Genital electrolysis

Electrolysis hair removal is mainly used to remove facial hair, but it is effective on your whole body, including your genital region. Most surgeons who perform Surgical Reassignment Surgery (SRS) strongly advise having genital electrolysis before SRS. Attention: the anal region will not be treated.

How much hair needs to be removed from the genital zone before a Sex Reassignment Surgery (SRS)?

Why genital electrolysis prior to SRS? Can’t I have my SRS without it?

Genital electrolysis is performed prior to SRS to avoid any problems with hair in your new vagina. In most patients, the area between the anus up to a part of the scrotum is going to be used to create the back wall of the vagina. The area from the scrotum up toward the base of the penis will also be used to build up the vagina. For most patients that require skin grafts for vaginoplasty, scrotal tissue is transplanted during SRS.

The most important reason to have the hair in that area removed is that there is a high risk of infection of the hair follicles. This risk may be higher even due to the friction that you will experience against that part of the skin during dilation but also during intercourse, for example. And since the skin is no longer exposed after surgery, because it is folded inward, it’s too late to remove the hair later on.

Many SRS surgeons emphasize that patients should have genital hair removal prior to SRS since it strongly influences the operation and its outcome. Some may not want to perform SRS if you still have hair in the area used for your neo-vagina.

Laser or electrolysis for your genital hair removal?

Although we have a laser hair removal machine at 2pass Clinic we strongly advise you to use genital electrolysis. Lasers have not been proven to be permanent, and since genital hair removal can often not be redone after the SRS operation, we argue there is no room for experimenting with unproven technology. 

Caution: Many surgeons use a “scrape” technique during surgery, where they scrape away the hair follicles, but results indicate this is not effective and complicates recovery (eg ingrown hairs). We recommend you rely on electrolysis.

How much hair needs to be removed from the genital zone before a Sex Reassignment Surgery (SRS)?

Vaginoplasty, using Penile Inversion, is the most common MTF genital surgery.

• This utilizes the penile skin to line the vagina, and the scrotal skin to create the labia.
• Some SRS surgeons use a perineal skin flap at the posterior end of the vagina, it is best to have electrolysis in this area.
• It is suggested to remove the hair around the base of the penis and the hair on the midline between the anus and the penis.
• If you plan to have genital electrolysis, please do consult with your surgeon as to his or her preferences.

Electrolysis How much hair needs to be removed

Should I remove more hair as a precaution?

As we explained, the marked area is the only area that will be used to build the vagina and hence the only area where it’s mandatory. If you have a lot of hair around this area, you can expect some hair growth near your vagina. This is no problem, it just depends on what you prefer. If you want to have more hair removed, you are free to do so for aesthetical reasons.

Practical: timeframe of genital electrolysis

• You should plan for genital electrolysis to take about a year, although some get it done sooner (7 months minimum). 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.
• As the complete hair growth cycle of genital hair is between 5-7 months, you will need at least this timeframe to completely clear all hair.
• In the resting phase (telogen phase) of the hair cycle, killing the hair is less effective as it is not connected to the growth center of the hair (papilla). Unlike your facial hair, where about 30 percent of your hair is in the resting phase, in your pubic area this is 70 percent. This means electrolysis in this area is less ‘effective’ and takes a longer timeframe to completely clear the area.
• A hair of the genital area stays in the resting phase for about 12 weeks, then it is active for 2-4 months. Ideally, an interval of 6 weeks between different treatments is recommended to catch a sufficient new load of “active hairs” every session.
• On average you will need 6 cycles of electrolysis.
• We recommend completing your genital electrolysis at least six weeks before, and preferably even 8 weeks before your sex reassignment surgery, so your skin has time to heal in case a complication occurs (e.g. an infection), as it could take a month to clear up.

The average timeframe for genital electrolysis

• An average timeframe looks like this, but as hair density varies from person to person you should not completely rely on it for your genital electrolysis.
  • 1st session: Book half a day of intensive treatment for the first session (8 hours with local anesthesia). Take care: 2 different electrologists will work on you: one in the morning and one in the afternoon. Genital electrolysis is very demanding for the electrologist. A full day is too physically demanding for the electrologist. Also, longer breaks are needed to keep fully focused for this zone.
    • 6 weeks of rest
  • 2nd session: half a day of intensive treatment
    • 6 weeks of rest
  • 3rd session: half a day of intensive treatment
    • 6 weeks of rest
  • 4th session: 2h
    • 6 weeks of rest
  • 5th session: 1h
    • 6 weeks of rest
  • 6th session: 0,5h
    • 6 weeks of rest
  • Remaining hairs: come by every 6 weeks for 15 min of genital electrolysis to remove the hairs that still pop up if necessary

So on average, we need around 24 hours to clear your genital hair (so it will cost you around 2500 euro if you choose to do it with local anesthesia) and on average the total timeframe for this would be about 1 year.

Preparation for genital electrolysis

• Shave the genital region 10 days prior to your genital electrolysis—Because after all the hairs are shaved, only active hair follicles will grow back, which in turn allows us to be more effective (you don’t electrolyze the hairs that can not be killed in this stage anyway).
• Iso-betadine soap—Hygiene before and after treatment is paramount, as there is a high risk of skin infections from genital electrolysis. We advise using Betadine liquid soap in the shower the morning of your genital electrolysis. Also the days after genital electrolysis, this can be useful. You must be scrupulous about hygiene when getting genital electrolysis, especially if getting it performed close to your surgery date.

Your genital electrolysis

• It is normal to feel nervous and embarrassed prior to your first genital electrolysis session. Know that for us, this is a routine treatment, and we will try to make it as comfortable as possible for you.
• If possible, we use the machine’s highest settings for genital electrolysis to get a high killing rate. Since the hair cycle is slower than in the facial area, and it already takes longer, a high setting will make it go considerably faster. A side effect might be a higher risk of scarring. 
• The skin itself is soft, wrinkled and rubbery in texture, and the follicles can be very ‘tight’ in some clients. It is essential to carefully stretch the skin around the follicle that's being treated. It might be necessary to push the needle into the follicle more forcefully than in other areas. 
• Removing genital hair tends to be more painful than facial hair removal. With local anesthesia, pain can be reduced significantly. You may need to take additional steps to alleviate pain. Some have reported adequate pain relief with painkillers and/or EMLA (numbing cream), where others found local anesthetics necessary.
• Meticulous post-treatment skin care is essential to avoid infection and aid healing.

Recovery and aftercare

• After treatment, the skin may be red and even slightly swollen. This varies from patient to patient.
  It is extremely important to take care of hygiene when you get genital electrolysis, particularly if your treatment is close to your operation date.
• Skin is more prone to infection after electrolysis. We’ll provide lotion to avoid this and to help heal your skin after the treatment.
• Scrotal tissue may heal slower from electrolysis than other parts of your body.

Read more about aftercare.

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Frequently asked questions

• Do you also remove hair from the genital zone before the sex reassignment surgery?

  Yes we do, we strongly advise electrolysis before the operation because laser is not always permanent, and after the operation you won’t get a second chance to remove the hair. Read all about genital hair clearing.

• Is electrolysis hair removal painful?

  The short answer almost no electrologist dares to give you is: yes it is. Some people can bear it, others barely. The longer version: Everyone has their own tolerance to pain. Descriptions of the discomfort vary from “no worse than a mosquito bite,” to “like having a rubber band snapped against my bare skin hard.” Electrolysis can give a stinging and pricking sensation, and each hair has to go through it. The degree of it is also relative to the area of treatment. Certain spots, such as the upper lip, are known to be more sensitive than spots like the brows. But! Luckily we provide local anesthetics, with which you will barely feel any pain at all! More information about local anesthetics!

• Can I shave my hair in between electrolysis hair removal sessions?

  Yes, one of the common misconceptions about electrolysis is that you have to let the hair grow in-between sessions. In fact, you can treat the hair as you would usually, even shaving the legs or face. The hair doesn’t have to be any longer than 1-2 mm for electrolysis to be effective. Longer hair is even contra-productive because it makes insertions more difficult. It is important you stop shaving 3 days prior to your electrolysis session. We should emphasise that in contrast to popular belief, shaving off the hair will not thicken it, coarsen it or make it grow more rapidly.

• Can I do Electrolysis at your clinic while recovering from the surgery?

  Yes, you can. We suggest you book 1 day of electrolysis a few days after the surgery through our website. If you have a choice though it is probably a more comfortable option to book the electrolysis a few days before your surgery.

• I suffer from psoriasis, can I still get electrolysis?

  On active psoriasis, zone electrolysis is contra-indicated.

• I suffer from PCOS (polycystic ovary syndrome), can I still get electrolysis?

  It is not a contra-indication, but in some people it doesn’t really help because too much new hair is recruited. You can read about the details of electrolysis on people with hirsutism/PCOS.

• Why can I not cancel my session less than two weeks in advance and get a refund like in a hotel?

  We understand your concern. If you cancel 3 days of an intensive program less than two weeks before, we will not find another patient to replace you because people need to plan these types of things in advance (take time off from work, etc). So these 3 days we will have to pay our electrologist, but she will have no client to treat. It is simply a different cost and income model than in a hotel. A hotel needs approximately the same staff if there are a few people less or more. In contrast to hotels, we don’t have 300 rooms but just a few electrologists that are fully booked most of the time. It is actually the same policy we use as with our operations (but there the cancel time is less than one month instead of two weeks). We hope you understand our policy.

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