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By Lahle Wolfe
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Information Links about PCOS
What is PCOS?
Myths & Facts about Electrolysis
Laser Hair Removal Links
Hirsutism (eMedicine Article)
eMedicine links to disorders that can cause hirsutism
Hirsutism (Article by The Endocrine Society and the Hormone Foundation
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Hirsutism - Excess Hair
What is Alopecia Hirsutism?
Hirsutism is the excessive growth of hair (thicker, darker and in greater quantity). Women normally have facial hair which is usually fine ("peach fuzz") and often not noticeable. When these hairs masculinize, or, turn into male terminal hairs, they become thicker, darker, and grow longer and faster. This gives the impression that there is more hair, when it fact, it is just existing hair follicles responding to disease or some hormonal imbalance.
Once a hair turns terminal it will remain terminal. In women, hirsutism is most common on the forearms, face, chest, and legs but can occur anywhere. In men, to be diagnosed with hirsutism, the amount of hair has to be exceptionally large because men have higher testosterone levels, a male hormone that causes hair to turn into terminal hairs sometime during adolescence. Women too, can be hirsute due to hereditary factors, but typically when a woman suddenly begins to develop signs of hirsutism that was not present in childhood, there is some underlying medical cause that should be addressed.
Hirsutism is generally caused by increased androgens, especially the male hormone testosterone. It is a common sign of polycystic ovary syndrome (PCOS) in women because elevated androgens are often associated with this condition. In addition to abnormal levels of testosterone, women with PCOS may also have unopposed estrogen (high levels of estrogen and low levels of progesterone).
Hirsutism can be caused, or made worse by:
One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman. But most women probably don't care where they score, excess body hair to any extent can cause emotional distress for both women and men.
Many people with unwanted hair seek methods of hair removal to control the appearance of hirsutism, they may try:
Electrolysis can accomplish miracles and at a fraction of the cost of laser treatment but takes a lot longer to cover large areas.
A needle is inserted into the hair follicle and stimulated with a mild electrical current. Be very careful who you choose because improperly done, electrolysis can cause scarring and infections. Personal referrals are often the best way to locate a qualified electrolysis. Make sure your technician either reserves needles only used on your, or, uses disposal needles. Done properly, pain should be minimal except in sensitive areas. Numbing creams or ice may be used.
The FDA currently has only approved electrolysis as a permanent hair removal treatment. However, it should be said in favor of laser hair removal that it can be less painful, faster, and just as permanent as electrolysis and without the same risk of infection. The reason the FDA has not approved the term "permanent" for lasers and limits laser ads to "hair reduction" is because some hair cannot be treated with a laser. With electrolysis, if you can see the hair you can zap it. Lasers, however, are picky. They do not work on white, gray, light red or blonde hair. But they do work well on darker hair; the darker and thicker, the better your results.
Also, only certain lasers are even partially effective on dark-skinned women, and few work in light-skinned women simply because they tend to have hair too light for the laser to pick up. Olive skinned women with thick, dark hair, are ideal candidates for laser hair removal.
Shop around, prices vary and are usually ridiculously overpriced. After being quoted more than $5,000 for laser treatment (3 treatments, on the entire face and chin) I found a wonderful plastic surgeon who only charged $150 per hour (you can cover a lot of territory in an hour). If you live in Northern VA and want the name of this plastic surgeon, e-mail me at Lahle@isletsofhope.com.
Since anyone can be trained to use a laser, be sure to ask about the credentials of your laser technician. Certain lasers are more effective than others, so ask which laser will be used.
Both electrolysis and laser treatments have some things in common:
To read more about laser procedures, cautions, and expectations, visit the MayoClinic.com.
Treating the underlying cause of hirsutism is critical because left untreated new hairs will become terminal hairs. Waxing, plucking, and tweezing do not make hair grow in thicker or faster (but it can cause ingrown hairs).
Anti-androgens may be effective in stopping the progression of hirsutism in women, even slowing down the rate of growth and thickness of the hair, making it appear less visible. A commonly prescribed drug for androgen-driven hirsutism in women is aldactone (spironolactone). This drug is a potassium-sparing diuretic (never take potassium supplement while on this drug) that is used sometimes to treat heart patients. Aldactone has the side-effect in women of blocking androgen product, that is certain androgens do not convert into the type that worsens hirsutism.
Some therapies that may be considered to treatment in hirsute patients include:
Alopecia Areata Sometimes Occurs Simultaneously with Hirsutism
Some of the same factors that cause excess hair, may also come into play with alopecia areata (AA) (disease and hormonal disorder).
In AA, scalp, or body hair loss occurs. It is not uncommon for women with hormonally-driven hirsutism to also suffer from AA simultaneously; they may grow facial hair, while losing scalp hair. The conditions, however, are entirely separate and need to be addressed as such.
For hirsute problems you should seek the advice of an endocrinologist to determine the underlying cause. For AA, seek out the advice of a dermatologist.
Page Updated 03/26/2006