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 vaginoplasty. Some information on this page may be outdated or may not apply in your case. Do not rely on this page for definitive information.

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My genital electrolysis tips

OK, I admit it. I was a little embarrassed, but I've known my electrologist for many years now. Luckily I've never had an active aversion to my genitals, I just wished they were different. I don't mind touching or looking at my genitals as part of electrolysis treatment. I hope you won't let embarrassment stop you from doing this. After a while, it didn't seem like a big deal at all.

Between March 12 and May 5, 1998, I did 8 hours to get to my first complete clearing. I usually did about an hour at a time, since the longer sessions I did got very tiring. I would have gotten entirely cleared in March, but when I started, my vaginoplasty was over a year away. When my vaginoplasty got moved up to June 16, I did as much electro as I could as quickly as I could.

The sensation definitely hurts much more than facial work. Where hairs under the nostrils really sting, I found pain from genital work to be more intense and longer-lasting. It's a delayed reaction pain, even with the EMLA. It hurt when she first applied the current, but the pain intensified for about two more seconds after after she stopped treating a hair. Because we were doing double and triple insertions, the pain would be peaking as the next hair got treated.

A few times I had to move to another area and let an area cool down. Otherwise it was like a constant, extremely intense pain moving from hair to hair. I actually screamed on a few. I'm not kidding when I say it really hurts. You just have to keep your eye on the big picture and think that you're improving your surgical outcome.

I found genital electrolysis essentially bearable with EMLA alone. The only area I found very difficult was the top side of the penis around the base. For most people, this is where the hair is most dense and possibly more coarse. It may be important to treat this area to avoid hair under the clitoral hood.

My final session, a three-hour marathon, proved to be the worst. It was the only time I ever cried during electrolysis. For some reason, the upper areas that needed clearing did not get numb at all from the EMLA. I found this out in the first minute of the session. The thought of three more hours of that broke me, and I started crying. Luckily, the scrotal area didn't hurt, so we did that while I reapplied EMLA on top. It was still excruciating, and I had to mentally prepare for each hair.

It was easily the most pain I've felt in my entire transition, and it lasted about an hour. It exhausted me and left me sore for a couple of days. But you know what? I forgot about it the next day for the most part. Once it's over, it's over. The main element of pain is the anticipation of more pain, I think. If you find it hurts, just keep in mind why you're doing it. Keep in mind you'll be done soon.

You can do it if you really, really want to.

Before day of treatment:

If possible, start your clearing after consulting with your vaginoplasty surgeon.

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.

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

    So you can take care of pain relief preparation such as anesthetic shots or EMLA.

    So you can do as much as possible during each session. If you can bear it, I recommend a two hour appointment.

    So you can go home immediately after.

Trim hair in areas to be cleared, especially if thick. I used the beard trimmer on my electric razor to cut everything down to about 2-3 millimeters (1/4 inch). Had to blow the dust off the thing and hunt for the cord! Trimming will make things much easier for your electrologist and will help if you're using EMLA. You could have your electrologist trim it during your session, but it saves treatment time and money if you do it yourself beforehand.

If you have a problem with pain, I recommend finding someone to inject anesthesia prior to your treatment. Since it's for a medical procedure, perhaps your doctor will do it, or perhaps he or she can recommend someone who could. You might find it worth the extra cost.

Day of treatment:

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

Get there early. Give yourself as much time as possible to get injections or apply EMLA prior to treatment.

EMLA use:

Get there early so EMLA can sit at least one hour.

Use a lot, especially around the base. I used about half a tube.

Put your underwear back on after applying the EMLA and cling wrap to hold it in place. If the cling wrap is put on properly, you shouldn't have any leaks.

Move around as little as possible after applying EMLA.Lie down if you can.

See my page on pain management for additional EMLA tips and pain relief techniques.

Carefully covering the EMLA with cling wrap is vital. Use two pieces: one that covers the scrotum from the anus to the underside of the penile shaft, and another that goes over the top and wraps around the base. The key is to have an airtight seal that will hold the EMLA in place.

During treatment:

I found accupressure extremely helpful. When working on the scrotum, I'd press hard with my fingers between my scrotum and inner thigh.This kept the pain from traveling down my leg. When I worked on the part above the penis, I would press down extremely hard on my pubic bone.

I had to do the area around the top of the base in several sessions, because the area got so raw that it hurt just to touch or stretch the skin.

Most people report that treatment of the scrotum is easier to bear than around the base. In my case, the top side of the base was much more painful than the lower side. Plan accordingly whether you like the hard part at first or at the end of a session.

Use the machine's highest settings if possible. You want a high kill rate, and any scarring will never be seen.

After treatment:

I had scabbing in the dense areas around the top of the base. I also had some pretty bad bruising in a couple of spots after one especially intense session. I also shed a layer or two of scrotal skin over the next couple of days.

You will need to find a balance between keeping skin moisturized and keeping skin clean and dry.

Put aloe on the area immediately after treatment, then cover it with tissue. I found it most comfortable to place one tissue between scrotum and penis before tucking, then placing another piece over the entire area after tucking. All this was held in place by underwear, which kept dry this way.

When you get home, cleanse the area thoroughly with mild soap and re-apply aloe.

If possible, try to stay in a bathrobe after post-treatment cleansing to let the area dry.

I found talcum or Lotrimin spray powder made the itching easier to bear.

Avoid tucking or any skin touching the treated area if possible the day after treatment. I believe keeping the area exposed to air immediately after treatment will help the healing process.

Avoid sexual contact after genital electrolysis, especially if you have experienced scabbing or peeling. You may get infection or slow the healing process.


Patient experiences

The following transsexual patients have been generous enough to share their experiences with genital electrolysis.

The following contributor had genital electrolysis prior to surgery with Schrang, and writes:

It's painful, it's nasty, it's another expense and it is almost mandatory. The best surgeons are recycling scrotal tissue for skin grafts and all of the surgeon who use the penile inversion technique are obviously using penile skin. Both of those areas of the body are hair-bearing and those hairs need to be permanently removed prior to vaginoplasty. You can expect to need 3 or 4 clearings, spaced 6 weeks to 2 months apart, for this area to become permanently hair-free.

A British reader had genital electrolysis prior to surgery with British vaginoplasty surgeon Dr. Royle. She writes:

I used EMLA cream (that's lidocaine/prilocaine 5%) topically, plus oral painkillers. I found that paracetamol/codeine did little, but co-proxamol was much better and combined with the EMLA made the pain tolerable.

You must also be scrupulous about hygiene when zapping `down there': the area is teeming with bacteria anyway, and a nasty skin infection is exactly what you don't want just before vaginoplasty. In addition to washing thoroughly, I swabbed with isopropyl alcohol before and after zapping, and applied a topical antibiotic (silver sulfadiazine) after. I got no infections.

I found the majority of hairs were killed on the first zap; the second left me almost completely clear, and a very few hairs needed a third hit (perhaps I didn't zap them properly the first time?). Pubic hair follicles seem very different to facial hair ones and are quite easy to kill; also, as long as you can tolerate the pain, you can be a little heavier on the zap time and power level to get a high kill rate: Unlike your face, it doesn't matter if you overdo it a bit and mark the skin slightly, after all the only person who will ever see it after vaginoplasty is your gynecologist!

BTW my surgeon insisted on no further zapping in the last six weeks before the op, to ensure that everything was fully healed. I think he was being a bit cautious though.

Been there, done that! With Royle's technique I had to zap a chunk of scrotal skin shaped like an inverted `U'. It wasn't much fun but the results are good: no hair inside, a very good cosmetic appearance, and sufficient depth and diameter in spite of having had very limited material available to work with.

Another woman who had genital electrolysis prior to surgery with vaginoplasty surgeon Toby Meltzer writes:

In preparation for my vaginoplasty, scheduled in October, Dr. Toby Meltzer suggested that I have my electrologist remove hair from a region on the back of my scrotum. He said she'd know what to do. Well, she said she had never done this, but contacted Toby via Dr. Anne Lawrence, and they got everything figured out, and so I am having that hair removed. EMLA isn't totally satisfying (i.e. the electrolysis hurts a bit) and so I was wondering if anyone else had had posterior scrotum hair removed prior to vaginoplasty. Any experiences or wisdom you could pass along?

I don't "object" to the concept, but we are not working with any operational background, so I feel like something of a "guinea pig." (which should not be construed as a demeaning term with respect to these animals, which have suffered quite a bit for medical sciences!)

Another reader had genital electrolysis prior to surgery with vaginoplasty surgeon Toby Meltzer, and she had the area numbed with injected anesthetic prior to treatment. I have compiled the following information from several of Laura's informative posts about her experiences. If the information seems a bit disjointed, it is due to my editing, not Laura's writing.

Introduction

Genital electrolysis is not a requirement, it's an option. It depends on your penis size and on your surgeon, among other things. The bottom line: ask your surgeon.

In Toby's typical vaginoplasty, the exposed penile skin is stretched very tightly from the old location of the penis to the new vaginal opening. There's not any extra skin there to play with. This is one of the ways that he gets away with using skin grafts less often.

Patients who might otherwise need skin grafts may be able to avoid them by clearing the scrotal skin of hair so that it can be used instead of a graft from another site. Scrotal skin is nice, darker colored, stretchy skin, which I think makes a better vaginal lining than skin from the abdomen would. Folks with plenty of penile skin probably don't need to bother. I did the whole thing to give Toby more skin to play with if he needs it.

Background

I heard about the possibility of scrotal electrolysis from Joy Shaffer about two months before my vaginoplasty. Joy was speculating that if there were a way to use more scrotal skin at the inner end of the vagina, it might be possible to stretch the penile skin a bit less tightly. This might leave a bit more of it exposed on the outside, with a bit of looseness and wrinkling, and that's perfect for forming nice inner labia later. The reason Toby hasn't tried this before is that the scrotum is usually all covered with hair. When he uses a small bit of scrotal tissue to form a pseudo-cervix, he scrapes it thin enough to kill the hair follicles. But that's not practical for a large piece.

Well, either Toby or Joy thought of the obvious solution to this: get electrolysis done on the scrotum. Ideally we would have started this whole process a lot earlier, so that we could be sure all the hair was gone by January.

Pain management

Electrolysis down there *hurts*. I would not recommend doing it without some serious local anesthesia. I had my zapper, Laura Pino, do a few test hairs just to see what it was like, and it was not fun.

Genital electrolysis isn't so bad if you use the right anesthetic. Joy shot a xylocaine/marcaine mixture into me about half an hour beforehand. The marcaine lasts a long time (4+ hours for me), but it takes a while to start working, and it really burns until then. The xylocaine doesn't last long, but it starts working very quickly, so that you don't feel too much burning from the marcaine.

The injections hurt a bit, especially up around my penis, but only very briefly. In most places, I couldn't feel a thing. I'm not sure I could have done it without the anesthetic. I suppose some serious, even narcotic, painkillers might have made it bearable enough without the local. If I were getting genital electrolysis done with EMLA, I'd probably take some fairly heavy painkillers too. Ultram seems to work pretty well for me.

Injections made the electrolysis almost totally painless, and it let Laura work a lot faster on me because she didn't have to worry about hurting me too much. The downside of that, at least for me, is that I'm scared of needles. The panic really got to me, and I almost passed out when I got up too quickly after it was over. But when I went in for round 2, it wasn't bad at all. I knew I could deal with whatever pain the injections caused, and I didn't have a reason to panic anymore.

Results

I had my zapper set the machine on "well done". <g> We left the thermolysis component about where we usually do, but we cranked up the galvanic side because that tends to have a higher kill rate. I actually ended up with a bunch of little, tiny scabs where the worst hair follicles had been. However, nobody but Dr. Meltzer and my gynecologist is ever going to see that skin again.

It took about five or six hours for the first clearing, spread across two sessions. The second pass two weeks before vaginoplasty took only a couple of hours. I wouldn't recommend doing it closer to your surgery than that, because the skin there (or mine, anyway), can take almost that long to heal fully. Interestingly, Toby said he was more worried about infections than about skin damage or anything else.

We ended up clearing my entire scrotum, plus a bit of hair around and on the base of my penis. We cleared my entire scrotum, because I (and possibly Joy) misunderstood which tissue Toby was going to use in the vagina. Because of that, my labia are nearly hairless. I kinda like them that way, though.

Toby did my vaginoplasty on January 17, 1997. He used a large amount of scrotal tissue - basically all of the lower half of the scrotum. If I remember the details correctly, he used it to form most of the posterior wall of my vagina, along with the cap at the end.

I'm very glad that I did, because it definitely saved me from needing a skin graft. I ended up with a pretty good sized vagina, and I had a very small penis to start with.

Labiaplasty

I had more electrolysis done around my clitoris, in preparation for labiaplasty on May 1st. Toby recommends doing a 1" semicircle above and around the clit. Joy suggested that I do a slightly larger area, basically a semicircle starting at the upper ends of my labia, and I took her advice. This time, the injections *really* hurt for a few seconds, probably because Toby did such a good job of making that area so sensitive. But it was still worth the trouble; I think I'll get a better result this way.

Thanks Laura!

A note on costs

Some electrologists charge higher rates for genital electrolysis. For instance, Electrology 2000 charges an additional $62 an hour for genital work. While I'm not happy about this trend, I hope the higher cost does not dissuade you from getting it prior to vaginoplasty. It will be money well spent, I believe.

I'd suggest not bringing it up with your electrologist, since most would not charge more-- especially for long-term clients. Some have reported spending $100 to $150 an hour for genital work, although I pay the same rate as facial stuff. I'm not about to rock the boat, either!

A reader writes:

Susan Laird and Guy Campo, both in the San Jose area, do genital electrolysis at much lower rates. If I recall correctly (and don't hold me to these prices), Guy charges $40 an hour and Suzie charges $60 an hour for genital electrolysis. Guy is colocated with Dr. Joy Shaffer, and Suzie is about a 15-20 min drive from Joy's office. I don't know what Joy charges for injecting local anesthesia, but I do know that if you're not already a patient of hers, she will charge for an initial office visit the first time. She will not give anyone massive injections like that without first taking that person's medical history.

Genital electrolysis at Electrology 2000

After reading some speculation and hearsay on the internet (imagine that!), I wrote to E-2000 co-owner Bren Piranio on April 5, 1998, to ask about E-2000's genital electrolysis policy, specifically if they do genital clearing on clients who have not done facial work at E-2000. Bren wrote back "We are beginning to, only for those who are transsexuals scheduling surgery, and the rate is $150/ hour, due to the difficulty of the work. This was at the electrologist's request due to the difficulty of the work, not just because it is what it is. It is the genital rate for all such work"-- i.e., clients who did no other work at E-2000, or clients who did all their work at E-2000.

Bren adds that total genital treatment time "may vary from person to person and with the design required by your surgeon, yet it may be a range from 4-8 hours on the average. Not everyone is average-- the cycle time is still 12 months as is true for all genital area work."

SA in TX shares this experience of her genital (or "South Pole") electrolysis at Electrology 2000, where they use injected anesthetics.

The other day, I experienced something which I had never experienced before. I was at Electrology-2000 for clearing of my genital area in anticipation of a visit to Neenah for vaginoplasty this coming April. (For those reading this and seeing this discussion for the first time, please note that you need as close to a year of clearing of most of the hairs around your genitals, including scrotal area, prior to surgery if the results are to be fully to your liking.) E-2000, as the company is often called, uses a process which includes numbing administered by a medically qualified individual and then the electrolysis is performed in a painless, rapid manner. I had had my face cleared several times earlier; the electrologists from this company will not do a persons' privates without knowing her; and this time was to be my first "down there".

I was a little apprehensive as I arrived in Dallas the night before and had a business meeting with the president of a company with whom mine is doing some consulting. But I told myself that this could be no more painful than my face with its upper lip and other sensitive places. Early next morning, I nonetheless found myself at the office, in a private treatment room, sanitized with white over the couch on which I would lay. I had removed my shorts and panties, covered my thighs and genitals with a paper sheet to ward off the air conditioning and waited. I could see my reflection in the unused television set in front of me where a, truly not bad looking woman with long, attractive legs had laid herself out with them straddling over each side of the couch.

I gritted my teeth and worried. I had never, never willingly let another touch me down there. Hadn't I always gritted my teeth and resisted during my prostate portion of my annual physical? Wasn't I very uncomfortable when my sexual partners earlier in life had wanted to do things with those very personal items between our legs? What was I doing here? Why was I going to subject myself to this particular brand of torture. Wouldn't the needle hurt as it always did as it was inserted?

Then it came to me. Next year I will be penetrated during my first dilation by the surgeon who will have created my vagina. A little later, I will visit my gynecologist for the first time. Nothing new nor bad there, but uncomfortable? Probably. Some day, I may be with a man. How would I react to losing control and having someone touching my clitoris and vagina? Was this not part of my preparation? The thought became clearer. This was a very important first step in letting others take control of me at certain times in my life. I am willingly becoming a woman now and am going to lose some control some of the time. I became serene, and the apprehension left along with the white knuckles.

A little later Dr Piranio, Electrology-2000's CEO and all important number, arrived and administered a very gentle series of injections which I did not feel. Then, Roxane, my electrologist for the day, came in and we talked about our kids, our lives and rock music. I left about six with a cleared genital area, an appointment to return in October and no apparent swelling nor any pain.

I drove the 3 hours to Austin and haven't looked back.

See the page on Electrology 2000 for more information about their procedures.

Genital electrolysis prior to labiaplasty

A reader writes:

I had electro on corresponding skin prior to my labiaplasty. My doctor numbed the area with injections of lidocaine. It made it much more manageable. I flew to the left coast to get it done because my doc was going to do the labiaplasty and could mark the area that needed to be zapped as well as do the injections. The electrolysist shares her office.You might check to see if your PCP can do the injections and coordinate appointments with your electro.

A reader writes:

I had electrology done "down there" in preparation for labiaplasty; 20 cc of Lidocaine to numb the area, plus a shot of Valium (the Valium probably was not necessary, but that's speaking only in retrospect) and there was no trouble at all ([name removed] drove me from the doctor's office to the electrologist's). I needed it to prevent hairs from growing inside the labia or from under the clitoral hood.

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