Hair removal

Important note

The information in this section is for informational purposes only and should not replace medical advice. Some medications and health conditions can affect the skin and its ability to heal, making some hair removal techniques higher risk for complications. It can be helpful to consult with a medical practitioner about which hair removal technique(s) may be best for you. 

Removing hair from the face and body

There are several ways to remove facial or body hair. There are several short-term hair removal options and more permanent methods, each with its own perks and limitations.

To help you make an informed decision about which approach is best for you, we’ve broken down this topic into three sections:

• Short-term hair removal (including shaving, waxing, threading and more).
• Long-term or permanent hair removal (such as electrology and laser hair removal) 
• Medically necessary hair removal (pre-surgical hair removal for certain procedures)

Short-term hair removal methods

There are plenty of short-term hair removal methods available. Choosing the ones that are right for you may involve some trial and error. After reviewing the information below, it can be helpful to talk to others who use these short-term methods. Advice based on their firsthand experience may help you decide which methods suit you best.

The presence or absence of hair can be an important part of your gender expression How a person outwardly communicates their gender, including name and pronoun choice, style of dress, and voice modulation. (Source: QMUNITY) . Estrogen-based hormone therapy has minimal effect on reducing hair growth. Testosterone-based hormone therapy leads to increased body and facial hair, which you may or may not wish to remove. 

Considerations for short-term hair removal

There are several factors you should consider when choosing a short-term hair removal method:

• Your hair removal goal — The hair removal options available depend on your goal, how often or conveniently you can remove your hair and whether the hair removal is required for surgery.
• Your health history and medication use — Tell your hair removal provider about your health history and medications you take. Certain health issues or medications may affect which hair removal options are best for you. In each method below, we’ve outlined some safety tips to help you make the best hair removal decision for yourself.
• Your ability to afford the service — Generally, the costs for short-term hair removal methods are lower, and the price depends on if you are using home-based or service-based methods.
• Your hair removal provider — Find a hair removal service provider who is experienced, knowledgeable and gender-affirming.

Shaving

Shaving is a hair removal technique that involves using a razor or a similar tool to remove hair from the surface of the skin. Common ways to shave include:

• Dry shaving with a foil or rotary head electric razor
• Wet shaving with a razor blade — which cuts hairs closer to the surface, producing a smoother shave

Contrary to popular belief, shaving does not make the hair grow back thicker.

Washing the skin before dry and wet shaving removes sweat and oil, possibly making for a smoother shave.

For wet shaving, a shaving lather or gel to soften can help prepare the skin and hair for shaving. It helps to soften the hair, making it easier to cut, and moisturizes the skin, reducing friction. It can also help to lift the hair follicles, allowing for a closer shave.

The following tips to minimize irritation when shaving are based on general knowledge about skin care:

• Use a clean, sharp razor
• Find a shaving frequency that works best for your skin to minimize irritation
• Shave in the direction of hair growth
• Moisturize or use pre-shave lotion before shaving to reduce friction
• Avoid shaving over the same area multiple times
• Use gentle, light strokes
• Rinse the razor frequently to remove hair and cream or lotion build up
• Products like aftershave may soothe any irritation after shaving
• Mild, unscented products can help minimize irritation

Shaving pros

• Fast
• Cheaper
• Painless
• Convenient

Shaving cons

• Hair grows back in 1–4 days
• Hair growth feels stubbly
• May cause ingrown hairs, folliculitis A skin condition in which hair follicles become inflamed, which may lead to changes in pigmentation. , rash or cuts

Safety tips

Plucking

Plucking is a hair removal technique that involves using tweezers to remove individual hairs from the skin, including the follicle, one hair at a time. It is most practical for small areas like the eyebrows.

• The following tips to minimize irritation when plucking are based on general knowledge about skin care:
• Use high quality, precision tweezers with a slanted tip
• Clean or sanitize tweezers before use to reduce the risk of infection
• Pluck in the direction of hair growth
• Soften the skin by having a warm shower or using a warm compress before plucking

Do not pluck hair in the weeks leading up to electrolysis or laser hair removal. Plucking can distort or remove the hair follicle, which is the part of the hair targeted for electrolysis or laser treatment.

Plucking pros

• Easy
• Cheaper
• Can be done more often than waxing because even short hairs can be removed.
  Results may last for several weeks

Plucking cons

• May cause temporary redness or irritation after treatment
• Can be tedious to pluck one hair at a time
• Sometimes painful, especially in sensitive areas (numbing with ice before plucking can help reduce discomfort)
• May lead to ingrown hairs or folliculitis

Safety tips

Injury to nasal tissue can result in infection. To avoid infection, trim nose hairs instead of plucking them.

Be aware that some companies market electronic tweezers as home electrolysis units. Unlike electrolysis, electronic tweezers do not offer permanent hair removal. They also emit radiation, so always follow the instructions if using these devices.

Threading

Threading (also known as khite or fatlah) is a hair removal technique that involves rolling a long, twisted cotton thread against the skin to pluck several hairs at once, pulling them out by the follicle. It has been used in the Middle East for centuries. Threading is known for its precision and ability to create clean, defined lines, making it a preferred method for shaping eyebrows. It’s commonly used to remove facial hair, including hair from the cheeks, ears and forehead.

The following tips to minimize irritation related to threading are based on general knowledge about skin care:

• Clean your skin before threading to remove any makeup, dirt or excess oil.
• Soften the skin by having a warm shower or using a warm compress before plucking.
• Avoid touching or rubbing the threaded area immediately after treatment and avoid applying makeup or other products for a few hours.

Do not thread hair in the weeks or months leading up to electrolysis or laser hair removal. Threading can distort or remove the hair follicle, which is the part of the hair targeted for electrolysis or laser treatment.  

Threading pros

• Quick 
• Can be done more often than waxing because even short hairs can be removed
• Results last for several weeks
• Results may last up to 2–6 weeks

Threading cons

• May cause temporary redness or irritation after treatment
• Sometimes painful, especially in sensitive areas (numbing with ice before plucking can help reduce discomfort) 
• Ineffective for large parts of the body
• May lead to ingrown hairs or folliculitis, which can lead to changes in skin pigmentation 

Safety tips

Don’t use this method on broken, irritated or sunburned skin.

Waxing

Waxing is a hair removal technique that involves applying a layer of hot or cold wax to the skin and then quickly pulling it off to remove hair from the root. The two standard methods are:

• Non-strip (hard wax)
• Strip (hot wax)

The following tips to minimize irritation when waxing are based on general knowledge about skin care:

• Clean your skin before waxing to remove any makeup, dirt, or excess oil.
• Consider trying a small test patch of skin to check for any potential reactions to the product.
• Avoid waxing over irritated or damaged skin.
• Avoid touching or rubbing the area immediately after treatment and avoid applying products for a few hours.

Waxing pros

• Results may last for several weeks 

Waxing cons

• May cause temporary redness or irritation after treatment
• May lead to ingrown hairs or folliculitis, which can lead to changes in skin pigmentation
• Incorrect waxing can cause burns, bruising or skin removal
• Sometimes painful, especially in sensitive areas (numbing with ice before plucking can help reduce discomfort) 
• The hair needs to be at least 2–3 mm long to be waxed again

Safety tips

Do not use this method on broken, irritated or sunburned skin. 

Sugaring

Sugaring is a hair removal technique that involves applying a sticky paste made from sugar, water and lemon juice to the skin, pressing it into the hair and then quickly pulling it to remove hair from the root. The idea is that the paste adheres to the hair instead of the skin, which can make it less irritating than waxing.

There are two methods of sugaring:

• Application and removal by hand — a slower but gentler technique
• Application by spatula with removal by cotton strip — a faster and potentially less expensive option (you may save money with a shorter appointment time)

The following tips to minimize irritation related to sugaring are based on general knowledge about skin care:

• Cleanse your skin before hair removal to remove any makeup, dirt, or excess oil.
• Consider trying a small test patch of skin to check for any potential reactions to the product.
• Avoid sugaring over irritated or damaged skin.
• Avoid touching or rubbing the area immediately after treatment and avoid applying products for a few hours.

Sugaring pros

• Results may last several weeks May create less skin irritation compared to waxing
• Clean-up may be easier because the paste is water soluble 

Sugaring cons

• Sometimes painful, especially in sensitive areas (numbing with ice before plucking can help reduce discomfort) 
• The hair needs to be at least 2–3 mm long to be waxed again
• May lead to ingrown hairs or folliculitis, which can lead to changes in skin pigmentation
• Incorrect technique can cause bruising or skin removal

Safety tips

Do not use this method on broken, irritated or sunburned skin. 

Chemical depilatories

A chemical depilatory are creams, lotions, gels or sprays that contain chemicals designed to break down the protein structure of the hair. It is applied directly to the skin in the area where hair removal is desired. The hair dissolves and can be easily wiped away. 

The following tips to minimize irritation related to sugaring are based on general knowledge about skin care:

• Clean your skin before hair removal to remove any makeup, dirt, or excess oil.
• Consider trying a small test patch of skin to check for any potential reactions to the product.
• Avoid applying over irritated or damaged skin.
• Avoid touching or rubbing the area immediately after treatment and avoid applying products for a few hours.
   

Chemical depilatories pros

• Results may last longer than with shaving
• Usually painless as it does not involve pulling or tugging on hair
• Regrowth feels softer

Chemical depilatories cons

• Can cause skin and eye irritation or allergic reactions
• Has a strong odour, so may not be a suitable method if you are sensitive to scents

Safety tips

Always follow the product’s instructions. Do not use this method on broken, irritated or sunburned skin. Do not use these on your face unless the label specifies that it is safe to do so. Do not use these products on any skin close to mucous membranes, like the vagina An internal organ located between the legs. A person may be born with a vagina or have one surgically created. When referring to genitals, the Trans Care BC website uses "internal genitals (vagina)" for trans people assigned female at birth (AFAB), and "vagina" or "vagina with vaginoplasty" for trans people assigned male at birth (AMAB), but there are many different terms that individuals may use. or anus.

Long-term or permanent hair removal methods

Electrolysis and laser removal are two options for long-term or permanent hair removal.

Electrolysis

Electrolysis uses electric current to remove hair by destroying the root of each hair follicle, which prevents future hair growth. For best results, it is crucial to work with a skilled electrologist.

There are three methods of electrolysis, each of which uses a different type of electric current:

1. Thermolysis — In this type of electrolysis, a high frequency is used to create heat within the hair follicle. This heat destroys the cells in the follicle, eventually preventing hair growth. It is faster than galvanic electrolysis and is suitable for treating larger areas of the body. 
2. Galvanic electrolysis — In this type of electrolysis, a low-level direct current is used to create a chemical reaction in the hair follicle. This reaction destroys the cells in the hair follicle, eventually preventing hair growth. It is often used for treating individual hairs or smaller areas. 
3. Blend — This treatment 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 to treat a range of hair types and follicle depths. To maximize the effectiveness of this treatment, follow your hair removal provider’s instructions for how to prepare for treatment. They may recommend that you stop all methods of hair removal other than shaving or depilatory creams a couple months before starting. They might also recommend that you stop shaving or trimming any hair in the days leading up to treatment. 

Electrolysis 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 (for example, dry, oily or mature) 
• 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

Electrolysis cons

• These treatments are expensive (anywhere from $25 to $250 an hour) 
• Repeated treatments are required over a long time (around 1–4 years for thick facial hair)
• It is also painful (over-the-counter and prescription topical anesthetics can help with pain management)
• Common side effects 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 
• Incorrect galvanic electrolysis treatment can result in tattooing (permanent black marks on the skin) 

Safety tips

Laser hair removal

Laser hair removal offers long-term, but not permanent, hair reduction on all parts of the body, except the eyebrow and ear. Lasers treat an area of skin rather than one follicle at a time like electrolysis does.

It is important to know that not all hair and skin types are a fit for laser hair removal. It is most effective when hair and skin colour are in high contrast, such as dark hair on light skin. Laser hair removal is generally ineffective on blond, strawberry blond, white or gray hair. Dark brown and black skin also has a much higher risk of burns, scars and hyperpigmentation (permanent darkening of the skin) with this treatment.

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

Devices

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 statement means it is crucial to work with a skilled, experienced and well-recommended laser hair removal provider who follows all safety measures when providing this service. Health Canada has Safety Guidelines for Facility Owners and Operators to follow; however, monitoring of their use is currently not in place in B.C.

Laser hair removal pros

• Fast 
• Long-lasting
• May produce some permanent results. 
• Some people find it less painful than electrolysis 
• Hair is often finer and lighter when or if it regrows

Laser hair removal cons

• Professional laser hair removal is expensive 
• It requires several treatments, typically three to six (or sometimes 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

Safety tips

Laser hair removal is an evolving industry that is unregulated in Canada. Training standards and equipment are highly variable. There is also limited research about the long-term effectiveness of laser hair removal. We recommend talking to a knowledgeable professional and doing your research before you engage with laser hair removal treatments.

If you have a health condition or use medication, you may not be a good candidate for laser hair removal. Do not use this method if you take Accutane, tetracycline or Retin-A. 

People with the following conditions should not use laser hair removal:

• Albinism
• Cold sores
• Diabetes
• Epilepsy
• History of keloid scarring
• Nervous disorders
• Open wounds
• Sunburn
• Those who are pregnant

If the area you wish to have treated has a birthmark or mole, have the treatment approved by your health care provider first.

Considerations for electrology & laser hair removal

When deciding what type of long-term hair removal treatment to use, you’ll want to take into account:

Your hair removal goal

The hair removal options available depend on your goal and how often or conveniently you can remove your hair. If your hair removal is pre-surgical, see the Pre-Surgical Hair Removal section.

Your hair and skin type

For electrolysis and laser hair removal, your hair colour and skin type will affect the recommended method. A combination of these treatments are generally recommended; however, electrolysis is the only method that should be used for hair removal for individuals who have:

• Light hair (blonde, strawberry blond, red, white, or grey hair)
• Dark skin

Tip

Ask for a patch or site test — work with your hair removal provider to try a patch or site test prior to starting your treatment. This helps determine if you have adverse reactions to the treatment.

Your health history and medication use 

Tell your hair removal provider about health history and medications that might impact the selected hair removal method. Read the safety tips for each hair removal method because electrolysis and laser hair removal should be used with caution.

Your budget 

What you can afford can impact your hair removal goal. Electrolysis and laser hair removal are costly and can take time and commitment to meet the hair removal results you seek. Costs in B.C. can range from:

• $55 to $250 per hour for electrolysis (some people need up to 300 hours to achieve permanent hair removal) 
• $125 to $250 per laser hair removal session (each treatment area can take up to eight sessions)

Tip

Know your budget and discuss it with your hair removal provider to determine whether you can afford to complete the full recommended hours or sessions for your chosen method. On occasion, providers may provide a package rate or lowered rates for clients.

Finding a good fit

Find a hair removal service provider who is experienced, knowledgeable and comes recommended in providing gender-affirming service. This is especially important when looking for an electrologist or laser hair removal provider, as there can be high risks with these methods. Damage done may be permanent (such as skin burn) which can impact your hair removal goals — especially for pre-surgical hair removal.        

In B.C., hair removal services are unregulated. Some electrologists and laser hair removal providers may have certifications or designations to prove their level of competency, however, there are no specific provincial regulations in place for their professions, operations and use.

When choosing a hair removal provider, you can seek out recommendations from:

• Trans, Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) and non-binary Umbrella term referring to people whose gender does not fall within the binary gender system of woman/girl or man/boy. Some individuals identify as non-binary while others may use terms such as gender non-conforming, genderqueer, or agender. Non-binary people may or may not conform to societal expectations for their gender expression and gender role, and they may or may not seek gender-affirming medical or surgical care. community members, friends and family members
• Organizations in your area that support trans, Two-Spirit or non-binary people
• Your health care providers may have recommendations to share 

Contact the Trans Care BC health navigation team for information

When choosing a hair removal provider, be sure they:

• Have experience working with trans clients (using correct pronouns and respectful language) and are knowledgeable in the hair removal goals you need.
• Offer a site/patch test to ensure the hair removal method is suitable for you.
• Run a sanitary practice. Ask about their needle disposal method (for electrolysis) or other one-time use supplies as well as the last inspection by an Environmental Public Health Officer.
• Have a business license (according to municipal requirements) and hold insurance.

For additional suggestions, read Hair Facts: Choosing an electrologist.

Pain management options 

Electrolysis and laser hair removal feels a bit like getting a tattoo. Speak with your hair removal provider if pain is a concern. Options for pain management can include distraction through video, music, conversation, virtual reality, oral pain medication or topical anesthetic (such as EMLA, Zensa, BLT or Tetracaine). 

Your expectations

Results of hair removal can differ by individual as well as the experience and skill of the provider. Keep in mind there will be varying results, side effects and limitations of the treatment for each individual.

Lifestyle and hormone changes affect your treatment plan

Attend hair removal treatment sessions as planned and notify your hair removal service provider if any changes occur in your diet and hormones so your treatment plan can be adjusted.

Additional hair removal resources

Find more information on electrolysis and laser hair removal at the Centre for Excellence for Transgender Health: Hair Removal

Medically necessary (or pre-surgical) hair removal

The Gender Surgery Program B.C. (GSPBC) recommends permanent hair removal prior to certain gender-affirming genital surgeries.

Some genital surgeries require medically necessary Treatments, procedures or services that health care professionals determine are essential for diagnosing or treating a medical condition based on established medical guidelines and individual patient needs. or pre-surgical hair removal on areas that are difficult to treat after surgery and are known to increase the risk of complications postoperatively. The GSPBC recommends permanent hair removal before the following procedures:

Phalloplasty with urethral lengthening

Pre-surgical, permanent hair removal via electrolysis is required. This hair removal is done on the strip of skin that becomes the urethra for phalloplasty A gender-affirming lower surgery to create a penis and scrotal sac (phase 1) followed by testicular implants and implants to obtain rigidity/erection (phases 2 and 3). . It is funded by the B.C. Ministry of Health and brokered through PHSA (Provincial Health Services Authority — Trans Care BC) who contracts with hair removal vendors. Funding only covers the section of the graft A surgical procedure in which one section of healthy skin is removed from a part of the body and used in another location (or in the same location in the case of nipple grafts). required for urethral lengthening A surgical procedure to extend the length of the urethra to allow for urination out of the tip of the penis. The procedure involves connecting a person's current urethra to the new urethra created in the shaft of the penis. .

Vaginoplasty

Pre-surgical hair removal is strongly recommended and, in some cases, required. This hair removal is done on the area of the genitals that will become the internal cavity for vaginoplasty A gender-affirming genital surgery to create a vulva (including mons, labia, clitoris and urethral opening) and vagina. . It is funded by the B.C. Ministry of Health and brokered through PHSA (Provincial Health Services Authority — Trans Care BC) who contracts with hair removal vendors.

The hair removal approach is determined on an individualized basis with the surgical team. 

• Hair removal for vaginoplasty is, ideally, done pre-operatively via electrolysis, laser or a combination of laser and electrolysis.
• You can discuss alternate options with the surgical team if significant barriers exist with hair removal. In some cases, manual hair cautery A medical technique that uses heat to burn or seal tissues to stop bleeding or remove unwanted tissue. may be possible during surgery. 
• The decision not to do pre-surgical hair removal should only be decided after an informed consent discussion with the surgical team.

Pre-surgical hair removal funding

There is funding available for medically necessary hair removal. 

The Gender Surgery Program B.C. surgeons make this funding recommendation at your surgical consult and will provide you with a recommendation letter.

Before beginning a treatment plan, you will need to be:

• Referred to the Gender Surgery Program B.C. by your primary care provider A person’s main health care provider in non-emergency situations such as check-ups and referrals. Family doctors, general practitioners (GPs) and nurse practitioners (NPs) are all primary care providers.  
• Contacted by the surgical team to set up your surgical consult where you will discuss hair removal requirements
• Given an information package (if pre-surgical hair removal is recommended by your surgeon) that includes a:
  • Recommendation letter
  • Diagram of where hair removal should be completed
  • List of PHSA-approved hair removal vendors

From there, you can:

• Contact a hair removal vendor from the PHSA approved vendors list to schedule an appointment. Provide your hair removal recommendation letter to the vendor so they know your hair removal is funded. PHSA pays the providers directly, so you will not have to pay the provider.
• Share a diagram of the hair removal regions with the vendors. Include the diagram for the following:
  • The strip of skin on the arm or thigh that becomes the urethra for phalloplasty
  • The area of the genitals that will become the internal cavity for vaginoplasty

Do not start hair removal before receiving your recommendation letter. The funding will not cover any hair removal expenses prior to approval. If you begin hair removal before receiving a recommendation letter from the surgery program, these expenses will be yours to pay.

Additional hair removal

There may be other areas where you would like to have hair removal done that extend past what is considered medically necessary. Any treatment on these areas would need to be negotiated with your hair removal provider and done at your own expense. 

Pain management and advocacy

Pain relief options may be useful in making hair removal more tolerable. Your hair removal vendor can provide options for funded topical pain relief and other strategies to reduce pain. 

• Benzocaine/Lidocaine/Tetracaine & Lidocaine/Tetracaine information sheet — find information about relief of pain related to medically necessary hair removal in preparation for gender-affirming surgery.
• Self advocacy in health care pain management for pre-surgical hair removal guide — learn more about pain management options, get tips on speaking with your provider and find suggestions on what to do if you are having trouble finishing your hair removal or no longer want to continue.