Laser hair removal whilst having Haemachromatosis - Transgender

Allergies, blood and immune system
1

Hi,

I need to have facial hair removal but have been told that having haemachromatosis, I may be a further risk towards possible skin damage, which could result in skin hypo/hyper-pigmentation. 

My Haematologist told me that skin discolouration could occur from having haemachromatosis, which I was aware about (and this is only if your iron levels aren't controlled) but I don't know if by simply having haemachromatosis, destroying the follicles that produce hair, by laser, could result in unsighlty skin damage that wouldn't otherwise happen if I didn't have haemachromotosis?

I've asked the haemachromatosis society and Christianos centre (laser clinic) but none of them have come back with any information based on people who have had laser hair removal, more a vague hypothesis on the matter at this stage involving detailed information I'm continuingly absorbing but being lead astray with as it's not an area I'm experienced with enough to gain a constructive enough opinion (biology). I'm transgender so need to have this done soon as poss. Any help would be great so I can look into whether I'm applicable to go ahead with it.  Thanks

I've been trying to find information on this for well over a year and would really appreciate any help.

2

Hello, 

You have an interesting question. My husband has the changes in pigmentation due to his condition, but our doctor told us it was from sun exposure (and HH). He also started going bald at 18, by 25 there was nothing left. I hadn't considered if his hair loss was due to HH as well. I am sorry that I do not have any answers but you could start the laser treatment in a less noticeable area and see if there are any skin changes. Best wishes, I hope you can find a solution!

3

NeilDee,

I've never heard of anything in relation to laser hair removal and skin discolouration in relation to haemochromatosis before.

The only thing about discolouration that I've heard of is that people with a larger amount of uncontrolled iron over a long period of time can look as if they have jaundice (have you noticed that your skin has a yellow tone to it?). None of the haemotologists that I've spoken with have ever mentioned any increased danger from laser hair removal.

Do you mind if I ask what your ferritin level is at right now?

So in a nutshell, based on the information that I have, I would suggest what Angela said. Is there another spot on your body that you'd like laser hair removal on that you could test it first?

4

Hi NeilDee, I have severe haemochromatosis, left undiagnosed with severe symptoms for 9 years.  Although I am now 'de-ironed', people are always commenting on my beautiful 'tan' although my forays into the sun are short.  It is not a jaundice colour, and I have seen a young fellow with almost liverish coloured skin so the colouration varies.

I have used an epilator (it pulls the hair out) on my face many times to deal with long fine menopausal hair with no problems.  I really can't see why any discolouration would occur, unless the laser burns the skin.  I agree with Angela and Megan.  Try it on your chest or back (of neck) first where you might have HH colouration.

I almost forgot, before I was diagnosed with HH, I had dermabrasion on a part of my face and if anything, it is paler there than the rest of my skin, although I think I am the only one who notices it.

HH can cause hair loss, and body hair loss.  I have just realised that I have no hair on my arms anymore and about 6 all up on my legs.  Underarms went years ago.  That's a bonus!  I have not yet come across anyone before with total loss of hair on head.

Scars from scratches and venesections are paler than my surrounding skin.

Good luck with your trials.

 

5

Hi Sheryl,

Thanks for your input.  Thats interesting when you talk about the surrounding areas of scars

and the difference in colour compared to the all round areas of the skin.

This is the kind of thing I want to look into, since I wouldn't want

any skin damage to result in this as it would be all over my face.

Scars I've had recently on my hands have healed fine, but scars from spots

on my chest after waxing have remained for longer than expected although

I can't be sure this is tied in with HH yet, but maybe skin pigment

can be affected in some way whilst having HH which is where my focus is.

I had a test patch on my face before I was diagnosed early this year.

I was told to go back to have another test patch done, as it blistered,

but was told the setting must have been too high. Theres conflicting

opinions from various laser clinics about this so its hard to read between

the lines as they could be bias or demonstrating confidence they might not

be as confident about as they come across (taking into account they are selling

a service and still presenting no facts as such, as helpful as I'm sure

they are being for me). They didn't know I had haemachromatosis before I had the

test patch but when I told them afterwards to reflect on whether the blistering

could have been tied in, they was completely unaware of what it was and never got back,

I suppose I'm a minority case to put so much research into in that respect.

From this, I think a good thing to ask people now is:

Has anybody with HH noticed any change of skin pigment surrounding scars,

that one would expect people without HH otherwise not to have?

Still, the scaring from a laser would be different to any other general cut

of such due to the physics and its deep penetration to the skin and damage

to the follicle and relation to the melanin which produces pigment - As

skin hypo/hyper pigmentation IS a risk for anyone considering laser hair removal,

I'm just wanting to see if the risk is greater whilst having HH.

It's hard to tell if there was any skin damage from the blistered

test patch, as there are a few subtle blemishes around there and I've been told

they must have had the settings too high.

I'm going to have another test patch with Christianos instead of the one I used,

so I'll see what results I get but I'm not sure that because I have HH,

it may be likely for any scarring to show up later on as the skin develops,

 after the skin tissue damage below has eventually reach the surface of the face.

Maybe I'd have to wait 5 or 6 months for that process to complete before I can

judge whether any damage has been done.

Any further thoughts or information would be great, what a useful forum this is!

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Hi Angela, thanks for your thoughts. I've mentioned a bit more in response to Sheryl's comment below, regards to my test patches etc.

My Mum has HH and her skin goes golden in the sun, which is believed to be a side effect of HH and my Nana's face went darker which is what prompted her diagnosis, and her diabetes.

Its not affected my hair, I'm not sure that is tied in to HH from what I know so far. I

7

In terms of skin pigment changing around scars - the only significant scar that I have is on my back (I fell on glass when I was about 10 or so and needed stitches along my spine) and the only difference I've noticed is that my scar has lightened and faded a lot - but that's most likely just because it was 15 or so years ago that this happened, and I doubt it has anything to do with HH.

Have you seen those commercials on tv for the at-home laser hair removal stuff? God, what's it called... I think it's called a "No-No"? I'm just wondering if you're willing to invest in something like that, which obviously wouldn't be on as grand a scale as going in for laser hair removal, maybe you could try that out for a few weeks?

Then maybe you could see if it makes a significant difference in getting rid of the unwanted hair and you could better judge whether or not a stronger laser would change your skin pigment/scarring.

8

Hi Megan,

Thanks for your opinions on this, it’s helpful but I need to know from either somebody who’s had experience with laser surgery, or if anyone can tell me whether tissue scarring from laser hair removal would be something to consider a barrier whilst having HH as there might be a greater risk or certainty of permanent damage since I have HH.  Or it could be that having HH doesn’t come into the equation, equally I’m not sure if by having HH yet, it would be a disaster for my face in any case.

I’ve spent nearly 2 years on/off researching laser hair removal systems and the ‘no no’ gadgets really are something to avoid for trans women.  There will be a certain amount of tissue that scars temporarily (or permanently if unlucky) in any laser hair removal system and the more expensive/flashy/up to date the machine, the more accurate it is at avoiding skin damage but that’s also down to the practitioner’s skill, so I’m also researching the best clinic to go with.  With most people the initial scarring will heal and still as of yet, research is continuously being carried out to discover the reasons behind bad skin reactions to laser - to know if HH has been noted to be a likely contributer is what I'm struggling to find out.  I've had a test patch but I'm still assessing the reasons behind the reaction I had, hopefully this forum will shed some light onto it, I've put a bit of detail on that in repsonse to Sheryl. The no no hair removal system isn't practical for trans women as ‘Male/androgynous’ hair and skin types/skin oils are very different to that of biological females due to the amount of testosterone and the difference in male/female endocrines.  I know laser surgery might not be your subject and thanks for any suggestions, it's just a long shot whether I find someone experienced enough in the biology of internal facial tissue and it's relation to HH.  Just after a bit of clarity if possible, on how skin under the surface, could be affected when damaged by laser light more when one has HH.

 

 

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Hi Neildee, it certainly is a long-shot question but worth it for you.  I have researched HH and its complications extensively and have not come across any research dealing with HH skin and scarring.  I just googled "hemochromatosis and laser scarring".  There were a couple of items which might interest you, in particular wikipedia's "Porphria cutanea tarda", a specific complication but might give you some clues.

You might have misunderstood me when I said the scars I had were paler than surrounding skin.  The surrounding skin is just the same as all my tanned skin.  The difference in colour is disappearing over time.

First, do you have skin bronzing or darkening from HH?  Is your skin also darkened where you don't expose to the sun.  A sign can be orange staining on the collar and armpits of your clothes.  If you don't already have it and you are reducing your ferritin iron levels, it is not likely to develop.

I really don't think the laser people have any idea - there is no research - and they would be just covering themselves.  Even drs and haemotologists have very little idea of all the complications of HH.  

Then, let's look at the bigger picture.

What is the worst that can happen?  You can end up with fine pale dots where you once had hair follicles, or dark coloured ones instead.  This can happen regardless of HH.  Although lasers are used to get rid of scarring!  They will fade, if not, skin coloured cosmetic tattooing can cover it.  Or, of course, as you are entering the female world, makeup!  Just like the rest of us females who have to cover up blemished and imperfect skin.  All the hormonal changes are likely to give you skin problems for a while anyway.

Retrieve, a retin-A cream will improve your skin - helps fade acne blemishes, and the Japanese are good at skin lightening products.  Is there some gel product which when smeared on scar tissue, it helps repair it a lot quicker?  I used Bio-Oil, and while it helped soften surgical scar tissue so that it didn't tighten up too much, I can't say it was fantastic, but I am sure there are other products out there now.

Another option is waiting till your hormone medication softens and thins facial hair and it can be removed with an epilator, which plucks the hair out till it finally stops growing.  I think even with laser removal you have to have several sessions because hair grows at different rates.

Applying bleach to early regrowth might be a temporary solution.  (Is laser removal better suited to light hair or dark hair?  Read something about it once.)

I am sure you also know of other options which might not be as fast as laser removal.

Once again, good luck.

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Hi Sheryl,

I've never had any skin colouring issues, my Mum has a more intense reaction to sunlight and I've always tanned easy but I have non of the symptoms such like orangeness or anything like that.  I don't know whether if this skin difference develops in future, the skin that had been previously affected would become visible eventually.

From shaving too closely (as I most likely saw it) I developed an infection that stopped me being able to shave, loads of aggressive spots coming up.  I went to a private dermatoligist as the NHS wouldn't let me have an appointment unless I was showing severe facial skin problems, and he said I had acne, although another laser clinic told me it was probably follicle'itus - which I can make more sense of as it seemed the follicles was inflected from close shaving repetitively every day for a few weeks. For about 5 months and I really suffered, which makes me more careful in researching this best I can and understanding what risks are attached to my skin type.  I never got to the bottom of why this actually happened and can only make my own judgement on the cause, I even tried a Chinese herbalist, eventually after months it went and hasn’t returned.

If it turns out I would have to correct any possible scarring with makeup or other surgery, personally I'd rather not have it or look into electrolysis which has seperate risks involved but I might be applicable if I need to go down that route as I had a test patch that turned out fine. 

Thanks for being so caring and sharing your thoughts and experience by the way!  Just so you know, I don’t think I’ll take hormones coz I won’t be able to present female for 2 years consistently, in order to prove that I’m transsexual to obtain them.  With hormones if I had them, I’d still keep my identity between my friends and present more female as and where I felt comfortable but with facial hair, it’s difficult to plan when you want to wear a bit of makeup and wear clothes more associated with ‘native females’. It’d be a vital step to have done before taking hormones, but for now I need to feel I can look as close to how I feel I should look at any moment I wish, it’d just destroy me if my face looked a mess afterwards and I keep seeing this guy walking around my area who looks like he has serious skin pigmentation problems, although covering up that with makeup would be easier and better than covering up stubble you can’t shave off yet.

I’ll have a look into what you saw on wiki, "Porphria cutanea tarda", I’ll need to take some time to read up more again as I’m pretty bamboozled with biology on this with it being something I’ve only read about, I could do with knowing more still but I suppose even the pro’s are always learning at this stage.

I do however, have the best skin colour and hair type for laser surgery as its dark and course and my skin isn’t dark, pretty average in shade but not too light although I think it’s sensitive. 

And, I have been told that laser hair removal improves the skin, I just can’t risk it affecting the colour of it in any way so I think if I can’t get the information I’m hoping for, perhaps to wait 6 months (average time for under layer of skin to reach the surface) after another test patch to see if theres been a bad reaction.  Thanks for much for helping, feel free to add to this post if you have any further thoughts  X