EXCESS HAIR GROWTH

There are several reasons a person might be troubled by perceived excess hair growth on the face and body.

Over recent decades, Canadian culture has grown rather intolerant of facial or body hair. For this reason, the threshold for hair removal action is much lower than it used to be, regardless of age or gender. And now the whole body is subject to scrutiny, as the trend moves in some men toward bare backs, chests, abdomens, etc., and in some women whole body hair removal. Of course, other societies and other eras in time might view hair as attractive or advantageous.

There are, however, conditions of increased hair growth that are considered by the majority in our society to be excessive and biologically aberrant. There is a list of causative factors or conditions that lead to a few distinct patterns of hair growth excess.

One pattern of excess hair growth is characterized by heavy growth of darker, coarser hair compared to the usual fairer, finer growth, over body parts that are not necessarily associated with gender specific growth. For example, outstanding growth over the full face, including the forehead, cheeks, ears, and nose in a young male or female would be conspicuous and aberrant. Of course, darker, coarser and longer hair is noticed while fair, fine, short hair in the same sites wouldn’t likely be noticed. Numerous factors are associated with this condition including genetics, metabolic abnormalities, and drugs. Treatment of the excess hair involves management of the underlying problem, and permanent hair removal, as desired.

The most commonly observed condition of excess hair growth that presents in Saskatoon is male pattern hair growth in a woman. This condition is known as Hirsutism, and by definition there is increased density of coarse dark hair in places normally stimulated by male hormones, eg facial beard, chest, low back, buttocks, and anterior thighs. In addition to being a source of severe loss of self-esteem for a girl or a woman with this condition, there may also be an underlying systemic disease.

Hirsutism occurs as a result of the androgenic (testosterone-like) effect of hormones on the hair follicles. Simultaneously these hormones may stimulate oil glands that in turn over-secrete and result in oily skin +/- acne. Virilization is an extreme outcome characterized by male body features such as male pattern baldness, deep voice, increased muscle bulk and infrequent irregular menstrual periods. Usually virilization is associated with marked and rapid increases in androgenic hormones, but fortunately this severe derangement is rare.

The diagnosis of hirsutism, however, is quite common, and usually associated with normal menstrual cycles and normal hormone measurements. This group represents the largest fraction of hirsute women. A second fraction is due to ingestion of a medication that is responsible for the increased hair growth, eg performance enhancing drugs, or cortisone type drugs. And finally the remaining fraction of hirsute patients has lab evidence of elevated androgenic hormones. The source of the increase is usually the ovaries, less often the adrenal glands, and rarely a hormone secreting growth.

The cause of hirsutism is usually simply evaluated by the patient history, examination, and lab tests as necessary. The vast majority of cases are clearly explained by this point and therapy is discussed. It is important to review this problem with your family doctor because there are risk factors associated with elevated androgenic hormones. For example, there may be some underlying insulin resistance predisposing the patient to diabetes mellitus or high blood pressure. Another example is the increased risk of endometrial (uterine) cancer that is associated with prolonged untreated irregular menstrual cycles.

There is overlap in treatment, regardless of whether or not there is found an abnormal level of androgenic hormones. Certainly laser hair removal is a shared recommendation. This is very effective in permanently eradicating the dark coarse hairs from the treatment zone, usually after 1 – 6 treatments. However, if there is ongoing stimulation from androgenic hormones, then there may be future hair conversion from fine & fair, to coarse & dark. The laser is only capable of treating existing dark hairs, and not future dark hairs, so laser treatments might be required in future if the hormonal stimulation is not managed. There are a few options for management of the hormone imbalance, each more or less suitable depending on your individual medical status. Management strategies may be discussed with the M.D. at Nirvana after a diagnosis is made, but your family physician will be provided the relevant data so that you may then follow up for further consultation with the physician who has the widest perspective of your medical history.

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