Perineal Hair Removal before gender affirming surgery is a vital step in preparing for procedures such as vaginoplasty. At WIH Hospital in Bangkok, Thailand, we provide medically advanced and safe solutions for transgender and nonbinary patients, ensuring a smooth and healthy transition with expert care led by Dr. Chettasak Tulayaphanich (formerly Dr. Chettawut).
When preparing for Gender-Affirming Surgery (GAS), especially male-to-female (MTF) procedures, understanding the difference in natural genital hair patterns between males and females is crucial — particularly when planning hair removal in areas that will be surgically reconstructed.
In individuals assigned female at birth, hair typically grows in the following areas:
These areas are normally hair-free, including the inner labia (labia minora), the vaginal opening, and the inside of the vaginal canal.
In contrast, individuals assigned male at birth tend to have thicker and more widespread genital hair. Hair commonly grows across the mons pubis, around the base of the penis, over the entire scrotal skin, and along the perineum — the area between the scrotum and the anus.
Hair removal before gender-affirming surgery is a vital step in preparing for procedures such as vaginoplasty. At WIH Hospital in Bangkok, Thailand, we provide medically advanced and safe solutions for transgender and nonbinary patients, ensuring a smooth and healthy transition with expert care led by Dr. Chettasak Tulayaphanich (formerly Dr. Chettawut).
Some areas of male genital skin that naturally grow hair will be surgically transformed into parts of the female genitalia — such as the vaginal opening — which are not supposed to have hair. To prevent unwanted hair growth in these sensitive areas, preoperative hair removal must be considered, especially in regions like the perineum.
Dr. Chettasak recommends hair removal in only one area before gender-affirming surgery (GAS): the perineum — the skin between the anus and the base of the scrotum. If you have visible or dense hair in this area, it can result in hair growth near the vaginal opening after surgery, which may affect both hygiene and aesthetics.
To prevent this, Dr. Chettasak advises starting the hair removal process at least 6 months before SRS. This allows enough time for permanent hair reduction through laser or electrolysis and ensures optimal surgical outcomes.
Laser hair removal employs pulsating light beams. The light is focused at the hair follicle, where it heats the melanin (the pigment in the hair), causing the hair follicle to stop developing hair momentarily. This makes this option more suited to people with fair skin and dark hair. It necessitates many sessions separated by 4-6 weeks. Because it does not permanently damage the hair follicles, it is extremely possible that maintenance treatments will be required.
IN CONCLUSION:
Best for dark brown or black hair
Safe for all skin tones
Gradually reduces hair density
Not permanent — hair may grow back thinner and slower
Laser is a good temporary method for hair removal before gender-affirming surgery, especially when time is short or if permanent electrolysis isn’t yet available.
“Laser slows hair down, but electrolysis is the gold standard for permanent results.” – Dr. Chettasak
Electrolysis is ideal for patients seeking permanent hair removal before gender-affirming surgery, especially for the perineum area. The dermatologist or skilled electrologist inserts a light probe into each hair follicle and passes an electrical current through it. Consequently, the hair root is destroyed. This is appropriate for everybody, regardless of skin type or hair color. It also requires multiple sessions but the result is more permanent pre-surgical hair removal when compared to laser.
IN CONCLUSION:
Permanent hair removal before gender-affirming surgery
Works on all hair colors and types
Treats each follicle individually
Can be painful — that’s why we offer electrolysis under sedation
so you can sleep through the procedure and wake up hair-free.
Important Note: It is not suggested to attempt one method of hair removal and then switch to another. To ensure your safety and the efficacy of the treatment, you must consult and be treated by a licensed technician, dermatologist, or electrologist who is trained to perform these procedures. Furthermore, it is critical that you follow the pre-treatment and post-treatment recommendations to avoid bad reactions and complications. Whether you choose laser or electrolysis, both are effective methods of hair removal GAS in Thailand, depending on your timeline and hair type.
Timeline: When to Begin Hair Removal Before Gender-Affirming Surgery
Starting hair removal before gender-affirming surgery early is crucial to ensure optimal results and reduce surgical risks. Because effective hair removal requires multiple sessions, it’s best to begin the process several months in advance.
Here’s a general timeline to follow:
6–12 months before surgery:
Begin laser or electrolysis sessions. Hair grows in cycles, and only active follicles can be targeted during treatment — so multiple sessions spaced 4–6 weeks apart are necessary.
1 month before surgery:
Stop all hair removal treatments. This pause gives your skin time to heal before the operation. Any irritation or inflammation needs to resolve prior to surgery.
Post-surgery (if needed):
If some hair remains or grows back, your surgeon may approve touch-up sessions beginning around 6 months after surgery — typically targeting external areas only.
Dr. Chettasak does not recommend preoperative hair removal on the scrotal skin in most cases. This skin is typically used to create the outer labia, where the presence of some natural hair contributes to a more realistic and feminine appearance.
In certain cases where additional scrotal skin is needed to construct the vaginal canal — such as in skin graft vaginoplasty — all hair and hair roots in the grafted area will be completely removed during surgery. This is part of the standard skin graft preparation to ensure the vaginal lining remains smooth and hair-free after surgery.
Electrolysis is highly effective for permanent hair removal — but many patients find it painful. At WIH Hospital, we aim to make the experience as comfortable as possible by offering electrolysis under sedation, allowing the patient to sleep through the procedure without feeling discomfort.
For patients who have extensive genital hair and have not undergone any hair removal prior to surgery, we also offer a one-time electrolysis session under general anesthesia (GA). This can be performed before your gender-affirming surgery (GAS) to help reduce the burden of repeated painful sessions while ensuring surgical readiness.
Our goal is to support your transition journey with care, comfort, and clinical excellence — every step of the way.
Because laser doesn’t destroy all hair stem cells.
It weakens hair growth but doesn’t eliminate it completely, especially in genital areas. That’s why Dr. Chettasak does not consider laser a permanent solution, particularly for surgery-related hair removal.
Diode laser works well on light to medium skin tones and coarse hair.
It penetrates deeply and covers large areas quickly, making it ideal for initial hair reduction.
Nd:YAG is safest for darker skin tones.
It has lower risk of burns or pigmentation and reaches deep hair follicles effectively.
If significant hair growth occurs, treatment can be resumed after a minimum of 6 months, focusing on the vaginal entrance, and surrounding areas. Always seek treatment from a reputable specialist trained for this procedure to avoid complications.
