A few words from a friend and fellow electrologist.
Although written from an American perspective, the sentiment remains the same in the UK
“How To Avoid Carpeting In Your New Engine Compartment!
The Importance of Electrolysis Prior to SRS”
Stephanie Diamond
Licensed Electrologist and Certified Laser Technician
Permanent hair removal prior to gender reassignment surgery is imperative! It is a requirement by most surgeons and must be done only by electrolysis. Yes, there are some surgeons that will tell you that they will “scrape the follicles during surgery.” Please do NOT rely on this! You do NOT get a second chance and let me explain.
“Scraping the follicles during surgery” or relying on laser hair reduction will lead to hair regrowth inside your new vagina! Hair grows in cycles and at any given time, 40% of your hair follicles are dormant. When a surgeon tells you that they are going to “scrape the follicles during surgery”, they are actually doing electrolysis on the skin of the penile shaft. During surgery, the surgeon removes the skin from the penile shaft and hands it to an assistant. That person takes the section of skin and performs electrolysis on it using thermolysis. The assistant then finishes prepping the section of skin to become the new vaginal canal and gives it back to the surgeon for placement inside the body.
So, even if all of the follicles on the skin that will become the vaginal canal are treated that are currently active at the time of surgery, there are still 40% of the follicles on that section of skin that are dormant and not currently active. Since they are not active, they will not be treated as the technician or Electrologist cannot see follicles when hair is not actively growing in them. Then, you must consider that the modality being used, thermolysis, has at least a 40% regrowth rate. This means that treating an active follicle with thermolysis will result in regrowth of hair at least 40% of the time. The regrowth may be thinner, but it is still hair regrowth. You can see that there is no way to ensure that the hair will be permanently eliminated relying on having your surgeon “scrape the follicles during your surgery.”
The next option is using laser hair reduction instead of electrolysis prior to gender reassignment surgery. Laser is NOT permanent removal, but can only be sold as permanent reduction per the FDA. What is the difference between permanent removal and reduction, and why is laser NOT permanent? In order for a treatment to be recognized as permanent, the proper treatment must result in the follicle and the surrounding stem cells, which is called “the bulge” must be permanently destroyed, causing the permanent destruction of that follicle from regrowth. Laser works by targeting the pigment in the hair follicle, the melanin. The target of the laser is called a chromophore. The laser targets the pigment and the heat it generates travels down the follicle to the kill the follicle at the base, the bulb. If the hair is in the early growth stage, known as the anagen stage, then the bulb is still connected to the blood supply. The laser travels to the bulb and destroys the bulb. However, laser does not destroy the surrounding area containing the stem cells, the bulge. Sometimes this happens, but not consistently. The other reason laser is not permanent is the fact that it will only work on hair that is in the anagen stage of growth. Once the hair moves to the next stage of growth, catagen, and later the final stage of growth, telogen, the bulb is no longer attached to the blood supply. Hair that is in the catagen or telogen stage treated by a laser will not be affected by the treatment because the bulb is not attached to the blood supply. This is why laser treatments must constantly be repeated every 6-10 weeks depending on the hair growth cycle of the area being treated. Laser also does not work on red, blonde, grey, white or light colored hair. This is because the laser light reflects off these colors instead of being absorbed. This is a problem that to date is unsolvable due to the physics of light and reflection, regardless of the wavelength or type of laser used.
Since laser cannot permanently destroy the hair and the bulge area consistently, the hair follicle usually will go dormant if not completely destroyed. The follicle can become active again once the stem cells in the surrounding bulge regrow the follicle. This can happen in a matter of weeks, months or years. Sometimes the follicles are triggered by a change in body chemistry. Our body chemistry completely changes every 5 years. As we age, our hormones change and this natural change can trigger the stem cells to regrow the hair follicles that were previously dormant or partially destroyed by laser.
Electrolysis is recognized as being the only method of permanent hair removal due to the fact that electrolysis can destroy the follicle and the bulge area regardless of which stage of growth the hair is currently in. Whether or not it is in the early anagen stage, the catagen mid growth stage, or the final stage, telogen. Electrolysis can be used on all hair colors and skin types as it does not target the melanin in the hair, but the tissue directly. Electrolysis is still an ongoing process due to the fact that 40% of the follicles are not actively growing, and only those follicles actively growing can be seen to be treated by the Electrologist. However, over a period of 18-24 months, the genital area can be permanently cleared for gender reassignment surgery.
Taking all factors into consideration, relying on the surgeon to “scrape the follicles during surgery” or solely on laser hair reduction, you WILL end up with hair inside your new vaginal canal. I have discussed this at length in person with Dr. Toby Meltzer. Dr. Meltzer advised me that he sees clients every week that did not have electrolysis and relied on the surgeon or laser treatment and they now have hair inside their vaginal canal. Dr. Meltzer confirms that there is no treatment or procedure that can be done to correct this after surgery. He is adamant that his clients have electrolysis prior to him clearing them for surgery and he prefers a full two years of treatment to ensure that internal hair growth is not an issue. He reminded me that as fully trained and licensed Electrologist, I have much more training and experience with hair, hair growth and hair removal than any medical doctor or surgeon.
Pain management would be an obvious issue to deal with in clearing the genital area. The area that has to be cleared is minimal, but does require that the penile shaft, complete scrotal sac and ½ inch area surrounding it must be cleared. The scrotal skin is what is used to form the new labia during surgery. You can talk to your physician to see if they can assist with medication to take prior to treatment. However, you never want to rely on any medication that may be addictive.
As an Electrologist and a transwoman, I recommend following Dr. Meltzer’s guideline for a two-year treatment plan to prepare the area for surgery. While the most work will be done in the beginning of the treatment program, the length of time will ensure that all hair is permanently gone and you do not end up with carpeting in your engine compartment! I don’t know about you, but I have gone through too much in my journey to want to deal with that issue simply because I wanted to rush my surgery or wanted to save some money.