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+---
+title: Hair Removal
+x-toc-enable: true
+...
+
+Introduction
+============
+
+**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.**
+