Perhaps the most effective (and long-lasting) method of hair removal is electrolysis. In this procedure, a fine sterile needle is inserted along the shaft of the hair follicle, and a tiny amount of electrical current is emitted to destroy the hair growth cells. As you might imagine, it takes a lot of skill and experience to do this well, and choosing the wrong electrologist can have disastrous results. If you have decided on electrolysis, then, the next step is choosing the best electrologist for you. I have had to choose an electrologist twice now—once to remove facial hair, and recently to prepare for gender confirming surgery (GCS). The following questions are ones that I have asked (or wish I had asked) when selecting a new electrologist.

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What are your qualifications?

In the U.S., each state has different credentialing criteria for electrologists. You can find the licensing requirements for your state at the American Electrology Association website (http://professionals.electrology.com/be-an-electrologist/electrology-licensing-requirements.html).

This page also includes contact information for the licensing bodies in each state. If you aren’t sure about an electrologist, you might be able to contact the appropriate agency for your state to find out if there have been complaints, etc. If your electrologist has any other relevant credentials, now is a good time to ask about them as well. Also, find out how long she has been in business and how many clients she has seen.

What experience do you have working with trans people?

This is especially important if you need electrolysis to prep for GCS, because it is important the electrologist know which areas need removal and which don’t. Also, because hair removal for GCS occurs in the genital area, she will need to be comfortable in that situation. Even if you need hair removal in the face or other body areas, though, it is helpful if the electrologist has worked with trans people before. A trans woman’s facial hair, for instance, often grows differently than that of most cis women, and an awareness of the unique growing characteristics will increase the chances of successful permanent hair removal. Make sure she is comfortable working with trans people and that she has already worked with several of us.

What types of electrolysis do you practice and how long have you been doing each?

First, make sure electrologists at this facility actually are doing needle electrolysis. Some places claiming to do electrolysis actually use some other method. There are three main modalities of electrolysis: Galvanic, Thermolysis (short wave), or blend. In galvanic, the current creates a chemical reaction that destroys the follicle, whereas thermolysis destroys the follicles by producing heat. The blend is a combination of both methods. You might also ask what specific equipment they use and how long they have been using it. The answers –especially to how long she has been doing each modality or using a specific piece of equipment – can give an idea of the experience and confidence level of the electrologist.

Do you have references?

The best way to find an electrologist is through referrals. If you know anyone who has had electrolysis, you can ask who they have used and if they would recommend that person. Most of the hair removal professionals I’ve used have been recommended by someone who has already used her. If no one can give you a referral, it is OK to seek out electrologists online, through Yellow Pages or similar directories, or online, but make sure she is willing to give you names of people she has worked with. Especially ask for other trans women she has worked with so you can learn her level of comfort and experience working with trans women. Ask references if they had it to over again, would they go back to this individual. Were they comfortable? Do they know of anyone who has had a bad experience with this electrologist? If so, what was the problem? Because references would be picked by the electrologist, they are more likely to be someone with a good experience and might not provide much negative information, but it is still helpful to ask these questions.

Do you charge for a consultation? Can you do a free test patch?

Most electrologists offer a free consultation and test patch, but some charge a small fee put toward the cost of your first session. If you are brand new to electrolysis, ask her to do a test patch so that you can get an idea of how it feels (spoiler alert: it will likely hurt, especially at first!) and see how your skin reacts to the treatment. The electrologist can also get a better idea of what is involved and can give you a more accurate estimate of the time and cost involved.

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What do you do for pain and aftercare?

First, if the electrologist tells you it doesn’t really hurt, run away. Fast. For most people, the procedure is painful, at least at first. The electrologist I use now applies liberal amounts of hydrocortisone during and after treatment to sooth the area. To further combat pain, I apply lidocaine to the area about an hour before treatment. With this care and after repeated visits, I find I am noticing the pain less and less, even as she works in some very sensitive areas!

But what about the cost?

You will notice none of the questions above involve price. Price is important—if you can’t afford the treatment it won’t matter how the other questions are answered – but it should not be the deciding factor. If it is down to two electrologists and their answers to the questions are about the same, then you would want to consider price. I’ve seen prices range from a low of $40/hour to $125/hour. Typically, you can expect to pay $75 to $100 for an hour session (some larger metropolitan areas you can expect
to pay more). Most electrologists schedule in 15 minute increments, with the price per 15 minutes decreasing with longer periods of time (for example, 15 minutes might be $40, 30 minutes might be $70, 45 minutes $85, and 1 hour $100). The electrologists’ abilities don’t always correspond to the price they charge: there might also be overhead and other costs that factor into the price. However, if you find someone who provides positive answers to your questions, but is much lower than others, it might pay to be skeptical.

Other considerations

When going for a consultation, notice the environment: does everything appear clean and sanitary?

Unsterile conditions can lead to infections. The electrologist should wash hands before beginning and wear sterile gloves when performing the procedure. The table should be cleaned or redraped between each client. Ask if disposable probes are used (if not, why not?) and whether an autoclave is used to sterilize other equipment. Consider that an electrologist is a health professional; if she does not look or act professionally (or if the work area does not look clean and sterile), that is a red flag, despite her reputation, experience, or what kind of references she has.

Take your time

The final consideration is to remember that electrolysis is a serious procedure that can have severe negative consequences when done poorly, so do not be in a hurry to select your electrologist. Take the time to ask all the questions that need to be asked, find all the information you need to make an informed decision. This also gives you a chance to listen to your intuition if it is telling you something is just not right with the person you are considering. More often than not, your subconscious is responding to cues we don’t even notice and your intuition is right, so it is usually a good idea to back off or get a second opinion if you get a funny feeling about using any particular electrologist.

Good luck in your quest for an electrologist. If you are careful, proactive, and trust your instincts, you are most likely to have a positive electrolysis experience.