Women's Health Specialists of St. Louis
Obstetrics and Gynecology

Articles - Facial Hair

Millions of women are affected by the excessive growth of facial hair. In fact, an estimated 7% of all reproductive-age women remove unwanted facial hair from the upper lip and chin once a week. Of those women affected by unwanted hair growth, 1 out of 4 will have an underlying medical cause of the excess hair growth. Hirsutism refers to the growth of coarse, dark hair where women typically grow fine light hair or no hair at all. These areas are typically the chin, upper lip, chest, abdomen, and back. Unwanted hair growth is sometimes caused by hormone imbalances, thyroid abnormalities, and certain medications or supplements. Symptoms that may suggest an underlying medical condition include acne, weight gain, male pattern baldness, and irregular menstrual cycles. Some ethnic groups, such as women from the Mediterranean region, have facial hair growth that is not associated with any abnormalities. Unfortunately, a family history of women with facial hair does not mean that there is not a medical cause of the hair growth. The most common medical conditions that cause excessive facial hair growth may also be inherited. In most cases, the cause of hair growth is an excessive production of male hormones or androgens. All women produce some androgens but some medical conditions can cause them to be produced in excess. When women produce excessive amounts of androgens the first symptom may be hirsutism. Treatment is important as persistent elevations of androgens can cause high cholesterol, heart disease, and many other chronic medical conditions. For this reason, women who suffer from hirsutism should reveal this information to their physician. Further evaluation may then be performed to exclude the possibility of an underlying medical disorder. In many cases, treatment of the underlying hormone imbalance will reduce or eliminate the unwanted hair growth. Treatment is also available for unwanted facial hair that is hereditary. Treatment options include both medications as well as medical procedures. Typically, medical treatments focus on reducing the production of androgens by the ovary and may include the use of oral contraceptive pills and/or anti-androgen medications. Cosmetic hair removal may be performed simultaneously. Options of cosmetic treatment of unwanted facial hair include: shaving, depilators, bleaching, electrolysis, and lasers. Waxing and plucking are not recommended as both of these procedures will result in the growth of an even thicker patch of hair. The treatment of hirsutism requires patience as this is a chronic condition that will likely require life-long attention. Most medications used to treat hirsutism must be used for three to six months before a noticeable improvement occurs. This is because the life cycle of a hair follicle is about six months. In the meanwhile, cosmetic treatments may be performed. Shaving is effective but often requires daily treatment and may result in skin irritation. Depilators are chemicals that cause the hair to be released from the follicle but are often associated with skin irritation. Bleaching can lighten the hair to make it less noticeable but may also cause skin irritation. Electrolysis is more expensive but very effective. In this procedure, the hair follicle is damaged with an electric current so that it does not grow back. Laser is also expensive but effective as it also causes permanent damage to the follicle. The limitation however, is that laser works best for dark hair in women with fair complexions.

The best approach for treating hirsutism is to both treat any underlying medical condition and eliminate existing unwanted hair. As not all patients who suffer from hirsutism are alike, it is important that a complete history and physical be performed in order to select the best combination of therapy.