Does Eyebrow Threading Carry Health Risks?

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A woman has her eyebrows threaded in London

When Reema Khan and her husband Mosin Mohammad launched their threading business in Chicago in 2003, the ancient hair-removal technique was little known to most Americans.

An alternative to hot-waxing and plucking that involves using a simple cotton thread to grasp and pull unwanted facial hair out by the root, threading has been commonplace for centuries among women in India and the Middle East. Over the past several years, the craft, which enthusiasts say is gentler and safer than other depilatories, has boomed in the U.S.

Indian-born Khan and Mohammad began their eyebrow-threading venture with a single kiosk in a mall, where they allowed curious customers to observe exactly what the technique involved. Today, the couple’s Shapes Brow Bar has 70 outlets across the U.S. and brings in about $14 million in annual revenue, according to Mohammad.

But the enterprise has hit a snag, inevitably perhaps. With the rapid growth in popularity of threading have come concerns about the health and safety of the method.

The issue: over the past two years, the state-run boards of cosmetology in Texas and Arizona have been issuing cease and desist letters to eyebrow threaders who practice without a cosmetology license. “People practicing threading should be required to have a cosmetology license for the safety of the public,” notes Susan Stanford, public information officer for the Texas Department of Licensing and Regulation, who says that poor sanitation, such as reusing threads on multiple customers, can spread staph infections and other contagious skin conditions. In Arizona, inspectors claim to have observed facial bleeding as a result of people’s skin getting pinched by the threads.

Juana Gutierrez, who works for Shapes Brow Bar in Mesa, Ariz., is one of five threaders who sued the Arizona Board of Cosmetology on June 29 for the right to practice the technique without a cosmetology license. She says that the health worries of the trendy practice are overblown. “It doesn’t cause bleeding. The only way threading causes bleeding is if you nick someone’s skin,” she says, which is extremely rare.

Gutierrez adds that threading is much safer than using hot wax to remove eyebrow hairs. “You don’t get irritated. You don’t get burned,” she says. What’s more, she says, some waxers double-dip the same applicator into the pot of hot wax, which can spread germs from one customer to another. Threading is also “more defined than waxing. It gets every little hair,” Gutierrez says.

Mohammad says that while he agrees that threaders should follow basic sanitation guidelines, requiring them to obtain a cosmetology license — which involves taking a course that can cost as much as $12,000 — is unreasonable. Threading isn’t tested on the state licensing exams, and few beauty schools even teach the craft. Most threaders, who typically earn minimum wage plus tips at Shapes Brow Bar, learned their craft from family or friends, not formal training programs.

“The boards don’t understand anything about threading. It’s plain ignorance and highhandedness,” says Mohammad.

Indeed, over the past few years, the states of California, Colorado, Indiana, Nevada and Utah have all exempted threaders from having to obtain a beauty license.

To find out how safe threading really is, Healthland spoke with dermatologist Amy Derick of Barrington, Ill. Derick says the practice is gentler on the skin than waxing, but it does carry health risks, including the potential spread of the herpes virus and staph infections through dirty threads and broken skin. “The consumer needs to be aware that there is a risk with threading, and you need to make sure that there is a clean thread, and the person is washing their hands,” she says.

Further, some 10 cases of “threading warts” — small raised bumps on the skin, which can be surgically removed — were reported in studies in 2007 and 2008 in the journals Clinical and Experimental Dermatology and the Journal of Cosmetic Dermatology. In the latter study, the authors concluded that “beauticians should be educated in maintaining hygiene and using sterilized thread for their procedures” and recommended that “persons wishing to go for threading should be encouraged to visit certified beauticians or beauty parlors.”

Potential customers who wish to make sure their threading practitioners follow at least minimum safety measures should also spend a few minutes watching the threader’s technique on other clients before submitting to the service. Since the procedure is so quick — it takes just three to five minutes to thread a set of eyebrows — it is easy to see whether the threader changes threads and cleans up between customers. It’s also worth checking online reviews on sites like Yelp or Angie’s List to see if there is a history of complaints at a particular salon or brow bar.

Mohammad says that his threaders at Shapes Brow Bar already follow basic hygienic practices, even though they aren’t certified beauticians. They use hand sanitizers between customers, always use a fresh thread, and regularly clean brow brushes and scissors with antibacterial germicides. Even the seats are wiped down daily with industrial-grade cleansers.

Hit with some $100,000 in fines in Texas and forced to pay legal fees of $200,000 to keep his shopping-mall kiosks open in that state and in Arizona, Mohammad says he is now focusing his business’s growth plans in states that are more tolerant of the practice, such as California. “I am not opening any more Brow Bars in Texas, and I’m not opening any more in Arizona until I see what the outcome is going to be,” he says.

The threading battle isn’t just a niche business or minor health concern, either. The Institute for Justice, a nonprofit civil liberties group that is providing legal counsel for threaders in Arizona and Texas, sees it as a fundamental assault on workers’ rights. “The government is taking away people’s right to earn an honest living,” notes Wesley Hottot, an Institute for Justice attorney. “It is about economic liberty and there being judicially enforceable limits on how the government can regulate your living.”

But as the legal battle rages on in both states, threading’s newfound popularity across the rest of the nation shows few signs of waning.

Anita Hamilton is a TIME contributor. You can follow her tweets at @anitafhamilton. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

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