The number of hair follicles each woman has is genetically programmed before birth. Hair follicles exist on every part of the body except lips, palms and soles of the feet. Most of our body hair is fine and uncoloured. Hair growth is controlled by our sex hormones, with androgens, for example testosterone, mainly being responsible for stimulating hair growth and increasing the darkness of body and facial hair. Hair follicles in certain parts of the body are more sensitive to the effects of androgens. We call these areas “androgen-sensitive” areas of the body. These areas include the upper lip, chin, lower abdomen and pubic region, upper arms and inner thighs. Androgen levels speed the growth of hair as well as increase the thickness and darkness of hairs.
For some women this is simply genetic and their blood hormone levels are completely normal. Other women may have elevated androgens such as testosterone circulating in their blood causing their increased hair growth.
Women experiencing excess body hair that is more than a minor cosmetic nuisance should seek medical advice to exclude an underlying problem. This is more likely if a woman is also experiencing acne and/or irregular periods. A sudden increase in hair growth may be a cause for concern and indicates the need for medical assessment.
Causes:
-- In most cases, the exact cause is idiopathic or never known. It can be congenital or acquired.
-- imbalance level of androgens - The condition often runs in families (genetically related) or you may have a tumour that control/affect these hormones.
-- ovarian cysts, such as polycystic ovarian syndrome (PCOS) => Read this interesting story
-- hyperthecosis - A condition in which the ovaries produce too much androgens
-- lung cancer
-- Cushing syndrome
-- congenital adrenal hyperplasia => This is an inherited condition producing anderogen hormones. It's usually diagnosed in childhood but may become apparent later in life, causing excessive body hair growth. It is diagnosed with specific blood tests.
-- Lumbosacral hypertrichosis (faun tail) with the possibility of underlying spinal dysraphism with potential neurologic sequels
What tests should be done?
Treatments:
Please note even if electrology and some laser hair removal can permanently remove hair cosmetically, but they don't remove the root cause.
Some Medical Treatments:
Studies following women for up to six months indicate that Vaniqa cream significantly reduces hirsutism in women with unwanted facial hair. Vaniqa works in two out of three women after about six to eight weeks of treatment. It works in women with light or dark hair and with light or dark skin colouring.
Because it is effective within a few weeks it works well with other treatments. Combining Vaniqa and laser therapy to treat hirsutism makes the laser more effective. Hair growth returns to its normal rate about 8 weeks after stopping the treatment. Side effects are few but may include acne, local skin irritation and rash. It must not be used in if you have severe kidney disease and is not recommended during pregnancy and breast feeding
Cosmetic management, such as electrolysis and LHR, is sufficient for most women but medical treatment is an option when hair growth is severe. For most women drug treatment is only a temporary measure.
Oral Contraceptive Pill (OCP)
The OCP is ideal for women requiring regulation of their periods or contraception. The OCP stops eggs being released by the ovaries. This reduces the production of the androgen hormone and can reduce hair growth. There are oral contraceptive pills that contain a hormone with specific anti-androgen activity, and these have been shown to reduce hair growth over six months.
- Cyproterone acetate
Cyproterone acetate can be taken in a low dose as part of an OCP or alone in postmenopausal women. In women with acne and minimal hirsutism, the low dose in the OCP (2mg/day) may be adequate, but women with moderate to severe hirsutism usually require higher doses to achieve a satisfactory response . The most common side effects include lowered libido, diarrhoea, nausea, weight gain, breast tenderness, and headache.
- Spironolactone
Spironolactone is often used first in treating hirsutism, being as effective as cyproterone acetate. The recommended starting dose is 100mg twice a day and should be continued for at least six to twelve months to achieve the best outcome. In women with regular periods spironolactone may cause irregular bleeding, whereas in women with irregular periods, menstrual regularity may occur. If necessary, menstrual cycles can be regulated by also using an oral contraceptive pill.
- Flutamide
Flutamide has been shown to be as effective as cypterone acetate and spironolactone, reducing hair growth by seventy percent after a year of treatment. In high doses liver damage is a rare side effect. This has not been seen in the much lower doses commonly used for treating women with hirsutism. Flutamide is not currently available for the treatment of hirsutism in Australia.
- Finasteride
Finasteride blocks the conversion of testosterone to a more potent form. In one study hair growth was reduced by almost half after 6 months of treatment, and when combined with an OCP the effects were greater. It is not clear if finasteride is as effective as spironolactone, cyproterone acetate or flutamide. Side effects with finasteride have not been commonly reported but may include headache, depression, breast tenderness and decreased libido. Women who may become pregnant should not use finasteride as it can cause genital abnormalities in the male fetus. Finasteride is also used to treat hair loss so it might stimulate hair grow, instead of reducing it. Interesting article: https://www.verywellhealth.com/taking-finasteride-for-pcos-2616525
Must read! => DIM
Avoid protein or other processed food from soy beans because it contains certain type of estrogens that can worsen some types of cancers, such as breast cancers, ovarian cancers and etc.
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