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Hair removal pain management tips

Note: I have moved most of my hair removal pain reduction information to:

The information below is a general summary, followed by information specifically for women who are transitioning.


  1. Because pain varies widely from person to person, you must experiment to find out what works best for you.
  2. You must work as close to your pain threshold as possible for the most effective treatment. Communication with the practitioner about this is vital. Have him or her turn it up if you can stand it.
  3. Get as comfortable as possible during treatment
  4. Find the time of day that works best for you. Early or late, awake or tired, everyone is different.
  5. Eliminate as much stress as possible on the day of hair removal appointment.
  6. Those on hormones and those requiring a lot of treatment may find their pain threshold decreases over time.
  7. Your diet can affect your sensitivity. Avoid stimulants like caffeine, chocolate, or sugar the day of an appointment.Some find a meal just before treatment helps reduce discomfort.
  8. In your early sessions, save the most sensitive parts for the end of the session. Once you have found an effective pain management method, try doing the sensitive parts first to see which way makes a session go faster for you.
  9. You may find an antihistamine reduces mucus production and swelling while working under the nose.
  10. Click here for a list of cheap and easy pain reduction methods.
  11. The most effective methods of pain reduction are prescription painkillers, prescription tranquilizers, topical anesthetics, and injected anesthesia administered by a medical professional. These carry certain risks you should know about.
  12. Distractions such as talking, listening to music, or holding something can help.
  13. Placing cotton rolls or folded tissue inside your mouth between the teeth and lips during treatment around the mouth can greatly reduce discomfort and mucus production during work under the nose. It also makes hairs more accessible for the electrologist.
  14. While some use alcohol or aspirin to reduce pain, these can cause blood thinning and prolong bleeding if a follicle is accidentally damaged during treatment.
  15. Avoid alcohol or prescription painkillers if you are driving to treatment.
  16. EMLA and ELA-Max are very popular topical anesthetics. EMLA requires a prescription and works best when applied carefully: cleanse skin with alcohol, apply EMLA in a thick layer, cover with an airtight dressing, which should be cut to size and taped in place, then wait until it reaches optimal effectiveness. This may vary from 15 minutes to 2 hours, so try at least an hour the first time and then experiment. Most people do not get 100% anesthesia from EMLA, but they get enough to make treatment bearable. It loses its effects quickly once uncovered, so timing is important. Many find that fresher tubes work better, and that it is affected negatively by temperature changes. Many prefer ELA-Max, because it’s over-the-counter and easier to use.
  17. Some electrologists and clients have made arrangements for injected anesthesia prior to treatment. Ask if you are especially averse to pain and don’t mind paying.
  18. Pain or the fear of pain should not keep you from getting hair removed permanently if you really want it.

If EMLA or ELA-Max don’t cut it…

As mentioned up front, EMLA and ELA-Max are a bit overrated at times. It is very difficult for most to get 100% anesthesia using these, but most people don’t need the pain eliminated, just reduced.

Topicals from compounding pharmacies

My pain-hating friend Janet reports she has obtained from a Florida pharmacy a prescription topical anesthetic like EMLA, but with a much higher dose of anesthesia:

So I’ve been using the Eutectic Plus ointment. I don’t have a lot of experience yet, but here’s what I know so far. It’s only available from one particular pharmacy in Florida: Medical Center Pharmacy, 4600 N. Habana Ave., Tampa, FL 33614, phone (813) 871-6154. A 30 g tube cost about $42 by UPS ground.

Since it’s an ointment, not a cream like EMLA, supposedly you don’t need the occlusive dressing. You still need to put it on pretty thickly and give it time to sink in — an hour or more if possible. Allegedly the stuff contains 15% active ingredients compared to EMLA’s 2.5%, but it’s kind of hard to confirm. It came in a tube that says only “Use as directed” and there are no instructions or ingredients given. The person who answered the phone when I called was only an order-taker and didn’t know what the stuff was.

In my two attempts at using it, I found it was no panacea. It certainly didn’t substitute for a dentist-administered novocaine shot. It did seem to reduce the pain, just as EMLA does, but not by a factor of six. It is easier to use, though, and since it’s thicker I think it lasts longer. The electrologist can leave most of it on your skin and just remove it bit by bit in the areas she’s working on.

Thanks Janet! If anyone else decides to try this, please let me know so I can include your experiences as well.

Gas anesthesia Some electrologists have begun incorporating nitrous oxide and other types of gas anesthesia for pain management.

Novocaine/lidocaine injections Some people have worked out a deal with a dentist or doctor to get shots of anesthesia before their hair removal appointment. In some states where hair removal is regulated this is illegal, so you may need to approach this subject with discretion. As with finding an electrologist, your best bet is to get a referral from someone. You might have to pay a small fee, but it doesn’t hurt to ask (pun intended). Some only charge for the ampules of anesthesia. People have reported it takes around 5 ampules at $2.00 apiece to do the entire face. That’s the low end. It will probably set you back something closer to $25 to $40 or more, but the numbness should be nearly 100% effective. Some people swear by this, and it’s the method used at Electrology 3000. If you don’t like the price you’re quoted, try bargaining or shopping around. Maybe your electrologist or a client is already doing this and can give you a referral. I have heard concerns about getting too many injections at once can affect breathing and swallowing, but I have not found any published data on this side effect. Check with the medical professional administering your shot if you’re concerned about this. Some find making all the arrangements very difficult, but for those who can’t stand any pain at all, it may be worth the effort.Janet writes: 

I found a local electrologist who works with a dentist to give novocaine shots, because pain control was the #1 issue with me. So far I’ve had four hours with her. The dentist did a great job on my upper lip. It was completely painless there. The shots he gave me in my lower lip weren’t as effective. He said he wasn’t sure they would be, and he can’t help me at all on other parts of my face.

Andrea’s advice

Believe it or not, there’s another TS named Andrea who writes about hair removal! She’s of Scots/Irish descent, too, but she still lives over there. Usual disclaimers: this is information, not medical advice, etc.

I personally do not recommend administering injectable anesthetics on yourself or without medical supervision due to the risk of complications up to and including death.

That said, the following information is copyright 1999 by Andrea Brown.


Local anesthetics work by causing a reversible block on nerve fibres. They vary widely in toxicity, potency, duration of action, solubility and ability to penetrate cell membranes.

Anesthetics are not completely safe. Some people can have hypersensivity reactions. These occur mainly with amethocaine, benzocaine, procaine. Amide based anesthetics such as lignocaine, bupivicaine, prilocaine, repivocaine tend to have a lower toxicity and side effects.


A single dose is usually safe enough but repeated doses can cause a build up in the blood plasma of anesthetic. If a person has a heart problem this can cause a heart attack especially if it contains adrenaline. Using repeated dosages without medical supervision is stupid and dangerous. Any electrolysist that states different is only interested in money and not your health. If you are going to a salon that specialises in one day clearance they will use the doctor attached to them. If there is no medical supervision my advice is to leave as you are probably being ripped of. You are also taking one hell of a risk if you allow anesthetics to be used on you without medical supervision.


Adrenaline is added to some local anesthetics. This causes constriction of the blood vessels affected as most local anesthetics cause dilation of the blood vessels. This is used because constricting the blood vessels in the area reduces blood flow keeps the anesthetic in the in the area longer. You do not require higher concentrations of adrenaline. The nerves associated with pain in electrolysis are mostly located in the dermis. There isn’t as much in the subcutaceous layer.

Any injections should take advantage of this and not inject below 6mm. Injecting below this is pointless as you are just wasting anesthetic and freezing more than you need to. Adrenaline should not be added to anesthetic when used in fingers and toes and preferably avoided in the legs and arms. You have to be very careful when injecting in the genital area as it is full of blood vessels and is quite easy to do an intravascular injection by accident.

HOW TO INJECT (Applies to hormone and anesthetic injections)

When injecting put the syringe needle in to the skin to the desired depth. Retract the plunger slightly, if it fills with blood retract the needle and move to a different site as you are in a blood vessel. If you do not and just inject into a blood vessel the anesthetic could reach your heart in about 30 seconds and so stop it or cause it to fibrillate. Do not inject within 4 cms of the pierced blood vessel as it could cause a surge of anesthetic to reach the heart and so cause heart problems. Preferably move to a different area.

When injecting don’t allow the needle to come into bone contact as a scratch on the bone can be extremely painful and long lasting. It is usually worse than toothache. When injecting inject very slowly so as not to damage the dermis, nerves, blood vessels etc. Do not inject into inflamed or infected tissues or use near an urethra that has been traumatised in any way. Under these conditions the drug can be rapidly absorbed at a rate which may lead to a toxic reaction. Blood plasma concentrations of anesthetic peak within 10 to 25 minutes and so medical surveillance is necessary for the first 30 mins after injection.


Cumulative overdose can lead to the following side effects: Inebriation ( drunkedness ), lightheadedness followed by sedation and convulsions and in some cases death. In the case of intravascular injection convulsions and cardiovascular failure can occur extremely rapidly followed by death.


  • LIGNOCAINE ( xylocaine ) lignocaine hydrochloride 0.5% to 2% either without adrenaline or with concentrations of 1 in 200,000. Do not use higher concentrations of adrenaline.
  • BUPIVACAINE ( marcain ) bupivacaine hydrochloride 01% to 7.5% ( 1mg/ml to 7.5mg/ml ) available with or without adrenaline.
  • PRILOCAINE prilocaine hydrochloride 0.5% to 4.0% ( 5mg/ml to 40mg/ml ).
  • PROCAINE procaine hydrochloride 2% or 20mg/ml.
  • ROPIVACAINE ropivacaine hydrochloride 2mg/ml to 10mg/ml.

Again, I personally do not recommend administering injectable anesthetics on yourself or without medical supervision due to the risk of complications up to and including death.