Hair Removal

The presence or absence of hair can be an important part of your gender expression and requirement for certain gender-affirming surgeries.

  • Hair removal from the face & body: Feminizing hormone therapy have very minimal effect on reducing hair growth with many being unsatisfied with the degree of hair reduction. Masculinizing hormone therapy leads to increased body and facial hair, which you may or may not wish to remove. The presence or absence of hair can be important part of your gender expression.
  • Hair removal for surgery preparation: This is a requirement set by most surgeons for phalloplasty and vaginoplasty procedures. Depending on surgeon and surgical technique used, hair is required to be removed from donor sites for phalloplasty, and external genital area prior to surgery. Hair remaining in the neouretha or neovaginal cavity can cause complications post-surgery. It is important to follow instructions and requirements set by your surgeon.  Electrolysis and/or laser hair removal are your only options for permanent hair removal or long term hair reduction.

This page provides an overview of various hair removal methods, as well as their pros, cons, and safety tips. There are a number of considersations when choosing a hair removal method. Visit the <Choosing a Hair Removal Method> page for more information.

Shaving

Shaving is the most popular method of hair removal for the face and legs. The common methods are dry shaving with a foil or rotary head electric razor and wet shaving with a razor blade. Wet shaving with a razor blade cuts hairs closer to the surface, producing a smoother shave. Contrary to popular belief, shaving does not make the hair grow back thicker.

Before both dry and wet shaving, some people use a preshave lotion to remove sweat and oil from the skin, making for a smoother shave. For wet shaving, you can use a shaving lather or gel to soften the hair and cause it to stand straight up. This makes the hair easier to cut and minimizes skin irritation. After either method, you can apply aftershave to soothe any discomfort the razor causes to your face.

To minimize irritation:

  • use a clean, sharp razor
  • shave every other day, rather than daily
  • keep the skin loose (not pulled tight) while shaving
  • don’t shave over the same area multiple times
  • use mild, scent-free shaving cleanser
  • use a scent-free aftershave that contains witch hazel, alpha hydroxy acid (AHA) or salicylic acid

Pros

Shaving is fast, cheap, painless and convenient.


Cons

Hair grows back in 1 to 4 days and feels stubbly. May cause ingrown hairs, folliculitis (a skin condition in which hair follicles become inflamed), rash or cuts.


Safety tips

If you have diabetes or use blood thinners, shave using an electric razor rather than a manual one. To avoid transmitting infections, don’t share razors with others.

 

Plucking

Plucking involves using tweezers to remove, one hair at a time, the entire hair shaft. It is most practical for small areas like the eyebrows. Make sure you pluck the hair in the direction you want it to grow.

Do not pluck areas on which you may wish later to have electrolysis. Plucking distorts the hair follicle, making it more difficult for electrologists to work with.

Pros

Easy and inexpensive. Effects last longer than shaving (2 to 6 weeks).


Cons

Tedious and sometimes painful, especially on sensitive areas. (Numbing the area with ice can help reduce discomfort). Hair may grow back thicker, darker and faster. May lead to ingrown hairs if the hair breaks off below the skin’s surface.


Safety tips

To avoid infection, do not pluck your nose hairs. Clip them instead. Be aware that some companies market electronic tweezers as home electrolysis units. But, unlike electrolysis, electronic tweezers do not offer permanent hair removal. They also emit radiation, so it’s very important to follow the instructions if you use these devices.

 

Threading (khite or fatlah)

Threading (also known as khite or fatlah) is a hair removal technique that has been used for centuries in the Middle East. It involves rolling a long, twisted cotton thread against the skin to pluck several hairs at once. It is commonly used to remove facial hair, including hair from the cheeks, ears and forehead.

Pros

Professional threading is inexpensive compared to professional plucking. Quick. Well tolerated by sensitive skin because no potentially irritating substances are used. Many consider it to be less painful than plucking, waxing or electrolysis. Can be done more often than waxing or plucking because even short hairs can be removed. Results last 2 to 6 weeks.


Cons

Mass plucking can cause irritation and itching. Ineffective for large parts of the body. May lead to folliculitis (a skin condition in which hair follicles become inflamed). Folliculitis can lead to changes in skin pigmentation.


Safety tips

Do not use this method on broken, irritated or sunburned skin or skin with active eczema, psoriasis or herpes lesions.

 

Waxing

Waxing is the second most popular method of body hair removal, next to shaving. It involves applying a layer of hot or cold wax to the skin, and then quickly pulling it off.

The two common methods are the non-strip method (hard wax) and the strip method (hot wax). The non-strip method causes less irritation. The strip method is faster but the hair grows back irregularly, rather than in one direction.

Pros

Because this method pulls hairs out at the level of the hair bulb, it lasts 6 to 8 weeks. Often the hair grows back softer. Many people have reduced hair growth after multiple treatments.


Cons

Wax can be irritating to the skin. It can cause redness, bumps, swelling and folliculitis (a skin condition in which hair follicles become inflamed). Folliculitis can lead to changes in skin pigmentation. These side effects are more common with facial waxing. Incorrect waxing can cause burns, bruising or skin removal. Waxing can be messy. It’s also painful. You must be willing to have stubble or regrowth of 2 to 3 mm until the hairs are long enough to be waxed again.

Waxing is not a safe method for everyone. If you are performing your own waxing treatment, check the instructions that come with your kit. If you are paying a practitioner to wax you, they will conduct an assessment to determine whether it is an appropriate method for you. They will not wax people who have a blood or circulatory disorder, epilepsy, diabetes, hemophilia, inflamed or irritated skin or lupus. They will not wax an area that has a fracture or sprain, an active herpes outbreak, varicose veins, a sunburn, scar tissue, moles, skin tags or warts.

Several medical treatments react negatively with waxing, including blood thinners, tetracycline, Retin-A, Accutane, Differin, chemotherapy and radiation. You may want to ask your heathcare provider if waxing is safe for you.


Safety tips

Don’t wax sensitive areas like the eyelids, ears, nose or nipple area. Don’t wax your own eyebrows, as wax may drip into your eyelashes or eyes. Avoid tanning 24 hours before and after waxing.

 

Sugaring

Sugaring involves using a syrup made from sugar, water and lemon juice to grab many hairs at once and remove them at the bulb. In this way, it is similar to waxing. The hair must be 2 to 3 mm long before treatment. This method can be used on any area except beards, the nostrils, inner ears or genitals.

There are two methods of sugaring: application and removal by hand and application by spatula with removal by cotton strip. The main difference is that the hand method is slower but more gentle and the spatula method is quicker and as a result, less expensive. For faces that don’t have a lot of facial hair, hand-applied sugaring is preferable to waxing because it doesn’t distort the hair follicle.

Pros

You can wait 6 to 12 weeks between treatments, and this time may increase the more you use this method alone. Less skin irritation compared to waxing, particularly with all natural ingredients. Minimal or no risk of burning or bruising. No risk of skin removal. The same area can be treated more than once without irritation. Regrowth is softer and less dense. Easy clean-up because the syrup is water-soluble. The syrup has natural antiseptic properties, which reduce bacteria and the chance of breakouts.


Cons

Some pain, but not as much as waxing. Possible side effects include folliculitis (a skin condition in which hair follicles become inflamed) and ingrown hairs, but these are less common with hand-applied sugaring.

There are some people who should not use this method of hair removal, and even more people who should not use the spatula method. Your sugaring practitioner will conduct an assessment to determine if sugaring is safe for you and, if so, which method is most appropriate. If you are performing your own spatula-applied sugaring treatment, get your doctor’s approval. If you are performing your own hand-applied sugaring treatment, avoid treating areas that are chapped, broken or sunburned or have pimples, pustules, moles, skin tags, warts or active herpes outbreaks. Get your doctor’s approval if you have phlebitis, diabetes or hemophilia.


Safety tips

Follow your practitioner’s after-care advice. This will likely include instructions to avoid fragrances and deodorants on treated areas and avoid sun and tanning beds for 48 hours.

 

Chemical depilatories

A chemical depilatory is a paste, cream or lotion that is left on the skin for 3 to 15 minutes, depending on the brand. The mixture breaks down the hair’s protein structure, causing the hairs to break off, so they can be wiped away. It is usually used on the arms and legs. This method is more effective on light, fine hair than dark, coarse hair.

Pros

Usually painless. Hair will grow back a bit more slowly compared to shaving (2 to 10 days). Regrowth will feel softer.


Cons

Can cause skin and eye irritation. If you are sensitive to scents, this may not be the method for you.


Safety tips

Do not use this method on any skin that is irritated or broken or has signs of infection. Do not use on the face unless the label specifies that it is safe to do so. Do not use on any skin close to mucous membranes, like the vagina* or anus.

 

Electrolysis

Electrolysis involves the insertion of a probe into each hair follicle to deliver electric currents that destroy the hair root. It is the only permanent method of hair removal.

There are three methods of electrolysis: thermolysis, galvanic electrolysis and  blend. Each method uses a different type of electric current.

  • Thermolysis allows for fast removal of fine hair with shallow to medium-straight follicles.
  • Galvanic electrolysis has the highest success rate for lack of regrowth. It is the slowest method, which may make it more uncomfortable. It works on distorted hair follicles, as well as deep hair follicles. Incorrect treatment can result in tattooing (permanent black marks on the skin). Can be followed by cataphoresis, which is beneficial for reducing redness and providing effective antibacterial protection.
  • Blend is a combination of galvanic electrolysis and thermolysis. It is the most popular method in North America. It combines the currents of the previous two methods, so that a wide range of hairs can be treated. This includes kinky and curly hairs and hairs with distorted follicles.

For best results, it is crucial to work with a skilled electrologist. 

Pros

Electrolysis can successfully remove all types of hair, regardless of colour, texture, or stage of growth. It can also successfully remove hair on all skin colours and types (dry, oily, mature, etc.). It can be performed just about anywhere on the body, except the inside of the nose and ear. After each treatment, any hair that regrows will be finer and lighter.


Cons

Electrolysis is expensive (anywhere from $25 to $250 an hour). It requires repeated treatments over a long time period (around 1 to 4 years for thick facial hair). It is also painful (though there are over-the-counter and prescription topical anesthetics to help with pain management). Common side effects of electrolysis include temporary redness, bumps, swelling and scabbing. Incorrect treatment methods can lead to blanching (temporary whitening of the skin), pitting or dimpling of the skin.

There are some health conditions that may prevent you from safely undergoing electrolysis, such as high blood pressure or epilepsy. Ask your doctor if electrolysis is a safe hair removal option for you.


Safety tips

After electrolysis, the treated area is prone to infection. Follow your electrologist’s after-care instructions. This will include information about cleansing your skin, using soothing products, avoiding makeup for a day and avoiding tanning and plucking. There are some home electrolysis devices on the market, however, performing electrolysis on yourself is very difficult, even for skilled electrologists. The consequences of inaccurate needle insertion can be severe and include permanent scarring.

 

Laser hair removal

Laser hair removal offers long-term hair reduction, as opposed to the permanent hair removal offered by electrolysis. It can be used on all parts of the body, except the eyebrow and ear. It is most effective on light, medium or olive skin with dark hair. It is generally ineffective on blond, strawberry blond, white or gray hair. Dark brown and black skin has a much higher risk of burns, scars and hyperpigmentation (permanent darkening of the skin).

To maximize the effectiveness of this treatment, stop all methods of hair removal other than shaving or depilatory creams at least 10 weeks before treatment. Shaving and clipping may be done up to 2 days before treatment.

There are many different laser devices used for hair removal. The most common are:

  • NeoDymium Yttrium Aluminum Garnets (Nd:YAG)
  • Ruby Lasers
  • Alexandrite Lasers
  • Diode Lasers
Laser machines used for hair removal, as noted by Health Canada, “operate with high emission levels and are therefore designated in the highest hazard classes (Class 3B & Class 4)”. This means it is crucial to work with a skilled, experienced and well recommended laser hair removal provider who practice the required safety measures when providing this service. Health Canada has put forth a Safety Guidelines for Facility Owners and Operators to follow; however, monitoring the use of the guidelines by providers is currently not properly implemented in BC.

As skills for providers vary with experience, visit <Choosing a Hair Removal Method> for tips in choosing a provider.


Pros

Laser hair removal is fast. Lasers treat an area of skin rather than one follicle at a time (as electrolysis does). It is long-lasting, and may produce some permanent results. Some people find it less painful than electrolysis. Regrowth is often finer and lighter.


Cons

Professional laser hair removal is expensive. It requires several treatments (3 to 6 or more). Side effects can include temporary swelling, bumps, crusting, redness, singed hairs that look like tiny black spots and temporary skin discoloration. More serious complications include blistering, permanent skin discolouration, scarring, intense itchiness and hives. There is a lack of evidence about the safety and effectiveness of laser hair removal over the long term. It is also an unregulated industry in Canada, raising additional safety concerns (i.e. about the training and experience of practitioners). Many people are not good candidates for laser hair removal, based on hair and skin colour, health conditions and medication use.


People with the following conditions should not use laser hair removal: epilepsy, diabetes, cold sores, albinism, nervous disorders, sunburn, open wounds or a history of keloid scarring. Those who are pregnant or who have gray hair should also avoid this method. Do not use this method if you take Accutane, tetracycline or Retin-A. If the area you wish to have treated has a birthmark or mole, have the treatment approved by your health care provider first.


Safety tips

Follow your practitioner’s advice regarding aftercare in order to minimize side effects and complications. This will likely include instructions about avoiding hot baths for 24 to 48 hours, using clean cold packs to soothe the treatment area, applying soothing ointments to keep the area lubricated and avoiding sun exposure, make-up and lotions for a period of time following treatment.

 


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