Permanent hair removal

Trans people often use permanent hair removal techniques to remove their facial hair, body hair, or hair from skin that will be used as part of a surgery.

The main options you can use for permanent hair removal are:

  • Electrolysis: Electrolysis is often required for treating light blonde, red or grey hairs, but can take a long time – often hundreds of hours for facial hair.

  • Laser: Laser can be much faster than electrolysis and some people find it less painful, but it is only suitable for certain hair colours. There are different types of laser machines available, with different advantages and disadvantages, such as working more effectively on particular skin colours. If you’re considering laser hair removal, discuss with your laser service what laser types they have available and what might be most suitable for you.

  • IPL: Intense Pulsed Light (IPL) is an alternative to laser, which may possibly be less effective on some skin colours, and is normally not offered by the NHS.

Different permanent hair removal techniques may be best for you depending on your situation. Some people use a mixture of these options (e.g. a course of laser hair removal to quickly remove the majority of hair follicles, and then electrolysis on anything that remains).

It’s not possible to undo the hair removal effects of these treatments. 

If you’re not looking to remove the hair on an area permanently, you could try non-permanent alternatives like shaving, plucking, waxing, threading, sugaring, epilating, or using a hair removal cream. If you’re using one of these methods, remember that only some of the hair removal methods are suitable for the delicate skin on your face or genitals, and to follow the instructions that come with products you buy about how to use them and where to use them.

Facial hair removal is often funded by the NHS for patients who have received a formal diagnosis of gender incongruence or gender dysphoria from an NHS gender clinic. This is not always enough sessions for complete removal of all facial hair, and you might need to pay to have more hair removal sessions outside of the NHS.

In Cymru/Wales, facial hair removal is not currently funded by NHS Wales.

In England, if you ask your NHS gender clinic for help with facial hair removal, they can make a referral to GDNRSS, who are responsible for arranging hair removal for trans patients. They should give you a list of local hair removal providers you can choose from. Some of these will be specialist hair removal services, while others may be part of local beauty salons.

The amount of facial hair removal that is funded is:

  • Either 8 sessions of laser hair removal, 
  • or 16 hours of electrolysis, 
  • or a combination of laser and electrolysis (funding for this is calculated by treating one session of laser hair removal as being equivalent to two hours of electrolysis).

IPL hair removal is not available on the NHS in England.

In Scotland, if you ask your NHS gender clinic for help with facial hair removal, they can arrange for this.

The amount of facial hair removal that is funded is:

  • Either a minimum of 15 sessions of laser hair removal,
  • or at least 250 hours of electrolysis treatment,
  • or a combination of the two treatments.

Pre-surgical hair removal is sometimes needed before genital surgeries like vaginoplasty, metoidioplasty, and phalloplasty. This is performed on the donor site – the area of your body that skin will be taken from to be used as part of the surgery.

If you’re having phalloplasty or metoidioplasty that involves lengthening the urethra, it’s very important that all “coarse” hair has been removed from the donor site to avoid complications like infections and problems urinating. If you’re having vaginoplasty, removing coarse hair from the donor site can also be important to reduce the risk of complications like infections.

Your surgeon will check if hair removal is required for medical reasons during your pre-surgical consultation. If hair removal is medically necessary before surgery, your surgeon will make a referral for you to get hair removal provided by the NHS.

Pre-surgical hair removal is funded by the NHS only if your surgeon decides it is medically necessary. If you’ve been told that hair removal is not medically necessary for you, but you’d like to reduce your risk of medical complications or would like it for aesthetic reasons, you can pay privately for hair removal on the donor site.

In our Transition Access Survey in 2022, over 90% of people who told us they had needed hair removal had paid for some or all of this themselves. You may want to access hair removal privately because you want or need facial hair removal before you are seen by an NHS gender clinic. You might also want it because you want hair removal on a part of your body that would not be funded by the NHS, or because you need hair removal before a non-NHS genital surgery. 

Hair removal can be expensive. In our Transition Access Survey in 2022, trans people told us that the average amount they had spent on hair removal was over £2000. Some employers have medical insurance policies that will fund hair removal as part of the medical transition cover they offer, so if you have a medical insurance policy, it is worth checking if hair removal is covered. 

If you’re not able to afford the cost of hair removal, you can be prescribed a cream called Vaniqa or Eflornithine which can slow how fast your hair grows on the part of your body you apply it to. Speak to your gender clinic or GP about this if you need to use this option.

To find a professional service offering hair removal, have a look at the:

You might also want to try asking for recommendations for hair removal clinics at your local trans support group. There is information about local support groups on our Sources of Support page.

Before you begin treatment, you should be asked to read information about potential side-effects of the hair removal method and how to reduce risks. You should also be asked to provide information about what medications you’re taking and any medical conditions you have.

You’ll initially be offered treatment on a test patch of skin. This helps you and your hair removal provider check that you’re not going to experience any serious side effects from the hair removal method or any products they are using on your skin. If you see any irritation or discoloration of your test patch, let your hair removal provider know about it.

If you’ve not had any significant side effects you can now start hair removal treatment. This will happen over a number of sessions. When the same area is being treated repeatedly, sessions should be around 4-6 weeks apart for the best results. The number of sessions required will vary from person to person depending on the amount of hair you are removing and will also vary between hair removal methods.

For laser or IPL hair removal, you’ll often be asked to shave before the treatment, but to avoid waxing, plucking, or other temporary hair removal. You should be given eye protection to wear during the procedure.

Professional hair removal treatment should take place in a private room, and the door is normally closed and locked while the treatment is taking place. You’ll normally be lying down on a table while you are treated. If you’re having body hair removal, you may need to remove your clothing from that area, or wear clothing that doesn’t cover it.

Laser and IPL appointments are usually less than an hour in length. Electrolysis may take place over a longer appointment if you and your hair removal provider are comfortable with this, and this can help reduce the total number of sessions that are required.

After leaving your hair removal appointment, remember to follow any safety instructions you’ve been given by your hair removal provider (like wearing sunscreen or other aftercare products). 

If you have had facial hair removal, your face may be visibly redder than usual in the hours immediately after the session.

If you’ve had laser or IPL hair removal, you may find that after a few years you need to have further ‘top up’ sessions to remove any new hairs or hairs that have regrown.

Permanent hair removal processes usually cause pain and discomfort. These are often a sign that the treatment is effective. The pain and discomfort should subside quickly.

If you feel you need to reduce the amount of pain, you can speak to the hair removal professional about your options for reducing pain during hair removal sessions. You could discuss options like ice packs, aloe vera, over-the-counter pain relief medications, or stronger prescription-only numbing creams. You may need to speak to your GP to obtain these creams.

It’s very important that you follow the advice of your hair removal professional. They may give you instructions to avoid certain things in the day directly after treatment, like shaving, wearing makeup, swimming, or vigorous exercise. These instructions are important.

After laser or IPL treatment, make sure to stay out of the sun as much as possible, and wear sunscreen. Remember that sunscreen needs to be reapplied on a regular basis.

Tell your hair removal professional if you’re experiencing skin irritation, or discoloration of the skin.

If you want to further research a hair removal provider, you could check to see if they’ve been inspected by Healthcare Improvement Scotland, the CQC in England, Healthcare in Wales, or the RQIA in Northern Ireland, though not all hair removal providers are required to be inspected. You can also ask to see details of your hair removal provider’s qualifications. For laser hair removal, you can expect a provider to have a Core of Knowledge level 4 qualification that is BMLA approved, and you can also ask to see their Treatment Protocol and check if this has been produced for them by a qualified Laser Protection Advisor.

You can also buy laser and IPL hair removal devices for use at home.

Home hair removal devices from major brands can cost £400-500 or more.

It’s your decision whether to buy an at-home device or use a professional service. A home hair removal device could save you significant money compared to professional services – but also might not deliver the results you’re looking for and cost you a significant amount of money to buy.

Your decision about whether to use a home hair removal device will depend on whether you feel comfortable taking the financial risk (it might not do what you need it to and cost a lot) and the medical risk (it may have side effects or be dangerous to operate).

Unfortunately, it can be difficult to make this decision. If you’re considering whether to use a home hair removal machine, here are some questions you might want to ask yourself before you spend any money – though the answers might be difficult to find:

  • Is it a laser device or an IPL device? Marketing materials can be confusing and may describe IPL devices as ‘laser’ which are not actually a laser.

  • Is it safe to use on your face? Many devices are specifically marketed for body hair only, and may not have been tested for safety on facial hair, or designed to have safety features for using on the face.

  • Is it powerful enough to be effective? Manufacturers often don’t publish technical specifications of their products, and there are multiple measures to compare (fluence, pulse duration, spectral range) when comparing a home device with professional devices.

  • Are the effects long-term? Medical studies of these devices often only investigate whether they’ll reduce the amount of hair you have in the short term, not how much they’ll remove in the long term. The medical studies are often also funded by the manufacturers of the laser devices which could mean the studies are biased.

  • Is it suitable for your skin colour or hair colour? Products are often only tested on lighter skin colours and people with darker skin may find they’re more likely to get side-effects. Marketing materials and product reviews may not tell you what skin colours and hair colours the device was tested on.

  • Is it slow to use? Home devices may be designed for use on small areas (like armpits) and not for larger areas like legs, and may take much longer to treat an area than a professional device. Most manufacturers don’t publish information about how fast you can treat an area with their device.

  • Is it dangerous to use? Some medical studies suggest that you could damage your eyes if you use a home hair removal device in the wrong way (you can read more about the possible risks in this paper). Other studies have suggested that there’s minimal risk of permanent side-effects.

You may find that a home hair removal device is most useful to you in combination with other hair removal methods. For example, you could use a home device to help reduce how much hair is growing in an area you’re regularly shaving with a razor, to treat chest hair while you have professional hair removal on your face, or to treat areas of your you’re not comfortable with a professional work on.

As you’re not being supervised by a professional, it’s especially important that you’re being safe when using a home device. To reduce your risk, you could:

  • Read any safety instructions you’ve been given with the device
  • Use the device on a test area first and check after 24 hours for side effects before using it on a larger area
  • Only use the device on your face if the device is designed for it
  • If the device came with eye protection, wear it
  • Only activate the device if it’s held directly against skin you want to treat
  • Wear sunscreen on areas that you have used the device on
  • Avoid using the device on broken or discolored skin
  • Consider whether you need to keep the device out of reach of children

You can read more about your permanent hair removal options in these resources:

transition menu
Surgery menu
Dictionary

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This page is based on information originally posted on genderkit.org.uk with permission.

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A disclaimer: TransActual do not provide medical, health, or legal advice. The content of this page is intended for information purposes only. It is not a substitute for medical advice, diagnosis or treatment from a medical professional. It is not a substitute for advice from a legal professional. We strongly suggest you consult a healthcare professional or legal professional for specific advice about your situation. TransActual do not advocate or recommend the purchase of any specific product and we do not endorse or guarantee the credentials or appropriateness of any health care provider, any product or any provider of insurance and legal services.

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