transit-website/hair-removal.md

% Hair Removal

You do NOT need to be on hormone therapy to have hair removal. Hairs whose follicles are properly destroyed cannot grow back however as hormones are what stimulates new hair growth and as everyone is affected by hormones, you should expect to require maintenance sessions at some point, how many and how often you need these will be determined by your own personal hormone levels.

When looking for a laser provider it is essential to do your research first. Ensure that you are being treated with a genuine laser and not an IPL machine. IPL (Intense Pulsed Light) is an old technology, relatively ineffective long term and far more painful. Unfortunately many providers will sell their machines as Laser when they are IPL so be aware of this

• there is no such thing as a Laser IPL machine, if the machine is being marketed in this way it is an IPL machine. Laser machines are not created equal and range from very cheap machines through to the very expensive . Again, research is essential as the type of machine used will have an effect on the treatment outcome as well as comfort levels during treatment.

The newest technology laser machines can treat all terminal hair except for grey hair. No laser can treat grey hair yet and as such electrolysis is the only option for those with grey hair. Clients with red hair will need to be assessed for suitability for treatment as the outcome will be based on how much red pigment vs brown pigment their hair contains. Clients with red hair should be advised that they will likely need more treatments than those with other colour hair. In some cases, both laser and electrolysis is required, for example if you have dark hairs and grey hairs. Again, your laser hair removal specialist can advise you on the best course of treatment.

When it comes to choosing a Laser Hair Removal practitioner we would advise you to choose someone who is accredited or licensed to the highest level (level 4 in the UK), is a member of the British Laser Association (UK), is audited by an independent Laser Protection Adviser and has good client testimonials. If you laser treatment is being paid for by the NHS you will also need to choose a provider who is NHS approved (UK).

The best quality Laser Hair Removal machines are FDA approved to work on tanned skin and with almost all medications. You should have a full consultation and patch test prior to treatment; during this consultation any medications or illnesses will be recorded and consequently confirmed as suitable for treatment.

You should expect quality Laser Hair Removal to be expensive. We advise to begin with the areas or priority first (usually face and genitalia) and then progress as desired. In some cases, especially if starting hormones, you might find that body hair becomes tolerable enough to simply shave or wax, if cost is an issue. If you are funding your own Laser sessions research and look around for special offers.

You will not be able to wax, pluck or thread either 4 weeks prior to beginning laser or during the course of your sessions as the laser needs to be able to target the hair follicle. Hair removal creams should *NEVER* be used as they contain pure lye which damages the skin.

Use sun lotion! The strongest you can find, e.g. SPF 50. You need to avoid even the slightest tan before laser. If you're planning a trip to Barbados, forget it. Do it next year.

Just before you go to a hair removal session, you should:

• Shave as closely as possible, so that you get the smoothest possible skin surface. This is because the laser is more effective at killing the follicles. If your hair is too much above the skin surface, it can end up absorbing the laser
• Take the strongest painkillers possible, at the highest dose, an hour before your session. If you can take more than 1 kind of painkiller, do so. (avoid morphine or anything that is addictive). Hair removal can be painful. Some people tolerate pain better than others, and how much pain depends on your hair/skin.
• Ask for anesthetic before your clinician begins the treatment

Hair removal can hurt, a lot, while it's being performed. You should take strong painkillers (non-addictive) before each session. Painkillers to take (1 hour before your session. Use all of them, if you can. Hair removal can be very painful!):

• codeine (3-methylmorphine) at 25mg
• paracetamol 1g (1000mg) (in USA it's sold as acetaminophen, brand name Tylenol)
• weed/marijuana, if it's legal in your country and easy to get (THC in weed is a powerful non-addictive painkiller) - smoke it about 20 minutes before your session. THC is also available in vapourized form. This is illegal in the UK, but completely legal in the Netherlands and parts of USA for instance (and de facto legal / not enforced against in Canada). The goal is to get stoned, but still be functional enough to make it to the clinic.

(NOTE: not confirmed): ibuprofen (in USA, the brand name is Advil) can cause the skin to become more photosensitive, according to 1 person that we've spoken to. You should assume that this is true, and not take ibuprofen.

You should also use this additional painkiller, 60 minutes before your session. Use a dressing (e.g. clear film used for food wrapping) and apply it over the areas that you're using the cream on, to keep the cream wet so that it can continue to absorb without drying up:

• Any kind of cream containing up to 5% lidocaine. E.g. EMLA gel contains a strong dose of lidocaine. Rub it all over the area that you're getting treated. E.g. your face. It's an anaesthetic, which will numb any area that it touches.

Your clinician may also provide anaesthetic, but hair removal clinics in most countries do not do this.

During the session:

• Clench your teeth, and hold your fists tightly (maybe hold onto something) and cross/twist your legs.
• Try to focus on something pleasant in your mind, to take your mind away from any pain you might feel
• Try not to focus on any current pain. The session will be over before you know it. Focus on the thought of doing something else that you plan to do later.
• Try to perform complex math equations, or anything that requires thinking. Even counting in your head from 1 to 9000 might help. (don't talk or move during treatment, though)

After the session:

• Don't shave for at least 24 hours. Also don't use any makeup or soaps/gels etc for at least 24 hours.
• There *are* certain types of gels that can rub on your face to soothe any pain you feel afterwards, to cool the skin down a bit. Ask for it at your clinic if you don't have it with you. E.g. exfoliating gel (anything that opens your pores will cool the skin down)

NOTE: the pain gets less and less, with each session. The first sessions are more painful, because there's more hair to remove. If you feel pain, take it as a good sign that the treatment is working!

Certain medication can weaken the skin and make hair removal dangerous. Your clinician should ask you what medication on, to assess safety.

Free NHS hair removal (UK)

If you're using an NHS (not private) gender identity clinic, they can approve you for hair removal on the NHS. Ask them about that.

TODO: add other countries here, that offer free or subsidised hair removal. Hair removal is expensive, and usually not covered by NHS or health insurance in most countries.