Hirsutism (Excess Hair)

General Description

Excess hair growth is known as hirsutism. For most individuals, the problem is simply a cosmetic one, indicating neither the presence of hormonal nor of gender abnormalities. In fact, if one examined a group of white females, nearly one-quarter would be found to have hair on the upper lip (with the condition being very apparent in 10 percent), and over three-quarters would exhibit coarse hair on their arms and legs.

Hair distribution is in large part genetically determined; if your mother has excess facial hair, you most likely will too. In general, women of southern Mediterranean and Near Eastern origin have more facial and body hair than do North American and Asian women.

Causes

About 1 percent of women complaining of excess body hair have a significant medical problem such as overactive adrenal glands or ovaries. Such women may also experience menstrual irregularities, weight gain, and acne. Since both benign and malignant tumors must be ruled out, hirsute women with these associated disorders should visit a physician and undergo examination and laboratory studies. Some drugs, such as Depo-Provera, Dilantin, and tamoxifen, can also induce hirsutism.

Medical Treatments

Many women are concerned about excess body and facial hair. Several means are available for the removal of unwanted hairs, the current gold standard being lasers and intense pulsed light (IPL).

Lasers and IPL are specialized light sources. Light used for hair removal passes through the skin and is absorbed by pigment within the hair follicle. The procedure can be safely performed on virtually any part of the body with excess hair, except about the eyes. Hair that is coarse and dark responds best to laser treatment. Blond or red hair is difficult to treat. When dealing with lasers, the lighter the skin, the better. Indeed, individuals with dark skin, including those with suntans, are not ideal candidates because the light will also target pigment cells in the dermis. As the pulses of light energy are of brief duration, discomfort is momentary.

Laser and IPL hair removal usually require multiple sessions, and in most cases, the results are best referred to as reduction rather than permanent removal. Approximately 20 to 30 percent reduction will be noted after each treatment with long-term hair reduction approaching ninety percent. Treatments are repeated every four to six weeks depending on location (shorter time intervals are required for hairs above the neck). Note that the FDA allows approved manufacturers to claim “permanent reduction” but not “permanent removal” for their devices.

Side effects associated with laser and IPL hair removal are transient redness, inflammation of the hair follicles (folliculitis), activation of fever blisters, pigmentary changes, and (rarely) scarring.

Commercially available light-based hair reduction devices for home use are now available. These appear to be safe and somewhat effective, although determining just how effective they are will require larger studies. You should make sure that any light or laser device marketed for hair reduction is approved by the FDA before using it.

Unsightly hair may be removed by electrolysis. In this procedure a tiny needle is placed within each hair follicle and a short burst of current is administered. The electrical charge destroys the follicle and prevents further hair growth. Similar to lasers and IPL, multiple treatment sessions are required. Electrolysis is time-consuming, somewhat painful, and not inexpensive. Results range from acceptable to excellent. Electrolysis is a viable alternative to treat light-blond, white, and gray hairs, as these are not amenable to light-based treatment modalities.

Shaving with either a safety razor or electric shaver is a simple, temporary means of hair removal. As noted, repeated shaving or plucking with a tweezers does not lead to increased or thickened hair growth. Hair plucking pulls the hair from the root. Results last about six weeks.

Another means of hair removal consists of the application of depilatory creams. These compounds cause a transient dissolution of surface hair following a brief application time ranging from five to ten minutes. Their use on sensitive skin may produce irritation.

Objectionable hairs may be rendered inconspicuous through bleaching. Again this is a simple, albeit temporary, measure to lessen the unfavorable cosmetic impact of excess facial hair.

Vaniqa is the first FDA-approved prescription cream utilized to slow the growth of unwanted facial hair in females. About half of women who use this product, applied twice daily, experience satisfactory hair reduction after several months of therapy. Hair excess linked to ovarian dysfunction is often treated with birth control pills.