Expert FAQ: Dealing With Excess Body Hair

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Body Hair Can Sometimes Be Unsightly, Sometimes Unhealthy

By Charlene Laino
WebMD Health News

Reviewed by Laura J. Martin, MD

March 21, 2012 (San Diego) -- Many women and men struggle with excess body hair on the face or other areas of the body. But beyond being sometimes just unsightly, it can also sometimes be unhealthy.

"If you notice a dramatic change in body hair growth or hair growth in an unusual pattern, you should not ignore it," says Sandy S. Tsao, MD, instructor at Harvard Medical School and a dermatologist at Massachusetts General Hospital in Boston.

"It could signal an underlying medical condition," she says. "And there are a number of safe and effective treatment options."

At the meeting of the American Academy of Dermatology here, Tsao discussed how to get rid of unwanted body hair.

Consult your doctor. I recommend that any woman with new excess hair growth, especially in a typical male pattern, discuss it with her doctor as it might be a sign of an underlying illness.

For example, there could be an increase in the level of androgens, or male hormones. Hair growth accompanied by other symptoms -- especially severe acne flares, increased muscle mass, or changes in voice -- could also be the sign of an underlying medical condition.

Your doctor may recommend that you be screened for polycystic ovary syndrome (PCOS), a condition caused by an imbalance of sex hormones that may result in irregular periods, obesity, infertility, and sometimes multiple cysts on your ovaries.

Other causes include adrenal gland tumors, insulin resistance, and Cushing's disease, a hormonal disorder caused by high levels of cortisol in the blood.

Yes. They include but are not limited to minoxidil, phenytoin, cyclosporine, androgens, danazol (Danocrine), anabolic steroids, methyldopa (Aldomet), and progestins (which are sometimes contained in oral contraceptives).

Depending on the underlying cause of the excessive hair growth, your doctor may prescribe hormonal treatments. But whether used in conjunction with hormonal treatments or alone, there are a number of non-hormonal options:

Office-based laser hair removal: Laser hair removal minimizes damage to the surrounding skin by only targeting the hair.

Traditionally, this treatment works best for patients with fair skin and dark, thick hair. But there now are lasers specifically designed for darker skin.

If you have darker skin, a word of caution, however: Melanin in the surrounding skin can absorb the laser and cause dark spots or a loss of pigment appearing as white spots on the skin.

On average, six to eight treatments permanently get rid of 80% of excess hair.

Electrolysis: With this procedure, heat or chemicals are used to destroy the hair follicle.

An advantage is that it, too, can offer permanent hair removal. But it has a number of drawbacks. Each follicle is treated individually, making it a tedious and time-consuming procedure. The procedure must be repeated on a weekly basis, and the process could take a few years for permanent hair removal.

And since each hair follicle must be treated repeatedly, it can result in an exaggerated pore size or dilated pores that are permanent.

Laser hair removal devices for at-home use: These devices can be expensive and have a number of limitations. They are only approved for use on limited areas of the body and cannot be used for facial hair.

They can require a lot of treatment time, so they work best for smaller areas such as the underarms. If used improperly, the device can burn or blister the skin, or even cause blindness. If you have dark skin tones, they can cause your skin to become either darker or lighter.

Over-the-counter hair removal creams: These are the most tedious and least effective of the temporary hair removal options. They can irritate and burn the skin, and results only last about a week or two on average.Bleaching: This technique requires upkeep every one to two weeks to keep coarse, dark hair faint and less noticeable.Plucking/waxing: These remove hair for an average of one to three weeks, but can cause side effects. Plucking can cause ingrown hair or folliculitis (acne-like bumps). Waxing can cause temporary burns or skin irritation and should be done professionally.Shaving: This requires daily upkeep and in some cases may be needed twice a day, if you experience a "5 o'clock shadow" effect with hair growing back by the evening hours.

Though no formal studies have been conducted, laser hair removal would likely overall be less expensive. It offers permanent reduction, while temporary treatments will carry a continued cost over time. And it requires fewer treatments overall compared with electrolysis, the only other method of permanent hair removal.

For laser hair removal, the average cost to treat a small region (upper lip, chin) is $150 to $250 per treatment; a medium region (underarms, bikini) between $300 and $450 per treatment; and large regions (back, legs) approximately $1,000 per treatment.

SOURCES: American Academy of Dermatology Annual Meeting, San Diego, March 16-20, 2012. Sandy S. Tsao, MD, instructor, Harvard Medical School; dermatologist, Massachusetts General Hospital, Boston.

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