Unwanted Hair and PCOS

Women of a certain age all know about dealing with problem hairs appearing where they are not wanted. Post menopause our estrogen levels drop, which allows androgens (male hormones such as testosterone) to cause an increase in those random mustache and whisker hairs!  

This is different from actual hirsutism (Heer–soot-iz-um), where women grow dark or coarse hair on their face, chest, arms, and back, as men do. This excessive hair impacts 70% to 80% of women with polycystic ovary syndrome (PCOS), which causes an overproduction of androgens. 

Excessive androgen levels can have the opposite effect on the scalp, leading to female-pattern hair loss (androgenic alopecia) in up to one in five women with PCOS. 

PCOS can start slowly in adolescence and result in excess hair growth, irregular periods, obesity, infertility, and sometimes multiple cysts on the ovaries. 

Medications for PCOS

There are medications that can help correct the hormonal imbalance caused by PCOS reducing the amount of androgens present.

Among the currently approved options:

• Birth control pills: Oral contraceptives can help by raising the level of female hormones while dampening the production and effects of the circulating androgens.
• Aldactone (spironolactone): The anti-androgen medication Aldactone inhibits the production of testosterone while blocking the androgenic hormone receptors on hair follicles.
• Flutamide: The nonsteroidal antiandrogenic drug flutamide (sold under the brand name Eulexin and others) is able to suppress androgen production without increasing female hormone levels. Due to the risk of liver toxicity, it should only be used under the close supervision of a healthcare provider.

Talk with your healthcare provider about side effects and possible interaction with other medications. 

Ways to Remove the Hair

Here are some options for hair removal: 

Shaving

No, shaving doesn’t change the color or thickness of hair. A sharp blade will cut the hair right at the skin’s surface, leaving a blunt edge which can be noticeable especially if the hair is dark. Shaving every day can lead to ingrown hairs and irritation bumps.

Waxing

Many women have used this method on facial hair as well as their “bikini line.” A thin layer of warm wax is applied to the area, a cloth is pressed into the wax and then pulled off then the wax has hardened taking the hair with it. Yes, it hurts. And can cause redness and swelling. Waxing kits can be purchased at the drugstore for home use. Because the hair is pulled out completely, waxing will last a few weeks.  

Depilatory and Bleaching Creams

Depilatory creams are used to dissolve hair using chemicals such as calcium thioglycolate or potassium thioglycolate. Bleaching creams just remove pigment from the hair, making it less visible. The cream is simply applied for a specified time and then washed off. The drawbacks are that the chemicals can be harsh, causing irritation and dermatitis. 

Electrolysis

Electrolysis uses a thin needle inserted into a hair follicle to deliver an electrical charge that kills the hair and root. While the procedure is considered a safe and effective form of permanent hair removal, any hair that is darker or thicker may require several treatments.

This is an effective procedure though it can be uncomfortable and cause stinging and swelling. It also can be costly; be sure to find an electrologist who has passed national testing and certification. 

Laser Hair Removal

For this treatment a dermatologist uses a laser light beam to the area. The removal is not permanent, but lasts longer periods of time than waxing or depilatories. Laser treatment is expensive and must be done by a skilled professional. It may not be as successful in people with lighter skin who have darker hair. You can expect a slight stinging sensation during the procedure, and there may be some short-term redness and swelling.