Hirsutism or abnormal hair growth is a frequent cause of concern for many women. Usually, the problem is seen mostly around the face with hair growth on the upper lip, chin, neck, jawline, and cheeks. Hirsutism can also extend to other problem areas such as the breasts, the lower abdomen, and thighs. Sometimes it can manifest itself as a general increase in coarser, darker hair on the arms and legs as well. In most cases, hormone changes are the cause of hirsutism; however, many women who develop these changes during puberty have simply a familial tendency to develop this problem.
Hirsutism is important to recognize because one should see a doctor to have hormone levels evaluated to determine if the condition could also represent the presence of an ovarian or adrenal tumor. In most cases, the cause is familial or related to a condition of the ovaries called Polycystic Ovarian Syndrome or PCOS. PCOS includes a combination of symptoms which can include irregular menstrual cycles, acne, hirsutism, weight gain, glucose intolerance (pre-diabetes), and infertility. To check for this condition, the doctor should take a careful history and physical examination, along with blood work to include levels for FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), Free and Total Testosterone levels, a DHEA Sulfate level, Thyroid Function Tests, and a level for 17-OHP. All in all, these levels check ovarian function, check for excessive testosterone or adrenal gland levels, and rule out a thyroid disorder. Also, a pelvic ultrasound is often indicated to look at the appearance of the ovaries. A careful physical exam will be used to note the pattern of abnormal hair growth and look for other signs of excessive testosterone production or tumor development.
Once the cause of the hirsutism is determined, then treatment is designed to reduce the development of new hair follicles. To rid the body of the existing hair, then Laser Hair Removal is the most effective means for hair that is pigmented. To prevent or reduce new hair growth, one could take spironolactone, a diuretic which alters hormone effects on the hair follicle. Also, oral contraceptives can be effective in that estrogen binds up the biologically active testosterone which leads to excessive hair growth. A newer treatment for PCOS involves the use of Glucophage, an oral diabetic agent, which aids in glucose intolerance and works on the ovary to correct the ovulation disorder associated with PCOS. Finally, Vaniqa cream applied to the skin can slow down hair growth, but not eliminate it or prevent it. Of course, each drug will be associated with some side effects, yet the patient and doctor can best decide which one would be most helpful for their situation.
Laser Hair Removal has certainly been a welcome cosmetic procedure for many women and men. With skilled clinicians, lasers can be very safe and effective for all skin types. The procedure is always performed in a series of treatments because hair is eliminated only when it is in the active growth phase cycle. With the correct energy and growth phase, hair can be reduced and eliminated by 10 to 20 percent with each treatment. Treatments are best performed when the patient takes care to keep sun exposure to the treated area to a minimum. Wearing a hat in the summer and using a sunscreen with a 30 SPF rating or higher is a must. It is important, however, to be on a medication to prevent new hair growth while undergoing laser hair removal, as well as after the series because the hormonal problems are likely still present. All in all, this will lead to the most satisfaction and long-term control of hirsutism. Therefore, it is advised that a doctor with trained staff be the ones to treat abnormal hair growth so that a serious medical condition is not overlooked.