be treating the cause (too much oil) while fraxel would simply treat the symptom (sebum plugs that are already there).

[~Chris~]

Well my problems started shortly after puberty. I assumed the plugs in my nose that I was sqeezing out was blackheads. That's what they looked like. I ended up just dealing with it for awhile until I finally went to a dermatologist about 6-7 months ago. When he told me it wasn't blackheads, and I couldn't get rid of it, I was pretty shocked. He told me that the Retin A Gel he was giving me for my acne would help it, but nothing would ever get rid of it.

After using RA for months, I've seen most of my facial acne disappear, except on my chin and upper neck, and the plugs in my nose caused by the TS have greatly diminished, however, I still have tiny little holes all over my nose, and each one has a dark spot in it that I can't squeeze out. Its like every hair follicle on my nose has several vellus hairs in it still, and I assume that those can't be removed? The plugging up has been helped, but the TS is still visible. I do have pretty oily skin.

Once again I appreciate all the help. I'm not sure what can be done about these hairs I have in my nose, or whatever it is, but hopefully you know more about it then I do =P.

I could try removing dairy and stuff, but if these are still the embedded vellus hairs that I'm seeing, a diet wouldn't change that would it?

[fivetotenyears]

Did you thoroughly read my post?

The vellus hairs are normal. Everyone has them in their nose pores. The sebum plug is what you should be treating. And not just doing a one time treatment like extraction. But decreasing the source of oil production and stickiness.

[~Chris~]

I understand, but with TS you have a larger amount of vellus hairs in each follicle (about 5-25) than 1, so I have small dark dots and uneven skin all over my nose. That's what's bothering me... I still have some plugs on the sides of my nose (nostrils), and those are more visible then the seemingly clear follicles on the rest of my nose. I notice you say "pores normally have vellus hairs in them", these small holes on my nose that contain the bundles of vellus hairs/sebum plugs, are they hair follicles or pores? Is there a difference?

I re-read your posts. I think you're confusing pore blockage with what I have. TS is when the hair follicles produce and retain several vellus hairs, from what I understand. These hair follicles then become blocked with sebum, I guess. Getting rid of what's visible isn't the same as blackheads, from what I understand. I could be wrong because I don't really understand this condition 100%, but the small black dots all over my nose aren't normal. I just wish I knew of a way to get rid of them.

[fivetotenyears]

A pore is a hair follicle. The medical term is philosebaceous unit (Philo mean shaft and sebaceous meaning oil gland).

Every pore in your body consists of a shaft that goes down to a hair bulb. Along the way sebaceous glands are off to the side of the shaft and empty oil into the shaft. Normally this oil lubricates the hair (if present) and oozes onto the epidermis to moisturize and water proof it.

If the passage way becomes blocked as it often dose than you get acne. Different forms of acne depend on how the pore is structured and how it is blocked.

For instance a blackhead (open comedone) is when the pore is open at the surface and blocked with sebum in the shaft, without the presence of infection (no infection because its open to the surface and air circulates to the plug preventing anaerobic bacterial growth).

On the other hand: a whitehead (closed comedone) is when the shaft is blocked and the skin cells are covering the pore opening. Anaerobic bacteria cause a small local infection and your white blood cells respond to the area. That's why you get that nice white pus head (dead white blood cells).

If the blockage is bad enough and infection bad enough then the blockage/infection backs up to the sebaceous gland itself which can rupture and cause cystic acne.

Anyway, hair bulbs can be dormant or in various other stages (anagen, telogen, etc.). They also can have different types of hairs growing out of them (terminal, medium, pubic, vellus).

Basically all bulbs have vellus hairs growing in them. Hormones and sometimes other factors (medications, diseases, etc.) determine if that vellus hair will grow into a terminal hair.

I'm sure if you have an abnormal amount of vellus hairs in each pore then that makes the sebum get trapped much more easily. However if you reduced your oil production and viscosity with Accutane and diet restriction than it wouldn't really matter.

Much less oil and less stickiness means much less TS. The plugs would take longer to form if at all. Therefore the diet restriction is certainly worth a try. Accutane's use is questionable.

Fraxel will certainly help the blockages and probably get rid of the ones you already have. One side use of Fraxel is to treat active acne. The theory is that it damages the sebaceous glands and moderates oil production. I saw a news cast about it.

Though this is questionable. They say acne may get worse with Fraxel before it gets better. But I can tell you that many people on the fraxel thread report that the laser made their skin permanently drier, as well as got rid of nose blackheads, and closed pores.

I'm not a doctor but why don't you be your own health advocate here?

Start first with restricting cow milk and dairy products (replacing them with soy is the easiest way). Do that for a month or two. I guarantee you will see differences in any acne you have as well as less oily skin.

If TS persists then speak with your doctor about LOW DOSE, SHORT TERM Accutane (10 mg or less).

Or alternatively you can try the Fraxel laser. Remember its either one or the other! Maybe best to try a Fraxel Spot treatment just on your nose TS. It will be much cheaper that way. You can do that first then follow up with an Accutane consultation if a series of Fraxel spot treatments does not help.

BTW, if you are a curious mind then go to http://www.keratin.com . There is a wealth of information as well a messageboard (though its pretty dead).

[~Chris~]

Thanks for being so helpful and taking the time to answer my questions. I'm going to try to cut out cow dairy and see what happens. I hate to be a pain, but you didn't answer one of my questions. The black spots I see on my nose that I can't squeeze out are pores filled with larger then normal amount of vellus hairs, right? If so, there is no way to remove these vellus hairs is there? I understand everything about the oil production, and oil plugs, but the bundles of vellus hairs are also a problem (complexion wise, not health wise).