How To Avoid Carpeting In Your New Engine Compartment! The Importance of Electrolysis Prior to SRS

A few words from a fellow electrologist. Although written from an American perspective, the sentiment remains the same in Canada

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.

Stephanie Diamond
Licensed Electrologist and Certified Laser Technician

Stephanie Diamond, author. Her Personal Story

When I came out in 2010, I had researched and read everything I could find on how to begin my personal journey to transition to be the woman I knew I really was. I understand that it is different for each individual, but the best advice I found overall was to start HRT (Hormone Replacement Therapy) and electrolysis first. Starting HRT is putting your body into a second puberty and is a slow and subtle process. Many individuals start HRT years before living full time as their true gender and some start HRT knowing they will never live full time as their true gender. HRT does cannot change the thick, coarse terminal beard hairs back to thin vellus hair, but removing Testosterone makes a huge difference in hair removal. Reducing the testosterone slows the hair growth process and trying to successfully remove the genetic male beard is very difficult if testosterone levels are at the normal male level.

Hair removal is also a very long process which depending on many factors as well as a financial and time commitment. Since electrolysis requires a small amount of hair growth for treatment, it makes sense to complete as much beard removal in order to avoid having facial hair showing once one is living full time as their true female gender. No woman wants to have visible facial hair showing through their makeup!

So, in the summer of 2010, I began HRT and electrolysis. I have always been someone who likes helping others and my previous career choices reflected that, whether or not it was during my law enforcement career, working as a CNA, repairing electronics and computers or designing and installing home theater and computer systems and networks. As I began having my facial hair removed, I instantly saw myself as an Electrologist. I saw first-hand the effect that getting rid of unwanted hair has on an individual. It truly is a game changer for anyone, regardless of their gender or gender identity. There is a psychological healing power when you remove that unwanted hair.

I was not able to immediately become an Electrologist, but it was my personal goal. I have always been one to never give up on a personal goal, despite the obstacles that life sometimes throws in our way. I also have always been one that totally dedicates myself to my craft and believe that you never stop learning. There is always something new to learn, another book to read, another source to research and another expert to contact for a new perspective.

I also saw how much misinformation is out there, and hair removal is a big business. There are many who prey on those that need hair removal with crappy products, misrepresentation of laser hair reduction and yes, even untrained, unlicensed or just poor work. The transgender community is the most under employed and unemployed group of society with a huge need for hair removal that makes us a very big target for those whom would like to take advantage of our pocketbooks and our desire to get rid of hair as quickly as possible. I have dealt with this myself during my transition before I became a trained, licensed and experienced Electrologist and Certified Laser Technician myself.

I did not realize at the time of my first clearing that the Electrologist who worked on me over treated me and I was very fortunate not to have scaring or pitting as a result. I did not know better at the time and only through my education and experience I now realize that even some who are “licensed, trained and experienced professionals” are sometimes not good at what they do. I also believe that having a personal connection to hair removal and having the experience of lying on a table as a client for hundreds of hours has a great impact on how you view your work and profession. I know it has impacted me in so many ways and has made me want to strive to provide the absolute best treatment to my clients as possible.

In my personal transition, I also found that the science and physiology of hair and hair removal continues to be ignored by most surgeons who perform SRS (Sexual Reassignment Surgery). Many surgeons are telling clients to not worry about having hair removal prior to surgery because they will “scrape the follicles” during surgery. Of course, we all want to avoid the added expense and discomfort of hair removal for SRS, so we believe these doctors. The problem is that these doctors may be amazing surgeons, they are not experts in hair removal. Hair grows in cycles and when hair is not growing and the follicles are in a resting stage, they cannot be seen since they are not active and do not have a hair growing inside them. Therefore, the follicle cannot be seen during surgery and cannot be removed. Even if the surgeon’s assistant who is doing the actual scraping of the active follicles were able to miraculously get 100% of the follicles active at the time of surgery, the follicles that are not active at the time of surgery will eventually be active months or years later as the area heals and the skin is reattached and blood flows through the capillaries in the skin and the follicles.

I have covered this in more detail in my article “How to Avoid Carpeting in Your New Engine Compartment – The Importance of Electrolysis Prior to SRS.” I mention this topic in this piece as it further shows that there is misinformation out there, and many times there is no false intent behind that misinformation.

I hope to help others avoid the mistakes or obstacles that I have made in my personal journey, so I will continue to find the most up to date and accurate information on hair removal. Whether it is electrolysis, laser hair reduction or the latest product or gadget being marketed online or TV.

With progress being made in getting exclusions removed from health insurance policies, we are seeing a huge growth in demand for hair removal. Insurance companies are also being required to cover hair removal for surgery preparation and facial hair removal as well. This is happening on a state by state basis, and a new change in Obamacare is also removing those previous restrictions as well. These insurance changes unfortunately do not affect health insurance policies that are self-funded by large employers.

I have been very humbled to have so many other incredible Electrologist’s and Laser Techs join the two Facebook groups that I created. They are an incredible resource of knowledge and experience and I strive to achieve what they have achieved in their careers. So I would like to thank them for participating and contributing their knowledge and shared passion for electrolysis and helping those in our community.

Those of you that I have had the pleasure to provide treatment know first-hand of my passion for hair removal and taking care of my clients. If you have any questions about hair removal, please ask. I certainly do not pretend to have all the answers, but I do know where to get them! If you have a question, I am sure someone has thought about the same issue as well. I also am an open book and if you have a question about anything regarding wonderful journey of transition, I am happy to provide input from my experience. Again, each person has their own journey, but I am a big believer in working together and supporting each other along this path.

Stephanie Diamond Bio

Stephanie Diamond is a licensed Electrologist in Nevada and California. Stephanie is also a certified laser technician in laser hair reduction, laser tattoo removal and laser aesthetics. She is the owner of Just Smooth You, LLC in Sparks, NV. Just Smooth You provides electrolysis to all but specializes in the transgender community. Stephanie welcomes clients who travel for her services and can provide accommodations for them.

Stephanie & Wife Brandi Stephanie and her wife Brandie, are MTF transgender and are active in the LGBTQIA Community. Stephanie and Brandie are passionate about educating others about our community, whether it is one person at a time or a large group. Stephanie is also available for public speaking.