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Trichiasis Treated with Electrolysis
  My first experience with Trichiasis was quite unusual. A veterinarian asked me to treat a patient of his who suffered from inverted eyelashes, the catch was that the client was a lhasa apso. I used the blend method and removed all the lashes that must have been bothering the poor animal. According to the vet the eyelashes that were removed never came back and, of course, our patient never complained.
  The animal was suffering from the effects of inverted eyelashes, a condition that afflicts many humans as well. There are three types of inverted eyelashes, including trichiasis, there is also epiblepharon and entropion. Epiblepharon and entropion are caused by the irregular development of the eyelid retractors characterized by a redundant skin fold under the eyelid which causes the eyelashes to be vertically orientated, touching the eyeball. While Epiblepharon tends to be tolerated well by the cornea and in most cases spontaneously resolves in the early years of life. Entropion, on the other hand, damages the cornea causing keratopathy, and surgical intervention is necessary in most cases. Trichiasis is singular among the others, where the position of the eyelid is normal, rather, the lashes point in the wrong direction. The primary causes of this condition are chronic inflammation and scarring of the eyelid which are results of lid infections, skin diseases, or trauma and the poor healing of tissue.
  Trichiasis is the condition best suited for treatment by means of electrology. In fact, the advent of electrolysis would not have occurred if it were not for inverted eyelashes. In 1875 Charles Michel introduced the use of a galvanic current in the removal of hair as a solution to the aforementioned condition. Electrolysis treatment is in the best interest of the patient because it is permanent, causes no side effects on the lid, and leaves no scarring. Tweezing is another possible treatment; however, this is only a temporary relief as the lashes return to irritate the eye within a few weeks. This can be extremely difficult and frustrating to a patient. The other alternative is cryosurgery. While the lash re-occurrence rate is small, this procedure requires the freezing of the afflicted area which disturbs micro-circulation thereby killing the hair follicles. The main complaint from patients is that the lid swells within a few minutes, in some cases blistering and oozing occurs for several days after the procedure which can cause scarring and deformation of the treated area.
  Eight years after my canine client, an ophthalmologist contacted me about one of his male patients who suffered from trichiasis. I had treated one of the doctor’s friends and she could not say enough about the effectiveness of electrology. After a meeting with the ophthalmologist and a short interview, I agreed to treat his patient, referred to as patient A. I met with patient A and in a brief consultation, I went over the history of electrolysis, how we can achieve permanent results, and due to the various stages of hair growth he would need more then one treatment. The time between treatments was determined by the fact that eyelashes have a three month growth cycle. I advised patient A of the choice of modalities available, shortwave and blend, as well as the necessary after treatment care. I explained my standards of sterilization and sanitation before I gauged patient A’s pain tolerance by removing a few eyebrows. I went over my qualifications, and I showed him my work with permanent makeup where I drew eyelashes for patients with alopecia and burn injuries. Those pictures made him feel comfortable with me and safe about his eyes. After I gained his confidence completely we scheduled our first appointment.
  Patient A required a total of six treatments. During the treatments I used a sterile stainless steel disposable probe, because stainless steel is used in most surgical instruments and is sturdier than gold plated probes. Also stainless steel has been known to be more comfortable than insulated probes. I used saline solution to clean the eyes before, during, and after the procedure. I also used Celluvisc TM eye drops to sooth mild irritation. The following are the settings of each treatment:

First treatment:
  Blend HF 22% time 6 sec. 0.22 MA

Second treatment (one month later):
  Blend HF 22% time 6 sec. 0.35 MA

Third treatment (Two months from the first)
  Micro-thermolysis, Time 0.040 HF 70%

Fourth treatment (Three and a half months from the second)
  Micro-thermolysis, Time 0.040 HF 70%

Fifth treatment (Four months from the third)
  Micro-thermolysis, Time 0.027 HF 80%

Sixth treatment (Six months later)
  Micro-thermolysis, Time 0.027 HF 80%

  The settings depend on the make and model of machine used, and most importantly the patient’s level of tolerance. Besides some minor tearing, there were no side effects. Re-occurrence rates depend on the capability of the electrologist and problems with scarring should be nonexistent.
Researchers are testing new methods for treating these conditions; currently, investigation is being performed in which the offending lashes are treated with an Argon Laser to destroy the hair follicle. Early results are positive, but more work needs to be done to make sure this treatment is well tolerated and safe.
  Today the use of sophisticated technology combined with the professional skills of an electrologist still remains the premier method of treating trichiasis

Lina K. Haralambous BS, CPE, FAAM
Electrology World 2007 - Vol. 26, Issue 2