Unwanted hair growth in women
Dr. Divya Ramkumar
Hirsutism is the excessive hairiness in women in those parts of the body where terminal hair does not normally occur or is minimal - for example, a beard or chest hair. It refers to a male pattern of body hair (androgenic hair) and it is therefore primarily of cosmetic and psychological concern.
The medical term for excessive hair growth that affects women is hypertrichosis.PCOS (poly cystic ovarian syndrome) is the commonest cause of hirsuitism. Some of the other conditions may increase the normally low male hormones.
The other causes are:
- Congenital adrenal hyperplasia, in turn mostly caused by 21-α hydroxylase deficiency.
- Cushing's disease
- Growth hormone excess (Acromegaly)
- Tumors in the ovaries
- Adrenal glandcancer, Von Hippel–Lindau disease
- Insulin resistance
- Stromal hyperthecosis - in postmenopausal women
- Obesity: As there is excessive peripheral conversion to androgens
- Use of certain medications such as tetrahydrogestrinone, phenytoin, minoxidil
Polycystic ovary syndrome is the most common endocrine abnormality in women of reproductive age, and its prevalence is estimated to be 4-8 per cent in studies conducted in Greece, Spain and the US. The incidence of PCOS is increasing the world over along with the rise inType 2 diabetes mellitus (T2DM). PCOS has also been noted to affect 28 per cent of unselected obese and 5 per cent of lean women. The health budget of India is unlikely to meet the expenses for imposing lifestyle intervention comprising dietary, exercise and behavioural therapy, tackling fertility, cosmesis, metabolic consequences like glucose intolerance, dyslipidemia, non-alcoholic steatohepatitis, coronary artery disease and consequences thereof.
Many women with PCOS demonstrate challenges to feminine identity and body image due to obesity, acne and excess hair; also, infertility and long-term health-related concerns compromise the quality of life and adversely impact mood and psychological well-being.
Gynaecologists and endocrinologists report that nearly 35 per cent of women in India in their reproductive age suffer from PCOS. Besides a failure to ovulate, PCOS also causes an overproduction of androgens (male sex hormones) and estrogen, resulting in excessive facial and body hair in women.
"Exercise and weight loss are the best ways to improve insulin sensitivity and improve the metabolic abnormalities associated with PCOS. Weight loss improves menstrual cyclicity, rate of ovulation and likelihood of a healthy pregnancy," they say.
What can your doctor do?
Your family doctor will be able to provide many of the drug treatments available (Although these are probably best taken in consultation with a specialist). Treatments aim to improve several aspects of PCOS, includingfertility, via the stimulation of ovulation, reduction of the insulin resistance and reduction of the increased hair.
How can you reduce the increased hair?
There's a range of non-drug treatments available for hirsutism. Once a serious increase in male hormone levels has been excluded, then local cosmetic options can safely be considered. These includebleaching, depilatory preparations, waxing, plucking, laser hair removal, electrolysis and shaving.
Each is usually effective, but expert advice should be taken because each method has its own problems. Bleaching and depilatory preparations can occasionally cause a local allergic reaction.Waxing and plucking though a little more effective than shaving causes folliculitis in the prone i.e. lead to inflammation and infection of hair follicles, requiring topical antibiotic creams.
Electrolysis gives permanent hair removal but is tedious, time-consuming, requires multiple sessions, is painful and cannot tackle large areas of the skin.
AtCarewellSkin & Laser Centre, we occasionally identify women who have not yet consulted their Medical Practitioner about symptoms consistent with PCOS, whilst treating excess and unwanted hair we are also able to encourage them to consult their medical practitioner so as to investigate the underlying causes and confirm or exclude PCOS as a cause.
If the symptoms improve with treatment of symptoms of PCOS (i.e. acne helped by oral contraceptives) the underlying condition of PCOS may not be detected until further problems present. It is important to discuss symptoms with your medical practitioner and investigate the possibility of PCOS rather than delaying and consequently exposing yourself to the risk of long term health problems like diabetes and cardiovascular disease.
Women with PCOS typically experience symptoms associated with excess androgen levels, including excess hair growth (hirsutism) and acne. An increased growth of coarse hair can occur on the face, nipple, chest, thighs or in the middle of the lower abdomen. For most women the appearance of excess and unwanted hair is distressing, and affects their self esteem and body image.
Women should not be embarrassed to consult professionals.Carewell Skin & Laser Clinic therapists are experienced, qualified and accredited to perform safe laser hair removal. Laser hair removal is an appropriate treatment with results superior to home remedies for excess and unwanted hair and laser is a safer and more effective treatment than electrolysis or IPL. Laser hair removalis the foremost and clinically proven way to manage hormonal facial hair.
As your treatment progress, you will first notice the change in texture of the hair. Hair will grow back finer, lighter and less noticeable. As laser treatments continue, after 6 – 8 treatments you will start to notice significant reduction in the amount of hair that is growing back. Up to 80 per cent reduction can be expected, in some cases up to 90 per cent hair loss can be achieved. Some patients require an ongoing maintenance treatment programme for the management of coarse hair.
When treating delicate areas such as the face, it is very important that you choose a medical grade laser. Carewell Skin & Laser Centre uses Genuine Diode Laser(808nm) with a dynamic cooling device for best results and your comfort.
Some women with PCOS also exhibit male-patterned hair loss (alopecia) as well as acne. We usually associate acne with adolescence, women who continue to get acne well after this time find it frustrating and embarrassing. In addition, the moderate to severe acne usually associated with PCOS can result in unsightly scarring. We use techniques like microdermabrasion, derma rollers, Fractional CO2 (carbondioxide) laser & Chemical peeling to overcome this condition which could be demoralising to women.
A further common symptom of PCOS is obesity, with up to 70 per cent of women being affected to some extent. Women with PCOS tend to gain weight in the abdominal region rather than on the buttocks or thighs, the usual areas woman “put on” weight.
Often the weight gain is related to ‘insulin resistance’, a condition that is typically associated with PCOS.Some women with PCOS who have insulin resistance are of normal weight, so regular testing is recommended and the absence of weight gain should not be considered as cause for complacence in managing PCOS.
Insulin is a hormone that allows the conversion of glucose (sugar) into energy. When insulin resistance occurs, the body produces more of the hormone to compensate; the elevated insulin level stimulates the body’s fat cells to make fat from nutrients and to store it, causing weight gain. A high level of insulin may also cause further increase in the production of androgens by the ovaries.
After evaluation, we offernon-surgical weight reduction & inch loss to our patients with indubitable results. We follow a triad of passive exercises from the clinic,active exercises from the patient’s part and diet regulation and results are maintained following the sessions by maintaining a healthy lifestyle!