Causes and control of unwanted facial hair in women

Dear Readers,

L.M. from Castleton, St. Mary, is a 24-year-old female with, she says, "a most embarrassing problem". Since her teens she has noticed that she has facial hair over her chin and even little "sideburns".

L.M. says that she is a pretty girl and the facial hair makes her feel unattractive and less feminine. In the past she has "shaved", "plucked" and "creamed" off the hair but it always grows back, and her chin in particular, is rough to the touch. LM asks what medicine is available to solve her problem once and for all.

Excess hair or HIRSUTISM is a cause of significant psychological disturbance in many afflicted women. Hirsutism refers to the growth of excessive hair in a male-like distribution in women. Excess hair can be present to a very variable extent in women with hirsutism and different areas of the body can be affected with considerable variations in the actual hair growth. Before Hirsutism can be confirmed in any woman she will need to be screened by a doctor to make sure that other underlying hormonal disorders are not present. POLYCYSTIC OVARY SYNDROME (PCOS) is a common female disorder characterised by menstrual irregularity, infertility, obesity, and androgen excess. In women with this condition male patterns of hair distribution are often present. This condition can be confirmed biochemically with hormonal blood tests or by pelvic ultra sound. Other causes of hirsutism would include androgen-secreting tumours of the ovary or adrenal gland, Cushings Syndrome, adrenal hyperplasia and acromegaly. These are all serious disorders which, once diagnosed, would require treatment.

The majority of women with excessive hair in a "male like" pattern have slightly excessive secretion of ovarian androgens associated with increased sensitivity to these hormones in the hair follicles located in the "masculine" areas e.g. face and abdomen. Hirsutism is often associated with acne.

Once other, more serious conditions have been excluded, the woman experiencing hirsutism should be comforted by the fact that the condition is not a serious disease and will not lead to an irreversible masculinization. The problem is a common one as is indicated by the frequent advertisements in the media for the treatment of "excessive hair". Women with this problem need to accept that the excessive hair growth might be a "natural thing" for them so that "long term" management may well be indicated.

Cosmetic management of hirsutism includes hair plucking, waxing, bleaching, using depilatory creams, shaving and electrolysis. Some women will use one or more of these methods on a daily to weekly basis. Electrolysis is useful when the unwanted hair growth is small, but again, its effect is temporary. With successful medical treatment cosmetic treatment is needed less frequently. Medical treatment is LONG TERM. There are several types of treatment. The pill, DIANE 35 has anti-ANDROGENIC activity and is useful in the treatment of acne and hirsutism and as a birth control pill. Also, many easily available oral contraceptive pills are effective when used for mild to moderate hirsutism. Another drug, SPIRONOLACTONE, has many medical uses, one of which is its effect as a moderately potent ANTI-ANDROGEN. CIMETIDINE, (an H2 histamine receptor blocker) also has anti-androgenic activity and can be used for this purpose.

The treatment of hirsutism should be managed by a physician who would decide on appropriate treatment choices for the woman. Many women will need to use a combination of several drugs in addition to occasional use of cosmetic methods.

Hirsutism is not curable but requires a sustained, continuous, life long effort to control the hair growth. The good thing is, unwanted hair growth can be controlled.

AJM

DR AJ MORGAN, Contributor

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