Specialists in the Medical & Psychological Aspects of Transgender Health Care 

Carl W. Bushong, Ph.D., LMFT
Richard A. Martin, Jr., M.D., FACEP
Kimberly L. Westwood, CPE, CCE
et al.
  electrolysis guide  
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home > Electrolysis Guide > Pain Management

 PAIN MANAGEMENT TOPICS  
Electrolysis Pain : What to expect; factors involved in the perception of pain.
Pain Control : A preferred method to alleviate/eliminate the discomfort of electrolysis treatment.
Oral Nonopioid Medications : Oral pain medication used in addition to topical pain management.
Adjunct Medical Support : Physician facilitated pain management during electrolysis treatment.
EMLA : A topical anesthetic.
Occlusive Dressings : Application instructions for cream type topical anesthetics like EMLA.
OTC topical analgesics : Non-prescription topical analgesics available to the electrology patient.
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Adjunct Medical Support

Most electrology practice, as it typically functions, involves brief treatment encounters with patients experiencing mild to moderate hirsutism (unwanted hair); the affected areas usually possess somewhat fine and shallow follicles. Treatment usually incorporates brief visits over extended periods of time as unwanted hair growth is brought under control.

But in many instances that involve transgender care, the electrologist is unable to sufficiently control the degree of pain and after-effects that are associated with extensive treatment with the use of over-the-counter preparations.

The three most widely practiced alternatives to medical pain management appear to be:

  • Shortening of the treatment encounter

    • CONTRARY EFFECT:
      Under many circumstances, beard removal may require approximately 200 hours of treatment. Treatment encounters that utilize no more than one or two hours may make the normal process of beard removal impractical. Maintaining a timeline congruent with hormonal management is especially important since increased sensitivity to electrology pain typically occurs as the skin softens.

  • Reducing treatment energy

    • CONTRARY EFFECT:
      Electrolysis energy is downwardly adjusted to allow for longer sessions to be comfortably tolerated. This reduction of treatment energy may minimize electrolysis pain, but the overall response to treatment suffers greatly with markedly fewer follicles killed.

  • Inadequate topical analgesic and antibacterial preparations from over-the-counter (OTC) products

    • CONTRARY EFFECT:
      While OTC topical preparations are often sufficient for less intensive treatment (fewer hairs, shallowly rooted), the extensive treatment associated with coarse, deeply rooted follicles may be too painful or intrusive for the patient. Patients may suffer needlessly through the process or prematurely withdraw from electrolysis treatment, transitioning with the added burden of a significant amount of facial hair remaining. Additionally, the intrusiveness of extensive facial electrolysis suggests a need for topical antibiotics following treatment, which have been demonstrated to significantly reduce recovery time and lessen the risk of scarring.

Here, the patient often requires the support of a medical provider as an adjunct to the electrology process.

In such a situation, the physician forms a bridge between transgender medical patient and the electrologist in order to safely provide the necessary management of medical therapies (prescribing of more potent topical anesthetics than are normally available OTC, and topical antibiotics as indicated), and providing the necessary patient education to allow for their safe administration during the electrology treatment encounter.

In such arrangements where non-physician ancillary health care providers are involved, an importance should be placed on meeting established training guidelines in their respective field; as the electrologist aids the patient in the application of prescription topical anesthetics and topical antibacterial preparations during the course of electrology treatment, one measure of proficiency may be holding a certification of CPE or CCE, as established by either of two national electrologist affiliations.  For more information concerning electrologist training and accreditation, please refer to Training & Licensing Issues.

In essence, the physician helps to facilitate a safe and controlled environment for the transgender patient requiring permanent hair removal. As in other situations where responsibility is placed on the patient to follow physician direction, maximum benefit is often based on proper compliance with the treatment plan.


Information provided and accessed through TransGenderCare.com is presented in a summary form and should not be used as a substitute for a consultation or visit with a physician, psychologist, electrologist or other health care provider. (See Terms & Conditions.) 

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