Excess Facial Hair in Women
By Darrel Arthurs, ARNP, DCNP
Frequently, women develop extra hair growth on the face, especially around their mouth and chin area. It can also occur on the breasts or even the lower portions of the abdomen. This hair growth is frequently referred to as hirsutism and can develop in the teen years, or more commonly, as a middle-aged adult or older. These hairs have become the bane of many women, since they tend to multiply and become darker and thicker over time. Frequently, women will come into the office and ask how to get rid of these hairs. Unfortunately, there is not an easy answer, and most women don't like the responses they hear. Even so, a few things can be done to decrease the occurrence and improve the appearance of these hairs.
There is actually a great deal to learn about hirsutism and its cousin, hypertrichosis. The science of these conditions, along with the proper way to evaluate for hormonal imbalances, including labs, signs, and symptoms, will be discussed at a later date. Today the focus is on the cosmetic issue of these hairs and some ideas that may help patients to be less insecure about them. The first method is tweezing, which is perfectly fine. Once the hair is removed it will take time to grow back since you are removing the entire hair bulb and all. Another method is shaving—which I am not a fan of. No current studies, which I am aware of, exist that indicate shaving actually makes the hair grow in thicker, but from my experience that's what happens. I usually recommend shaving as a last resort and only at the minimum that it must be done.
Electrolysis and thermolysis have both been used for many years to help with hair removal. There are multiple types of treatments with these machines—some of them more effective than others. The drawbacks to this type of hair removal are the time required to treat and the length of treatments. Usually, the treatments are weekly with a time commitment of one to two hours and may last up to five years or more. The cost of these treatments can add up over time, which is why this procedure is best used in small areas only.
A topical medication exists for hair removal. It is a prescription and runs about $120.00 per tube, taking 4 to 8 weeks to show effectiveness. The cream must be continued or the hair growth will redevelop. For very small areas, this may be a good treatment plan, and I have several women who come in yearly to get refills. They say the tubes last about two months before they need refills.
Laser hair removal has gained a great deal of attention over the past few years and become much more mainstream in treatment. It is effective for most people and will remove the hair for up to six months after two to six initial treatments. At this time, there are companies selling handheld laser hair removal devices. These are still new and have not been thoroughly tested as to their reliability. The cost of laser hair removal is decreasing in many areas as more and more demand increases the supply. Some of the lasers will treat multiple areas such as the back, bikini, chest, face, neck, and shoulders. It must be noted that laser hair removal is only useful for thick, dark colored hairs and not fine vellous (peach fuzz) hairs. The method of action for the laser is to follow the color of the hair into the hair follicle to destroy the bulb.
Darrel Arthurs's passion for dermatology developed while he was serving in active duty in the U.S. Navy. Since then he has accumulated over 11 years' experience in medical and surgical dermatology. Currently he works independently in a small city in northeastern Oklahoma. Arthurs is on the NADNP Board of Directors.