Hirsutism is one of the common symptoms of PCOS and also the most difficult to deal with. That’s because hirsutism or excess facial/body hair growth is a visible change of PCOS that can affect the way a woman feels about her body. However, it is encouraging to know that there is a wide variety of treatments available to manage hirsutism and that it is important to discuss with your doctor about how much these features affect you.Start PCOS Treatment
Androgens, sometimes known as ‘male hormones’, are normally present in both men and women, but at much lower levels in women. All women produce small amounts of androgens in body tissues, including in the ovaries.
In women, the female sex hormone oestrogen makes the hair fine and soft. On the other hand, male sex hormones, androgens, are responsible for dark, coarse hair. When there is an excess level of androgens produced, it imparts male-like characteristics such as excessive body hair, scalp hair loss and acne. This kind of hormonal imbalance is often seen in people with PCOS who show elevated levels of androgens and hence present symptoms of hirsutism.
Excess growth of facial and body hair is called hirsutism. Hirsutism tends to have a pattern. The hair typically grows in areas where it is more usual for men to grow hair, such as the face, chin, chest, and back. Also the hair is thicker and darker than usual.
Remember that hairiness is not the same thing as hirsutism. Body hair can be determined by a lot of factors and your genetics has a huge role to play in your hair color, hair distribution and thickness. Hirsutism should be differentiated from generalised excessive hair growth which is mostly seen on forearms or lower legs, and is not due to androgen excess. It is not only imperative to identify the cause of hirsutism but also important to know how to recommend the right treatment based on the main causative factor.
One way to differentiate between normal hair growth from hirsutism is to check for growth patterns. Has your hair growth suddenly become more coarse? And do you observe hair growth in areas of the body such as face, back, chest, abdomen and inner thighs?
So if you are experiencing such male-pattern hair growth along with irregular periods, scalp hair loss, acne and weight gain, it is advised to see a doctor who will recommend appropriate blood tests, to check for your PCOS risk levels.
PCOS is an endocrine disorder which means it affects the endocrine system. Endocrine system consists of 8 major glands in your body that are involved in growth and development, sexual function, metabolism and mood. Improper functioning of the endocrine system, which includes the glands that produce hormones can result in hormonal imbalance, which is characterised by too much or too less of hormone levels. In PCOS specifically, there is an imbalance in the hormone levels of insulin and androgen that is responsible for causing the symptoms.
The underlying hormonal imbalance, especially in the levels of male hormones can cause excess facial/body hair (hirsutism), acne and scalp hair loss. These symptoms can sometimes feel difficult to cope with because these are visible to others and it can negatively impact on how a woman feels about her body. Although hirsutism doesn't affect your physical health, it can affect you psychologically and create body image issues. You might experience stress, anxiety, or depression with hirsutism.
For hirsutism, threading, shaving, waxing are all effective in reducing hair growth. Depending on your preference and suitability, you can choose any of these. Though simple and inexpensive, these methods are temporary and have their own side effects like physical discomfort, scarring, or in some cases folliculitis or irritant contact dermatitis. For some people, laser might be another option that can give more last results than shaving or waxing.
Shaving is one of the most common and easy methods to remove hair. You can not only shave any part of the body, it is also painless and cost effective. Having said that, the results are temporary (upto a few days) and you need to shave every few days to maintain the desired results. Although it seems like a simple technique, shaving can cause razor bumps, nicks or cuts if not done properly.
Waxing is another common hair removal method that gives more lasting results (upto a few weeks) than shaving. Waxing removes the hair from the follicles (root), hence delaying the growth of new hair. You can easily wax on large parts of the body such as arms, legs, underarms, delicate areas and even upper lips. However, waxing can be painful and might not suit everybody. If you have sensitive skin or any skin conditions, waxing can leave your skin red or irritated. It is also not recommended to wax if you are using certain medications such as isotretinoin or certain antibiotics.
Depilatories are products in the form of lotions, creams or gels that dissolve unwanted hair. Depilatories give better lasting results than shaving and are easy to use. These products can sometimes irritate your skin so it's always better to test it out first before applying to a larger area.Apply a small amount of product to the area and see if it burns or stings. Wait for 24 hours of the applying the product and if you don't have a skin reaction, you can use the product.
For women with PCOS who are struggling with excess facial hair or body hair - laser hair removal is the most effective treatment for significant hair growth reduction. And thanks to advances in technology, most people can safely have laser hair removal. However, laser hair removal can be dangerous in inexperienced hands and should be performed by a trained professional only.
The way laser removal works is when laser emits a light that is absorbed by the pigment present in hair follicles (melanin) and heat is generated. This heat damages the hair follicle thus delaying or inhibiting future hair growth.
Laser hair removal does require multiple treatments, a single sitting of the laser is not enough. And the results may vary depending on your hair colour and skin type. Although laser hair removal does not guarantee permanent results, when the hair regrows it is usually finer and lighter in colour.
Electrolysis works by sending electrical currents through the hair follicle which damages the follicle, preventing the hair from growing back. Since hair grows in cycles, you may need multiple sessions to get hair removed permanently. Electrolysis is the only permanent way to remove hair and once the hair is removed you won't need maintenance treatments. It can work on all skin types, regardless of colour. Electrolysis should be performed by professionals only, in experienced hands it can cause scarring or burns.
You cannot diagnose PCOS only on the basis of hirsutism. Although PCOS is one of the major causes of hirsutism, there can be other conditions that can cause hirsutism too. To confirm PCOS, your doctor might recommend certain tests such as insulin, testosterone, thyroid and prolactin blood tests and ultrasonography scans. If you are experiencing hirsutism along, or have other symptoms such as irregular periods, weight gain, acne or scalp hair loss, speak to your doctor to understand the root cause.
Hirsutism is one of the PCOS symptoms that takes the longest to show improvement. While other PCOS symptoms like irregular periods and weight gain can start improving as early as 3 months in, hirsutism can take upto 9 months to see a visible difference - often longer. Usually women opt for a combination of cosmetic treatments such as shaving, waxing or laser along with medications such as oral contraceptives or anti-androgen drugs to manage hirsutism. Although cosmetic treatments for hirsutism do help in making it easier to live with the symptoms - they only provide short-term solutions. So you have to develop sustainable lifestyle habits to see changes in hirsutism and to manage PCOS for life.
And following a healthy lifestyle is a very important part of your treatment plan. This means eating a nutritious and balanced diet, exercising regularly, managing stress and getting good quality sleep each night. Following a healthy lifestyle helps manage the underlying hormonal imbalance which can in turn reduce signs of hirsutism.
In certain cases, where cosmetic treatments haven’t worked for excess hair or acne, birth control pills or oral contraceptive pills (OCPs) can also help. Although we associate oral contraceptive pill with birth control, OCPSs can also help manage PCOS symptoms by reducing the levels of androgen in the body. This is because most oral contraceptives in the market today contain anti-androgen agents. These basically reduce the amount of free testosterone in your body through which it brings down these symptoms.
Anti-androgens are also available for use in more severe cases of scalp hair loss, excess hair and acne. They should be considered in treating hirsutism only after cosmetic therapy and 6-12 months of the oral contraceptive pill haven’t worked for you. Spironolactone is one such anti-androgen drug. However, anti-androgen drugs can be harmful to an unborn child as it can cause birth defects. For this reason, anti-androgens must be used with some form of contraception and in women who are not trying to conceive.
You should take these drugs only under the guidance and advice of a medical professional.
However, there is some emerging research on some natural therapies for the management of hirsutism.
One of them is the benefit of having spearmint tea for hirsutism. Recent research has shown that spearmint tea may be used as a treatment for mild hirsutism in women. Its anti-androgenic properties may help reduce the level of free testosterone in the blood which can help manage hirsutism better. However, the research around using spearmint tea for hirsutism is limited and more robust studies are required before any conclusions can be made in regard to its effectiveness.
Having said that, it is encouraging to know that natural remedies like spearmint tea can be beneficial to your diet. But home remedies alone will not help you reverse PCOS and are only a complementary therapy to your treatment. Always discuss with a doctor if you're trying any home remedies.
If you are not sure whether your excess facial hair or body hair could mean hirsutism, speak to a doctor who can help you understand the root cause of your symptoms. Being hairy does not always mean hirsutism. Hirsutism has a pattern and a professional can help you identify those patterns. At Veera, our doctors and experts specialise in treating PCOS and give you the care you deserve. Regardless of your symptoms and concerns, our care team can help you understand your body better and give you access to the right guidance and resources.
Symptoms of PCOS can show up in many ways and hirsutism is one of them. If you are not sure if your symptoms indicate PCOS, take our free PCOS risk screening quiz that is developed by clinicians and experts to help you understand your PCOS risk levels. Depending on your symptoms, medical and family history, you could either fall in the low, medium or high risk category.
This screening quiz is a great preliminary assessment to understand where you stand in terms of your PCOS risk levels and can help you access the right treatment options.
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