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Hair 101

All You Ever Wanted to Know About Unwanted Hair


Much of this information was gathered from Dr. Sara Rosenthal's book Women and Unwanted Hair, as well as Sheila Godfrey's Principles and Practice of Electrical Epilation.  While this information is no substitute for consulting a physician, we are dedicated to helping everyone learn about unwanted hair. This page discusses different aspects of unwanted hair and targets females.  Many men also deal with unwanted hair, we are by no means ignoring their issues.  For more information, please contact your physician. 


Hair That Is "Not Supposed to Be There"


Excessive hair growth can be identified by many different terms.  You have probably run across the term Hirsutism, perhaps Hypertrichosis, and even superfluous hair.  In many resources these terms are used interchangeably but there are important distinctions.  
Excessive hair (key word here is excessive) on the face, especially around the chin, upper lip, breasts or chests, or basically hair on a woman that matches a male hair pattern on a female body is known as hirsutism.  Men can have hirsutism when their hair is truly excessive in hormonally dependent areas.  A diabetic woman with a full male pattern beard would be said to have hirsutism.


Hypertrichosis is basically excessive hair on men or women that tends to be in places that are outside the pattern areas described above.   Someone who has a cast on their leg who grows unusually large patches of hair under the cast could be said to have Hypertrichosis (hyper=excessive/accelerated trich=hair).

 
Superfluous hair or garden variety  “unwanted hair” is considered such whenever it appears on areas of the body that are considered to be either culturally unacceptable, or unattractive.  It isn't an abnormal amount or location when considering the makeup of the whole population, it is just undesirable for a woman to have a noticeable light mustache.  The color of the unwanted hair is also key; the darker it is, the more visible—which makes it more of a problem for dark haired women than for fair haired women.  If you are dark haired, for example, the fine hair on the upper lip or around the hairline may feel abnormal but it’s not; it’s merely visible. And even though excessive hair growth on the face or male-patterned hair growth on the body is considered “abnormal” in women, it’s actually very, very common.


Common Causes of Abnormally Excessive Hair Growth

  • Too much androgen secretion:  Many women secrete too much androgen as a result of conditions such as Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Disease (PCOD), which affects 6-10 percent of the general female population and accounts for half of all hormonal disorders affecting female fertility.  Because androgen levels are out of whack, PCOS sufferers can develop abnormally excessive facial or body hair.  For more information on PCOS, visit  www.PCOSupport.org .
  • Genetics:  Some clinicians will cite “racial” or “familial” genes as a cause of hirsutism, but this isn’t an authentic cause per se.  Having said that, if you’re of Mediterranean descent, you are more likely to experience noticeable or “unwanted” hair growth that a blonde Scandinavian woman may not.
  • Stress:  In response to stress, your adrenal glands pump out “stress hormones” or catecholamines that speed up your body.  But since your adrenal glands also make androgen, increased stress can also increase circulating androgens in your bloodstream, which can cause hirsutism.
  • Obesity:  Certain body types (wherein more of the weight is carried in the upper body) are more susceptible to hirsutism because they are associated with insulin resistance.  Also, fat cells can make androgen just as they can make estrogen.
  • Overactive adrenal glands: This is a side effect of tumors resulting from certain pituitary diseases, such as Cushing’s Disease (for more information, visit the National Adrenal Disease Foundation at  www.medhelp.org/nadf).  Cushing’s Disease and PCOS are often accompanied by irregular periods. 
  • Oversensitive hair follicles:  Some of us are genetically wired with hair follicles that are simply more sensitive to androgens.
  • Side effects of certain drugs:  Many drugs can cause either androgen secretion and hirsutism, or the opposite—hair loss or alopecia.  As a general rule, when taking either a prescription or an over-the-counter drug, be sure to ask about common side effects.  Drugs that commonly cause hair growth in women include:  Dilantin (used to control seizures), Danazol (used in extreme cases of endometriosis), Cyclosporine, Steroids (used in a variety of drugs, particularly asthma medications)
  • Oral contraceptives:  Certain OCs can increase circulating androgen levels, while others decrease them.   For a list, please click here to view the PDF article on drug induced hirsutism by International Hair Route Magazine or read the appropriate section in Dr. Rosenthal's book Women and Unwanted Hair.
  • Insulin resistance & Diabetes: This is when your cells stop responding to the insulin your pancreas makes.  Too much insulin can actually cause hirsutism.  For more information, see The Diabetes Page located on Dr. Rosenthal's web page.
  • Thyroid disorders:  Certain thyroid disorders could cause hirsutism.  Once your thyroid problem is treated, however, it’s likely no new hairs will be stimulated to grow.  
  • Rare endocrine disorders:  An increase in androgen levels can result from a number of very rare endocrine diseases, such as Hyperandrogenic-Insulin Resistant-Acanthosis Nigricans (Hairan) Syndrome.

Hormonal Treatment for Unwanted Hair

Much unwanted hair growth occurs as a result of hormonal imbalances, which are correctable. Ironically, many women actually uncover a potential underlying hormonal problem during a visit with an electrologist (a person who performs electrolysis). And while hormone therapy will not make the hairs you already have disappear, it can stop the growth of new hairs. Be sure to ask your doctor about common side effects of each of the following therapies before you say “yes” to hormone therapy.

  • Oral contraceptives (OCs): The most common form of hormone therapy used to treat hirsutism, OCs tend to improve what are called “androgen-related side effects,” such as acne and unwanted facial hair. That said, too much progestin, which is synthetic progesterone, can also cause these kinds of side effects. If your acne and/or unwanted facial hair predates your use of OCs, you may notice a marked improvement; however, if these “symptoms” occur after you’ve started an oral contraceptive program, you may be on the wrong pill, and should consult with your doctor about alternatives. 
  • Spironolactone: This is a diuretic that appears to counteract the effects of androgen hormones in the skin. Frequently called an antiandrogen drug, spironolactone is not recommended if you’re at risk for osteporosis.
  • Cortocisteroids: These will prevent your adrenal gland from making androgens, but they’re not recommended as a first-line hormone therapy for hirsutism.
  • GnRH analogs: GnRH (gonadotropin releasing hormone) analogs are normally used in fertility treatment and—because they come with many menopausal-type side effects—should be reserved for more severe cases of hirsutism where OCs are not appropriate.
  • Natural progesterone therapy: If birth control is not an issue, this may be an appropriate means of correcting an underlying hormonal imbalance. For more information, see Natural Progesterone: The Natural Way to Alleviate Symptoms of Menopause, PMS, and Other Hormone-Related Problems by Anna Rushton, Shirley A. Bond and John Lee.