I am a 24 year old male, of middle-eastern / Mediterranean background. I started progressively course body hair, in a normal developmental pattern, first in the genital region, then legs, arms, and thighs.. when i was about 10-14 years of age. initially it was finer and seemed like my vellum was actually become black. By the time i was 16 i had begun developing dense thick course black androgenic body hair all over my body with the exception of the small of back, my hands, feet and upper face. Around this time the hair on my head began to thin, and i was balding by 19, and fully bald (male pattern) by 23 after about a year of having given up the losing battle w/ Minoxidil. My balding and body hair has been largely in line with my maternal grandfathers hair loss. Around my late teens i also remember taking a blood test to see if maybe irregular thyroid levels were to blame, as i understood it they came back more or less normal... though i certainly bear all the features and qualities associated w/ elevated levels of testosterone i don't think i bear much of the common presentation of hyper or hypo - thyroidism. I've attached a near-equivalent photograph of what my presentation looks like.
Regardless, my excessive body hair has had enough of an early psychological impact of myself esteem and body-related self-confidence that i have essentially been unable to allow myself to be seen without a shirt on outside of a clinical setting, excepting w/ my immediate family, since i was 15 years old. I am now almost 25 years old, and over the years this has prevented me from participating in many sports and outdoor activities.. and most importantly its been a huge blot on my self-confidence and capacity for vulnerable intimacy in relationships.
Past Attempts to address:
In the past at the age of 17-18 my parents paid for laser-hair removal sessions (6 total spanning over 16 months, separated roughly 8 -12 weeks apart) and found the treatment to have minimal effect, actually disfiguring or denaturing the appearance with constant irritation, ingrowns, and acne (that is otherwise unheard of on my skin) rather than thinning it out to something approximating 'normal' or 'presentable'.
I also found myself unable or hesitant to schedule these sessions (which were full back, shoulders, sides, and upper arm treatments) both because of the cost which i had to subsidize .. and the pain associated because of the density and course-ness of my thick black androgenic hair and my comparatively pale skin. My body hair's distribution is basically a full body suit from ankles to elbows, and fully covering my upper torso like a jacket, thinning only in the small of my back.
For the later sessions i would often buy several large tubes of lidocaine to apply to as much of the areas as i could cover.. and would effectively be applying enough that i would feel dizzy, dehydrated and groggy with mild ataxia throughout the sessions and the immediate aftermath.. despite this, i found this afforded little relief from the pain as i couldnt fully apply enough to any one area (since i cant quite slather my entire anterior boddy with a thin-layer, id be applying it too thinly, more like an ointment or sunscreen to get enough coverage for the most sensitive areas. Regardless the pain of the ruby(?) lazer basically felt like the constant splatter of hot frying oil on my skin.
I have also tried waxing which i found to be absolute torture and which i could never get past 3 or 4 strips off before abandoning the enterprise... especially faced with the prospect that in order to get the job done id basically be looking at maybe 30-40 strips.
my question is this, and is two fold. If you only have time to address one section, please favor the latter.
A) From an unbiased medical perspective is there solid evidence of current laser hair-removal methods showing significant medium to long term reduction ... like more than 50% even in cases of dense body hair that is distributed throughout the body in a manner that has at least a vaguely natural look - especially when demarcated by sudden borders (at the waist, beginning of chest, abdomen)
and is has there been any evidence demonstrating, or failing to demonstrate an increased risk of hyperplasia, dysplasia or neoplasia associated with these treatments? If there is a lack of sufficient research, on the matter, are there inductive grounds to assume there would be? In my case in the absence or correlatory factors like sun-UV or tanning exposure?
I'm contemplating either restarting a laser-hair removal regimen which would require a significant poriton of my monthly income... and would only be worth it given high probability of favorable outcome, or alternately beginning regular waxing sessions with a professional aesthetician. I understand that after a few repeated waxings the hairs will start to come in thinner, more ready to pull, and less densely populated. Is this true?
B) In order to make either waxing or laser removal a viable option based on my past experiences i feel pretty sure i would need something substantial for the pain. Topical Lidocaine was too expensive and impractical given the surface area and, with the amount of coverage was causing my to feel dizzy etc. ....
First on a practical level (something i could reasonably be prescribed for the sessions or expect that a dr. might suggest) for the management of acute pain associated with hair-removal to faciliate just getting through the sessions themselves). Are traditional analgesics/opiate-based painkillers effective in this regard? My impression was that they were mostly useful for constant sustained pain, and not deadening immediate sharp acute pain the likes of waxing or laser hair-removal.
Second, on an academic level (so including anesthetics pain-killers whose use might be impractical for the application/context) such as perhaps dissociative anesthetics and NMDA antagonists, like Ketamine or N02... would dissociatives like these, in theory be more conducive to numbing or dampening the perception of this kind of immediate acute pain that traditional opiates etc would be? If so is there a safe alternative from this family that could be useful in this application? It seems like a topical solution is unlikely or is one, what about a systemic one, or something perhaps subcutaneous that could be administered in a clinic immediately prior to a session??
I assume what i'm looking for is an and not so much an analgesic? is this correct?