Threading: a timeless method for facial hair maintenance and potential complications.

Sir,

Threading is an ancient Eastern form of epilation (removal of the entire hair by the root) that has recently gained significant popularity in the West. Threading originated in India and migrated to the Middle East and China, where the practice was usually reserved for special occasions. Today, threading is commonly used as an alternative to other forms of epilation (e.g., plucking, waxing, sugaring, lasering, electrolysis), depilation (e.g., shaving, trimming, chemical hair removal), and bleaching, for maintenance of unwanted facial hair.[1] The precise technique involves rapidly rotating a twisted loop of thin thread across the skin to entrap hair [Figure 1a and b], with the option of removing a single hair or multiple hairs simultaneously.[1] Although considered fairly safe, rarely reported dermatologic side effects include folliculitis, pseudofolliculitis, molluscum contagiosum, verruca plana, hyperpigmentation and vitiligo koebnerization, stressing the significance of proper technique, disposable threads, and sterilization of reusable materials.[12]

Figure 1

(a) Threading is commonly employed at beauty salons for eyebrow hair removal and shaping. Initially, one end of thread is anchored, usually in the teeth of the operator, while the other end, which is coiled multiple times, glides over and entraps unwanted hairs. This maneuver is used to remove multiple hairs simultaneously with one swift pull. b) Subsequently, the skin surrounding the eyebrow is held steady for more precise shaping and removal of single hairs. Maintaining tautness not only eases the extraction process, but is also thought to reduce pain associated with the procedure.