According to Dr. Bowers (I think), virtually all SRS surgeons do follicle scraping. Given that, it appears that some believe they can do so completely effectively and others do not. The post-ops I know personally have gone to either Meltzer or Brassard. The ones that went to Meltzer did electrolysis first. The ones that went to Brassard did not. (Brassard does not want it done.) Neither has had any hair issues.
On the painkiller topic, my doctor prescribed compounded cream that has 6% lidocaine and 6% tetracaine. I never filled it because I don't need it for regular electrolysis. If I go the genital electrolysis route, I probably will. She says this compound is far more effective than Emla, which has 2 1/2% lidocaine and 2 1/2% prilocaine.