Electrolysis: body and genitals

Welcome! The information on this page is written for a transsexual audience. For a general market discussion of body and genital hair removal methods after reading this page, please visit: hairfacts.com

Please consult with your surgeon about the recommended areas to clear prior to SRS. Some information on this page may be outdated or may not apply in your case. Do not rely on this page for definitive information.

Summary

Body electrolysis:

Wait to start body work until your face is being cleared with an hour a week.

Many people find that testosterone blockers reduce body hair significantly over time.

Some with light skin and dark hair found laser to be helpful forreducing the darkness and coarseness of large amounts of body hair.

Many people only do electrolysis on face and possibly genitals prior to SRS, doing the rest with temporary methods.

Electrolysis is usually prioritized in this order:

1. Face first and foremost
2. Genitals prior to SRS
3. Highly visible areas, such as back of neck, outer ears and hands.
4. Hair considered "masculine," such as eyebrows, chest, shoulder, back, buttock, and bikini line hair.
5. Less common areas like abdomen, arms, legs, feet, and armpits are sometimes felt to be necessary.

Genital electrolysis:

SRS surgeons have been able to drastically reduce the need for abdomen and hip skin grafts in patients who cleared hair from the scrotum and penile base prior to SRS.

Some don't get genital electrolysis and don't feel they needed it.

Some post-operative SRS patients have reported that unremoved hair in and around their new vaginas caused aesthetic and functional concerns.

Consult with your SRS surgeon as to his or her preferences for area to be cleared.

Most surgeons will scrape or cauterize hair follicles on the graft site just before use, but doing electrolysis before surgery increases the likelihood that all follicles will be destroyed before the graft is part of your vagina.

You should plan for genital electrolysis to take about a year, although most get done sooner.

Your electrologist may require a letter or phone call from your doctor or therapist indicating that genital electrolysis is necessary in preparation for a medical procedure.

You may have to pay a higher hourly rate for genital electrolysis.

You must be scrupulous about hygiene when getting genital electrolysis, especially if getting it performed close to your surgery date.

Most people find genital electrolysis more painful than facial work. You may need to take additional steps to alleviate pain. Some have reported adequate pain relief with painkillers and/or EMLA, where others found injections necessary.

Treatment should be done at the highest machine settings. Unlike your face, it doesn't matter if you scar the skin slightly.

Most SRS surgeons recommend completing genital electrolysis one to six weeks before SRS. I recommend completing it at least six weeks before, and preferably 8 weeks before.

Most SRS surgeons recommend waiting to begin genital electrolysis prior to labiaplasty until 6 to 8 weeks after vaginoplasty, and to complete it one to four weeks prior to labiaplasty.

It is possible to get genital electrolysis post-surgically, but treatment may be more difficult or impossible in certain areas.

If you can't afford to risk your time, money, or the quality of your surgical outcome on unproven technology, you should invest in the only proven permanent hair removal option: traditional electrolysis where a probe is inserted in the follicle.

If you think it may be extremely painful for you, you may want to schedule a small test session at the end of a facial session before committing to a big block of time.

Treatment suggestions (see tips below for more):

Try to schedule genital work when you have a large block of time:

Trim hair in areas to be cleared, especially if thick.

Wear old underwear and loose pants or a skirt, especially if using EMLA.

Most people report that treatment of the scrotum is easier to bear than around the base. Plan accordingly.

Meticulous post-treatment skin care is very important to avoid infection and aid healing.

Genital hair removal with lasers has not been proven permanent.

SRS surgeon Toby Meltzer recommends electrolysis, saying he has seen no data showing that lasers are permanent.

SRS surgeon Eugene Schrang thought lasers were promising in 1997, but now feels it would not be effective on enough patients to be cost effective. Dr. Schrang will not go on record saying laser is permanent or that he has seen permanent results.

Electrology 2000 will do pre-SRS genital clearing whether or not clients did facial work with them. As of April 1998, they charge $150/hour for genital work for all patients, even those who have done facial work there.

Non-facial electrolysis

Wait to start body work until your face is being cleared with an hour a week. Spend your money and energy on your face at first. You'll be glad you did later.

Luckily, many find that hormones, especially testosterone blockers, greatly reduce body hair after six months to a year of continuous use. Most people who do have body hair at that point choose to do their chest and shoulders or back first. Another popular area is hands, especially if yours are quite hairy. Although there are a few brave souls who do their arms and legs, most prefer to save a great deal of time, pain, money, and potential scarring and use a non-permanent method for legs and arms.

Electrolysis inside nose and ears

Most electrologists won't do these areas for those unlucky enough to have hair in these areas. If they do, you will probably find it extraordinarily painful and prone to infection (that's why they don't do it). Look into pain management techniques above if you happen to find someone willing to do this.

Body work

Rosalind wrote, "I had an extremely hairless chest. I just wanted what was there to be eliminated. It took about 3 hours total to remove what at first appeared to be 10 hairs. But to get all of them and the ones that weren't above the skin at the time and the follicles that weren't killed the first or second or third time is what took so long." So, just as it takes a while to do the face, it can take a while on the body."

On May 5, 1998, I did my first bit of chest electrolysis. I found it quite bearable in the center of the chest, but it got more and more uncomfortable as we moved toward my throat and outward from the center. I used no pain relievers of any sort, although when I do the ones around my nipples, I will certainly slather on some EMLA. I found accupressure quite helpful near the treated site. I'm glad I never plucked or waxed my chest, and I'm glad I waited until the hormones had a chance to thin it. There's not much there, although like Rosalind, I found it deceptive once I started treatment.

I'd recommend once you start chest work not to shave any more. The hairs take longer to grow that facial hairs, and even though I could feel them, they were very hard for my electrologist to find, since they were so short from shaving. I would feel around for one, and when I felt one, I'd tilt my head up in order to see it. They were hard to see unless the light hit them just right, and oftentimes I'd see one my electrologist couldn't, and vice versa.

If you have a lot, I'd also recommend thinning versus clearing. The skin on your chest takes much longer to heal and is thinner, so it's more important to be conservative to avoid scarring. I know someone who has tiny white marks on her chest from overzealous treatment. To avoid that fate, start your chest before you're in a big rush to get it done.

Most of the information in this overview about facial electrolysis also applies to body work. The only area worth noting might make your eyes water just reading about it...

Genital electrolysis prior to sex-reassignment surgery

This is a recent recommendation in response to advances in SRS technique using scrotal skin for vaginal reconstruction. Some post-operative SRS patients have reported that unremoved hair in and around their new vaginas caused aesthetic and functional concerns.

Additionally, newer SRS procedures using scrotal grafts can eliminate the need for skin grafts taken from the abdomen or hips in most patients, providing hair has been removed preoperatively.

Surgeon recommendations

Check with your surgeon on his or her preferences. Depending on your amount of genital tissue, it may not be necessary for you.

Toby Meltzer

2002 update: please see the new Meltzer paper with his recommendations for electrolytsis prior to SRS.

SRS surgeon Toby Meltzer wrote in his 1998 information packet :

The penile skin is used to reline the vaginal vault, which eliminates the need for grafts in most cases. In patients with a shorter penis (less than five inches [12.7 cm] erect when measuring from the underside), distant grafts may still be avoided if the scrotum is cleared of hair preoperatively.

Dr. Meltzer recommends electrolysis for this procedure. His diagrams for the area to be cleared can be found at the end of this page. In my April 13, 1998 consultation with Dr. Meltzer, he told me that the vast majority of patients requiring skin grafts can use scrotal tissue if electrolysis has been used to clear the hair. I have asked him to write a brief synopsis of his observations and results, which I will include here as soon as I receive them.

Eugene Shrang

2002 update: please see the Eugene Schrang's site with his recommendations for electrolytsis prior to SRS.

SRS surgeon Eugene Schrang has some information from 2002 on hair removal prior to SRS:

Hair can be removed by electrolysis or laser prior to surgery.  But better still is the cutting away of the hair follicles while thinning the graft with scissors which can be done by me at the time of surgery followed by electrocoagulation of the follicles.  This saves the patient time and money not to mention great discomfort from painful electrolysis.  Since electrocoagulation is time consuming, we charge an extra $500 for this. 

No matter what method is used to remove hair, the removal of ALL hair follicles is usually never completely accomplished and some hair may grow in the neo-vagina.  This is why you must begin early to remove as much hair as possible from the scrotum if you wish me to use your scrotum as a full thickness graft and do not want me to remove the hair at surgery.

See also this diagram prepared by Dr. Schrang

(Regarding methods, there has been a lot of speculation about Dr. Schrang's opinion of laser hair removal. After initial interest, Dr. Schrang did not purchase a laser and is not willing to go on record saying laser is permanent. For more on this, please see the section below on lasers vs. electrolysis for genital hair.)

Drs. Menard and Brassard

Montreal surgeons Yvon Menard and Pierre Brassard write in their informational packet:

I perform the inversion technique. When the penis is too short, I use the excess skin from the scrotum to have sufficient amount of skin for the vaginoplasty. I am enclosing diagrams describing the technique used. Because I perform a perineal skin flap at the posterior end of the vagina, it is best to have electrolysis on this area. It is marked in the brochure (1 inch above the anus and an area of 1 inch X 1 inch).

(Regarding methods, there has been speculation about Dr. Menard's opinion of EpiLight hair removal. I wrote to him on April 19, 1998 about this, and I will publish his statement as soon as I receive it.)

Dr. Seghers

Belgian SRS surgeon Dr. Seghers suggests removing the hair around the base of the penis and the hair on the midline 7 inches forward from the anus. If you plan to do genital electrolysis, check with your surgeon as to his or her preferences.

Recommendations from TS organizations

AEGIS

I have included the full text of a medical advisory put out by Dallas Denny of the American Educational Gender Information Service (AEGIS) on the topic. The AEGIS advisory recommends genital electrolysis prior to ANY SRS procedure.

AEGIS SUGGESTS ELECTROLYSIS TO AVOID PROBLEMS OF HAIR IN NEOVAGINA

(originally released January, 1995)

The Problem

Vaginoplasty using the penile and penoscrotal inversion methods, with or without skin graft or skin flaps, can result in a neovagina which is lined with hair-bearing skin. As the hair grows, the vagina can become choked with hair. Not surprisingly, many transsexual women find this extremely embarrassing.

Some sex reassignment (SRS) surgeons do not appreciate the extent of this embarrassment. During a presentation given at the October, 1993 meeting of the Harry Benjamin International Gender Dysphoria Association, one prominent surgeon remarked that although his procedure sometimes results in hair-bearing vagina, his patients do not seem to mind. Reports we have had from transsexual women indicate, however, that they DO care.

Our Recommendations

We recommend that surgeons doing male-to-female SRS become aware that hair-bearing vagina is extremely embarrassing for their transsexual patients, and to provide them with materials educating them about the problem and indicating where they should consider having electrolysis to avoid hair-bearing vagina.

We recommend that electrologists be aware that transsexual women who are seeking SRS have legitimate reasons for seeking electrolysis in the perineal area.

We recommend that persons seeking male-to-female SRS who have excessive hair in the pelvic region consult with the surgeon they have selected in order to determine which skin will eventually be inside the vagina so that they can decide whether electrolysis is desirable and so they can schedule electrolysis and surgery accordingly.

All parties should keep in mind that electrolysis is a gradual process, and that it can take a year or more to completely clear an area.

While most electrologists will do this for clients they have treated for a while, many will balk if you approach them with this request first. Besides, you should begin with your face anyway, which will take longer than any genital work you may need. For most electrologists, hair is hair, and they're used to working around women's bikini lines. However, if you run into some resistance, you may need to get a letter or phone call from your doctor or therapist indicating that genital electrolysis is necessary in preparation for a medical procedure.

Looking Glass Society

The following is excerpted from the Looking Glass Society's website:

Many don't get it and don't feel they needed it. A transsexual client will probably feel intensely embarrassed about merely possessing male genitalia, let alone allowing someone else to see them. However, it must be said that genital electrolysis contributes greatly to a satisfactory outcome of the surgery... Hygiene before and after treatment is paramount, as there is a high risk of skin infections from genital electrolysis. Some clients report using Betadine liquid to good effect, before and after genital electrolysis.

The skin itself is soft, wrinkled and rubbery in texture, and the follicles can be very 'tight' in some clients. Careful attention to stretching the skin around the follicle being treated is essential, and some electrologists find a relatively stiff needle, such as some of the one-piece designs, helpful as it may be necessary to push the needle into the follicle considerably more forcefully than with any other site on the body, and a highly flexible two-piece needle may be prone to bending.

Comments from a practitioner

In September 2001, I got the following note:

I mentioned to you once before that I do genital electro. I just comleted my 24th clearance and have had a problem with her I thought was a one of before.

I have encountered a possible problem with it. On two people I have had a section of skin where the scotum joins the penile skin being damaged and healing a lot slower after high power treatment with electro and four people who have had a longer healing time for that area that any other part of the genital area.

The last person the skin didn't scab over for almost two weeks and kept weeping from a point in that area about 1cm square.

The rest of the genital area that was done healed very quickly as usual.

I usually do the genital electro under local anesthetic and treat hairs in that area differently from the face. I set the machine at very high settings.

The skin at the top of the basis of the penis heals very fast and very well in my experience.

Scrotal tissue on the other hand I have noticed tends to heal a lot slower in some people. It may be an idea to warn people about this in your gential electrolysis section

I would suggest people be informed that they really have to have had the last session about 8 weeks before there operation in case a complication like this occurs as it could take a month to clear up.

I strongly urge you to use traditional electrolysis for this important procedure. Lasers have not been proven to be permanent, and since genital electrolysis can often be done only once or twice, there is no room for experimenting with unproven technology. If you can't afford to risk your time, money, or the quality of your surgical outcome on unproven technology, you should invest in the only proven permanent option: traditional electrolysis where a probe is inserted in the follicle. Please read my extensive analysis of laser hair removal before deciding to try lasers.

Dr. Schrang's comments

Dr. Schrang's statements are more an endorsement of his onsite surgical hair removal than of laser hair removal. This is by no means a ringing endorsement of lasers.

Dr. Meltzer's comments

On April 13, 1998, I had an office consultation with SRS surgeon Toby Meltzer. I asked him his opinion on laser heir removal, and he said he had not seen any clinical data showing it was permanent. He added that if he thought it was permanent, he'd buy a machine for his office and use it. Dr. Meltzer is currently preparing a statement on laser hair removal for this site, which I will include as soon as I receive it.

Again, please read my extensive analysis of laser hair removal before deciding to try lasers.

Other genital electrolysis pages at this site

I have also compiled a page of consumer tips and experiences which you should read before starting.