Eyebrow threading: a popular hair-removal procedure and its seldom-discussed complications

Removal of eyebrow and facial hair by 'threading' has gained popularity worldwide. Threading is an ancient Eastern method of removing unwanted facial and eyebrow hair by a technique whereby one end of a cotton thread is held in the mouth of the technician and the other end looped around individual hair shafts, which are then pulled out. This is repeated in quick, successive movements. In India, this is used extensively for shaping and removing eyebrow hair. Threading now enjoys immense popularity with women worldwide, irrespective of race or colour, and is an accepted method for removing eyebrow hair and shaping the eyebrows. However, this popular cosmetic procedure has some significant dermatological side-effects and is not familiar to many dermatologists. To our knowledge, this is the first report of verrucae occurring in threaded eyebrows. Other complications include erythema, folliculitis, pseudofolliculitis, hyperpigmentation, and depigmentation, including koebnerization of vitiligo. This report should alert dermatologists to the possible complications that may arise from this popular aesthetic epilatory procedure.