Tag Archives: regrowth

Small Victories

I made it 10 days without pulling my hair!

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We are often hardest on ourselves so after pulling a few hairs, I’m giving myself the same advice I would offer another trichsters who stopped pulling for any length of time and then pull again.

Don’t stop celebrating that victory just because you slipped up.

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Although it seems like all that work was for nothing, it’s not in vain. Every time you resisted the urge to pull was a small victory, another step closer to recovery. You are building strength and training yourself not to pull.

It’s a long hard process, but you’ve already done a lot of the work. You are learning ways to be aware and self-sooth without pulling. It didn’t start overnight so it will also take time to fully stop. Next time it will be that much easier. đź’ś

 

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Persistence not Perfection

Trichy Insights

Let’s strengthen those weak muscles!  

Just persist until you are successful!

My solace tonight as I persist in my journey to recovery from trich comes from comments of some of the people on the Fairlight Bulletin Board posted on Amanda’s Trichotillomania Guide.

Definition of Success

I just wanted to add another observation to all that has been said about making a commitment to not pulling. Think of it as exercise. When I started walking a couple of months ago, I thought a mile was forever. Now that I’ve been walking regularly, my stamina has increased, and a mile goes by quickly. I can’t run a marathon (yet!), but I am stronger. In the same way, as we practice not pulling, we’re building “muscles” that make it easier not to pull. The first couple of weeks are horrible, but then it gets easier–if you persist. I’ve slipped a couple of times…

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NAC for Trichotillomania

Research shows that nutritional supplements may help mental health including trichotillomania. Lately I have focused on inositol and NAC as I have heard about these supplements in many trichotillomania communities with varied success.

I started taking NAC (N-acetylcysteine) about two years ago and have noticed a decrease in my urge to pull when I take it 5-6 days per week. I take2-600mg capsules in the morning and 2-600mg capsules in the evening, giving me a total of 2400mg of NAC. Doses between 1200-3600mg may be helpful according to this article,  N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania

I recently added inositol to increase the benefits of NAC.  It is generally agreed that a large dose is needed for inositol to be effective with trich. I worked my way up to 18g per day. I do this by mixing 3 teaspoons or 1 tablespoon of inositol in water 3 times a day. I have found the Jarrow brand powder dissolves best. It is available on amazon for a reasonable price. I mix it with warm water as it dissolves better that way. You can add it to fruit juice or other sweetened drinks.  I simply mix the powder with ~3 oz. of warm water and drink it plain as it has a mild sweet taste that I actually like.

 

NAC and Trichotillomania

By Fred Penzel, Ph.D.

**Please note the following: This advice is purely informational, and not in any way meant to be a substitute for treatment by a licensed physician. Do not try this, or anything else, without first consulting your physician. If your M.D. has not heard about it, refer them to the following article and let them decide:

Jon E. Grant, JD, MD, MPH; Brian L. Odlaug, BA; Suck Won Kim, MD, N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study. Arch Gen Psychiatry/ VOL 66 (NO. 7), JULY 2009.

 

Over the years, it has become apparent that prescription medications, as remedies for trichotillomania (TTM), have proved to be somewhat of a disappointment. These meds have been employed since the early 1990’s, and although they may be seen to work occasionally for some individuals, research indicates that their overall effectiveness is not great for the majority of sufferers. When they do appear to work, it is most likely that they are actually helping with coexisting problems such as depression and anxiety that are impacting the pulling, but not directly causing it. The discovery of a new compound with a greater level of direct effectiveness would be considered a blessing to sufferers. If this compound were also an over-the-counter remedy, it would be even better.

This very thing was confirmed in 2009 with the publication of an article by Grant, Odlaug, and Kim in The Archives of General Psychiatry, titled “N-acetylcysteine, A Glutamate Modulator, In the Treatment of Trichotillomania.”This study, which lasted 12 weeks, investigated the use of the amino acid N-acetylcysteine (NAC) in 50 patients with TTM, and found that 56% of them were rated as improved or very much improved. A much smaller previous pilot study had also found positive results.

So what is this compound? NAC is a both a pharmaceutical drug and a nutritional supplement used primarily to treat Cystic Fibrosis, and also to treat individuals suffering from acetaminophen overdoses. In the former case, it thins mucus, making it easier for patients to cough it up, and in the latter case, has liver detoxifying effects. It has also been said to aid in the treatment of cocaine addiction. Some practitioners out there are also exploring the use of NAC in the treatment of OCD, although whether it is effective or not, is still unproven.

What exactly is NAC? NAC is a natural sulfur-containing amino acid that is a breakdown product of the amino acid L-cysteine, and is in turn broken down by the body and converted to a powerful antioxidant known as glutathione.Antioxidants can repair oxidative stress in the body. Oxidative stress occurs when cell metabolism produces an increased level of oxidants known as free radicals that tip the balance between themselves and antioxidants in the body.These free radicals can cause the breakdown of cells, damaging proteins, genes, and cell membranes. Substances known as antioxidants act by neutralizing free radicals, and some are produced naturally by the body. Some have theorized that hair-pulling may be the result of the effects of oxidative stress within the brain, and that NAC can help reverse this.

NAC is also what is known as a chelating agent. That is, it hastens the excretion of heavy metals such as lead, mercury and arsenic from the body by binding to them. While this is of course, a positive benefit of taking it, it also causes the body to excrete copper, zinc and other essential minerals when used over time. Some research says this effect may be minimal, but others have suggested that it is necessary to take supplements containing copper, zinc, and other vital minerals when using NAC. Until this is settled, it is advisable to take a daily multivitamin plus minerals along with the NAC. It is often recommended to take extra vitamin C, itself an antioxidant, along with NAC, as it can also assist in raising glutathione levels. The amount of vitamin C one should take has been said to be in the range of 500 mg. per day.

As far as taking NAC itself for a BFRB, we have been using the following approach:

1. Start by taking one, 600 mg. capsule of NAC daily for the first two weeks along with a daily multivitamin plus minerals, in addition to 500 mg. of vitamin C. You will most likely not see any changes on this dosage.

2. If the NAC appears to be well tolerated, increase it to 1, 600 mg. capsule, 2x per day. Again, wait two to three weeks to see if there is any reduction in pulling activity.

3. If there are no changes, or only minimal changes in pulling, increase to 1 capsule, 3x per day, and again wait two to three weeks to see if there is any noticeable result.

4. If there is only little or no change, you can then increase to 4, 600 mg. capsules per day, and wait another two to three weeks. Take 2 capsules for one of the three daily doses, to make a daily total of four.

5. If there is still little or no change, you can increase up to what is the maximum of 5, 600 mg. capsules per day. A total of 3,000 mg. is the maximum you should take as a daily dose. Take 2 capsules for two of the three daily doses, to make a daily total of five.

6. If after 4 weeks at the maximum dosage there is still no result, then it is likely that it is not working, and can then be discontinued.

As with all medications and supplements, there are no sure things. It is ultimately all trial-and-error. We hope that NAC will help, but just keep in mind that it will not necessarily work for everyone. Remember that it was shown to be effective for about 56 percent of the subjects in the original research study.

NOTE: There are some very important precautions that should be observed when taking NAC.

1. It should be noted that there are some individuals who suffer from cystinuria, a genetic disorder that causes cysteine to build up in their urine. If levels of cysteine molecules become high enough, they clump together to form kidney stones. It is therefore recommended that those with this problem not take NAC.

 

2. In addition, NAC supplementation might increase the side effects associated with nitroglycerin and isosorbide, two medications commonly used to treat angina.

 

3. Using NAC at the same time as the hypertension drugs ACE-inhibitors might cause blood pressure to drop too low. It might also excessively strengthen the actions of immunosuppressant drugs.

 

How N-Acetylcysteine (N-A-C) Cured My Depression and Anxiety

The maternal side of my family contains a history of severe mental illness. My maternal grandmother suffered from schizophrenia and died in a mental ward. My mother has been institutionalized repeatedly, suffering from a decades long battle with bipolar disorder.

My younger brother is a legitimate sociopath. He is not merely “dark triad.” He has actual antisocial personality disorder. He has no feelings of empathy or kindness or decency. Lacking the vision to rob banks or become a drug kingpin, he is currently free after spending 10 years in prison for shooting his one-armed drug dealer.

In other words, there’s some funny business in my DNA.

I used to get depressed and feel anxious. I never had full-on panic attacks, but I would have severe anxiety that would leave my brain spinning. My skin would break out in rashes.

I conquered this anxiety through two means, as anxiety and other mental illnesses have two components – physical and psychological.

The psychological components of anxiety come from society and the brain washing. That is where state control, reframing techniques, and other Mindset Training comes into play.

The physical components of anxiety and depression come from a variety of sources – poor nutrition, lack of sunlight, excessive oxidative stress, high cortisol, and heavy metal poisoning.

glutathione

N-Acetylcysteine (N-A-C) has been clinically proven to help treat symptoms of anxiety and depression.

N-Acetylcysteine is a powerful nootropic with still many unstudied benefits. N-A-C has been used by visionary doctors to help treat intractable depression and anxiety.

Why haven’t you heard about the magical effects of N-A-C? Simple. Go on Amazon and see how much a bottle of N-A-C costs.

My mom was on a $1,500 a month cocktail of drugs. No one would listen when I suggested they buy a $15 bottle of N-A-C. But the science is there.

See, N-acetyl cysteine for depressive symptoms in bipolar disorder–a double-blind randomized placebo-controlled trial(“NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.”) (PubMed.)

See also, N-acetyl cysteine as a glutathione precursor for schizophrenia–a double-blind, randomized, placebo-controlled trial. (“These data suggest that adjunctive NAC has potential as a safe and moderately effective augmentation strategy for chronic schizophrenia.”) (PubMed.)

N-A-C depression anxiety

Why does N-A-C help treat depression?

Acetylcysteine is a glutathione precursor. That is, acetylcysteine is converted into glutathione.

Glutathione is an antioxidant that used by your liver to detox your body. Emergency rooms give high doses of NAC to patients that have overdosed with Tylenol.

Resources:

  • The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine (Amazon).
  • Smash Chronic Fatigue: A Concise, Science-Based Guide to Help Your Body Heal, and Banish Fatigue Forever (Amazon).

Could mental illness be caused by toxins that your liver is unable to clear from your body, due to a glutathione deficiency?

That is not so far fetched, and in fact the cutting-edge of mental health research is on the role toxins and oxidative stress play in mental illness.

See, The efficacy of adjunctive N-acetylcysteine in major depressive disorder: a double-blind, randomized, placebo-controlled trial (“These data implicate the pathways influenced by NAC in depression pathogenesis, principally oxidative and inflammatory stress and glutamate, although definitive confirmation remains necessary.”) (PubMed.)

See also, The Glutathione System: A New Drug Target in Neuroimmune Disorders (“Glutathione depletion and concomitant increase in oxidative and neurological stress and mitochondrial dysfunctions play a role in the pathophysiology of diverse neuroimmune disorders, including depression, myalgic encephalomyelitis/chronic fatigue syndrome and Parkinson’s disease, suggesting that depleted GSH is an integral part of these diseases.” (PudMed.)

Do you know what else boosts glutathione?

Carrot orange pomegranate juice

How much N-A-C should you take?

That would be medical advice, which I don’t give. However, participants in the studies usually used between 1 and 2 grams daily.

Why take N-A-C instead of glutathione?

If N-A-C is a precursor, wouldn’t it make more sense to take glutathione directly? That seems intuitively correct. There is some evidence to suggest that N-A-C is more bioavailable than glutathione.

I personally use N-A-C because that was the compound studied. How much glutathione would one need to take to get the same benefits that one can obtain from 1 to 2 grams of N-A-C? As I don’t know, I went with N-A-C.

You are of course free to try both for yourself to see what works best.

What brand of N-A-C is best?

As the supplement industry is unregulated, I generally prefer to use use two brands of supplements – Life Extension Foundation and Jarrow.

I personally use Jarrow’s form of N-A-C Sustain, which is time released. (Amazon).

For more information on oxidative stress, nutrition, and various maladies, watch this video.

Minding Your Mitochondria

Regrowth Facts

MOST people DO have the capacity for hair regrowth. Most TTM people who do not think that their hair will regrow is because they HAVEN’T been in recovery LONG enough, so they think it won’t fill in, so they actually keep pulling. According to Dr. Novak, the LARGEST % of people HAVEN’T damaged their follicles enough to stop regrowth.

Peach fuzz or thinner than normal hair is a GREAT sign because it means your follicle IS still ALIVE! It does also mean it is temporarily traumatized, and that your hair is in a state of HEALING. Peach fuzz is a precursor to regular size hair, just as in babies.

Kinky hair also is a GREAT sign because it means your follicle IS still ALIVE! It does also mean a temporarily traumatized follicle, and that your hair is in a state of HEALING. The waiting game is LONG for these to go back to straight. One trichster said, “I have hair almost to my waist, and as I have changed my head criteria, I have foot long hairs that are at least 6 inches of kinky before they went back to straight.”

So, it is not an overnight process. Pulling out the kinky hairs is a mistake because you are actually making them more kinky each time, and traumatizing the follicle more each time – so it will take that much longer for it to go back to straight. It is possible, although NOT likely, that kinky hair might stay that way. In other words, for MOST people, once it is kinky, it WILL eventually go back to normal. (It is the eventually that we have a hard time with.) If your hair is growing in white, it will probably change back to its regular color after awhile. Means the color sac is (usually temporarily) traumatized, and will eventually start producing color  again. Age also was a factor in this. I have also had this experience. Some of my hairs go 1 inch and half Grey before changing back to dark brown. Again, a small % of people could permanently experience loss of
color – usually older people closer to the normal graying age.

Myths vs. Facts

Myth – There is a pervasive, erroneous worry out there that “root” pullers damage their hair more than the “other” pullers.

Myth – If/ when you pull and get the “white” thing, you won’t get their hair back, or higher probability that you won’t get your hair back..

FACT – If the hair comes out, the root IS out, and ALWAYS is out, no matter what is attached to it.

FACT – It DOESN’T matter anyway, because the old root DOES NOT generate the new hair.

FACT – The MAJORITY of us can have TOTAL regrowth!

FACT – VERY IMPORTANT – What you may or may not see attached to the root has NO affect on possibility for regrowth. It is NOT a sign of permanent damage! People see all kinds of weird things on the roots – and there are tons of things that go in that make the root look different at different times in the growth stages – size, shape, color, stuff attached to it, etc.

FACT – Pulling lots of the white things means you are pulling all the “Youngest” hairs. It may mean it takes longer for those hair follicles to gear up again since they normally wouldn’t regrow until that hair died and fell out naturally.

FACT – Pulling the kinky hairs will probably make them even more kinky – further SLOWING down the healing process for that follicle.

FACT – Pulling the extra thin (peach fuzz) hairs makes the healing process START over, you would have to get a new extra thin (peach fuzz) hair, before you could get a regular hair, so you are SLOWING down the
healing process.

FACT – You can see above how our own pulling patterns can make us think we are not getting our regular hair back, when in fact we ARE!

RECOVERY TIME FRAMES

Different areas of hair have different chances for recovery speed.

Lashes – FULL recovery, some people can get them in 6 months, if you have been pulling for years and years – could be 2-4 years.

Eyebrows – FULL recovery, can be slower than Lashes – this is an area more easily damaged and does not regrow totally back for some people.

HEAD – FULL recovery, 2-6 years for Normal Hair! Think about it, your hair only grows 1/4- 1/2 inch a month, and you have to wait for each hair pulled to start its growing cycle again. Plus, if it is growing in kinky or “peach fuzz”, you have to wait a long time (my experience 6 months), for that phase to change back to regular hair. And then you have to grow length again. I think the Doc’s time frame also takes into account people who are in the process of recovery, and having occasional pulling relapses.

On possible damage forever – Even in this chance, it would be pretty rare for someone to be able to damage ever follicle on their entire head! There are usually physical signs on your skin (not the pulled out hair) if you have permanently damaged follicles. If you had scabs and scars, that could be a sign for those particular spots of possible permanent damage. You would STILL have to wait to recover from TTM behaviors, and stop picking at those areas for MONTHS before you would know for sure. Female pattern baldness areas are the easiest permanent damage area, and some people in recovery do have thinning and damage in those areas. But again, that is not the experience of MOST people! You can’t even begin to evaluate that until you have been pull free for months to years!

HAIR BIOLOGY

2a). The white thing is NOT the root, it is the Root Sheath (surrounds the root) – also sometimes called the bulb. The white thing is only present in Growth Stage 1 of hair (the youngest stage).

*The root sheath is what drives me wild.  I can’t stop until I find one with that thick clear coating around the root.  I can often feel them as those are the hairs the itch the most or are extra wiry.  Of course after I find one I just want more.  Its always just one more…but it’s never only one more.

2b). The part you pull out is the root. The root sometimes has the white root sheath around it, sometimes NOT. Sometime the root will have other things on it, including a black bulb.

2c). If you pull out your hair, you usually can see the root. It looks very different at different growth stages. It
is the rounder part at the bottom – but how round or oval it is varies depending on the growth stage. Sometimes it is so round it looks like an onion with a stalk, where the root is the onion. Sometimes it is so
straight, the root is just the 1mm at the bottom (it is big enough to see). If you see the white bulb, the root is under the bulb, more towards the bottom. Sometimes there are other types of cells attached to the root, which can be different colors, or different textures, some kind of see-through, some not. If you see an “ink spot” at the bottom, that is probably because you also have a root sheath or attached cells looking “white” or “lighter color” – and are seeing the “black ink spot” at the bottom which is just a spot of the root without the root sheath. i.e. like looking at the end of a hot dog (root) sticking out of the bun (root sheath).

2d). Normally, when hair falls out on its own, the root falls out, and the hair grows back completely. You can’t damage the root by pulling, because it is gone. The root has nothing to do with regrowth. “

Regrowth

One of the biggest concerns for trichsters is hair re-growth. It is also one of the most difficult questions to answer. Re-growth will largely depend on the duration and intensity of the pulling. There have been cases where people who have pulled for 30 years have achieved full coverage once they have become pull free, whilst other have permanent damage after 5 years of pulling.

First lets look at the structure of the hair. KERATIN, the same strong protein that makes fur and feathers in animals, and the outermost layer of skin and nails in humans, is the main protein composition of our hair.

Each strand of hair consists of three layers.

MEDULLA – is the innermost layer which is only present in larger, thicker hairs.

CORTEX – This is the middle layer and is responsible for the texture and color of hair.

CUTICLE – This is a thin, colorless protective layer. Below the surface of the skin is the hair root, which is enclosed within the hair follicle

At the base of the hair follicle is the DERMAL PAPILLA The dermal papilla is fed by the bloodstream, which carries nourishment to produce new hair. The dermal papilla is very important to hair growth because it contains receptors for ANDROGENS, which regulates hair growth. To understand how hair grows lets take a look at the normal hair growth cycle. Hair follicles follow a genetically programmed cycle that can be broken down into 3 stages.

ANAGEN – GROWTH PHASE About 85% of hair follicles are in the growth stage at any one time. This stage varies from 2-5 years with hair growing approx 10cm per year. Eyelash, arm and leg follicles have a shorter growth stage lasting only a few months so the resulting hairs are shorter.

CATAGEN – TRANSITIONAL PHASE This stage lasts about two weeks. During this stage the follicle shrinks to 1/6 its normal size. The lower part of the follicle is absorbed by the body and hair growth ceases.

TELOGEN – RESTING PHASE About 15% of hair follicles are in this stage at any one time. The resting phase normally lasts about 2 months. During this stage the bulb of the hair shaft moves closer to the surface of the skin. This causes the hair to loosen and then it is shed. At the end of the telogen phase the hair follicle re-enters the anagen phase. The follicle enlarges again and a new growth cycle starts.

Hair is continually shed and renewed by the alternating cycle of growth, rest, fallout, and renewed growth. Each follicle follows this cycle independently of others, so the total number of hairs normally remains consistent. On average 50 -100 hairs are shed per day. This does sound a lot but when you consider the total number of follicles on your scalp is around 150,000, it is a very small amount.

FOLLICLE DAMAGE When you pull a hair the hair follicle will try and repair any damage that has occurred. The human body has a remarkable way of repairing itself but this can take some time. If you pull a hair and the root is not pulled out this means that the hair is in its resting phase, however if you pull a hair with the root attached the hair is in the active phase which means it is actively growing. If you pull part of the root out this can damage the hair follicle.

The BLACK tip you see on some hairs is the area responsible for color pigment. While the hair follicle is repairing the hair will grow but the MELANIN (which gives hair its color) will not have ‘fused’ with the protein cells that are our hair, causing the hair to grow in grey or white. In time your normal hair color may re-establish itself, but this is not always the case. The follicle may be repaired enough to grow but the formation of melanin can cease which causes the hair to stay grey or while. Hair can also grow in different eg- if you have straight hair it may grow in curly.

If you pull the hair and the whole follicle comes out with a RED tip, you have just detached the blood supply and muscle. This is permanent damage. This means that the hair will NOT grow back.

RECOVERY TIME FRAME Different areas have different chances for recovery speed. This is just an estimate of how long FULL recovery will take. You will see new growth fairly quickly in most cases.

LASHES – Some people can get FULL recovery in 6 months but if you have been pulling for many, many years it could be 2-4 years.

EYEBROWS – FULL recovery can be slower than lashes because this area is more easily damaged and for some people it does not totally grow back.

SCALP – FULL recovery for normal hair can take 2-6 years. This sounds like a long time but you have to remember that your hair only grows about an inch a month.

You have to wait for each hair pulled to start its growth cycle again and if it is growing in “funny” you have to give you body time to repair itself, then you have to wait to grow length again.

Coconut Oil and Castor Oil for Hair Growth

I have read about the benefits of castor oil and coconut oil for hair regrowth.  This is an affordable hair treatment so I ordered some of each and will post my results.

castor oil $6.79

coconut oil $12.95

Here is a great tutorial about using these products:

Using Castor Oil and Coconut Oil to help your hair grow!

*Update*

In my experience these products do not cause hair to grow faster or thicker.  I would recommend these products for hair conditioning, but that is the extent of their wonder.

Biotin for Hair Regrowth

I have started taking Biotin to help my hair grow back.  Biotin is a B vitamin found most commonly in prenatal vitamins. Biotin is supposed to encourage hair and nail growth. Right now I’m taking 10,000 mcg per day as that seems to be a helpful amount for me. Whether it really helps my hair grow better time will tell, that is if I can stop pulling long enough to let my hair grow back.

For those of you who are unaware, extremely high levels of biotin are the “miracle” workers that can be found in 99% of these hair growth medications that are being sold on the market today. Biotin is a water soluble B vitamin that produces keratin, increases hair elasticity, and protects the hair from becoming dry. It also helps thicken the hair to give the appearance of fullness. It is usually paired with MSM which my some hair, skin, & nails supplement do contain.

Will They Grow Back

One fear I have obsessed about is that my hair, lashes, and/or brows will not grow back.  In a quest to find answer, I fond the following information most helpful.

According to the book “The Hair-Pulling Problem A Complete Guide to Trichotillomania” by Fred Penzel. There is a huge section on hair growth charts and facts. If you haven’t picked up this book I highly recommend it for understanding more about trich.

According to the book, Eyebrows Average Daily Hair Growth Rate Female is 0.16 mm.

Average Daily Rate of Hair Growth by Age and Area- Young Adult Eyebrow 0.14 mm. Mature Adult 0.16 mm.

Time Required for Eyebrows Regrowth of pulled Hairs by Age and Area- Young Adult 65 (days). Mature Adult 56 (days).

Time Required for Regrowth of Pulled Hairs by Area and Sex-
Eyebrows Female 61 Days.

According to the book, although there is not a chart on eyelash growth, it should be noted that eyelashes are the slowest growing hairs on your body, with a daily growth rate of less than 0.16 mm. The follicles tend to go into a telogen, or resting phase following removal of hairs. Also note that these are merely average figures. The actual amount of time it takes for your hair to grow back may differ from the time spans, as hair growth can be affected by many different factors.

According to the book damage beyond re-growth could only occur if infection is in the follicle, this can lead to permanent scarring of follicles, preventing further hair growth. This is more likely to happen as the result of picking at the skin with implements such as needles or tweezers to get at hair roots or ingrown hairs. A hair shaft grows from the papilla, and as long as the papilla has not been seriously damaged or destroyed, hair will continue to grow.