Excessive Hair Growth: Getting to the Root of the Problem

Women love thick hair; that is, unless it grows in places they don't want it to.

Eight percent of women have unwanted hair growing on their upper lip, chin, cheeks, neck, arms, abdomen, or back. Hair growth in these areas is common for men, but when it happens to women, many search for hair removal solutions. They might be better off though, if they went to the root of the problem—their health.

According to the American Academy of Family Physicians, 60 to 80 percent of women with hirsutism (excess hair growth) have excess androgen production.  That means they produce more "male" hormones like testosterone than women normally produce. All women produce some androgens, but excess and unwanted hair growth is a common symptom for women with out-of-balance reproductive hormones. It's a classic sign of Polycystic Ovarian Syndrome, which can lead to infertility, weight gain, acne, menstrual irregularity, and diabetes.

Some other causes of unwanted hair growth, although rare, include:

  • Tumor or cancer of the adrenal gland
  • Tumor or cancer of the ovary
  • Cushing's syndrome
  • Congenital adrenal hyperplasia
  • Hyperthecosis (a condition in which the ovaries produce too much male hormones)
  • Medications (testosterone, danazol, anabolic steroids, glucocorticoids, cyclosporine, minoxidil, phenytoin)

Rarely a woman with hirsutism has normal levels of male hormones, and the specific cause of the unwanted hair growth cannot be identified.

What can you do about unwanted hair growth?  It comes down to two options:

  • Treat the underlying health problem and/or
  • Remove the hair.

Your doctor may be able to prescribe medication to help balance your hormones These include:

  • Birth control pills
  • Hormone replacement therapy
  • Androgen blocking medications like Aldactone and Eulexin
  • Topical creams that reduce hair growth like Vaniqa

Obese women are encouraged to lose weight, which impacts insulin resistance, development of diabetes and, in turn, reduces hair growth.

There are pros and cons to all hair removal techniques.

  • Plucking works well for very small areas (like a few strays on the chin).
  • Bleaching lightens hair to make it less visible. It's painless and inexpensive, but bleaching products have strong odors, and results only last until new growth comes in.
  • Waxing and sugaring remove hair by ripping it out below skin-level.  They're safe and can be done inexpensively at-home or (for a much higher price) at a salon. Waxing can be painful, but rarely causes skin irritation as long as clean techniques are used.  Results last  three to five weeks. 
  • Shaving is safe, painless and fast, but results only last a few days and may cause hair to appear thicker or stubbly when it grows back.
  • Depilatories are chemicals that dissolve hair at the skin surface.  They have a strong odor and may cause skin irritation.  Results last slightly longer than shaving, but since hair isn't cut bluntly, re-growth may not appear as "stubbly".
  • Electrolysis delivers a small electric current directly into the hair follicle.  This destroys the follicle and permanently prevents hair growth.  It's effective, but painful, expensive and time consuming since only a small area can be treated in a session.  Skin irritation, discoloration, and scarring can occur though newer techniques performed by certified experts minimize these problems.
  • Laser treatment works similarly to electrolysis, but treat follicles in larger areas over several sessions until they're destroyed.  Up to five treatments per area may be required.  It's expensive, but results should last a lifetime.  Some patients require an occasional repeat of treatment.

If you notice excess hair growth in new places, talk to your doctor. He'll help you determine the cause or refer you to someone who can.



MELISSA H. HUNTER, M.D., and PETER J. CAREK, M.D., Medical University of South Carolina, Charleston, South Carolina

Am Fam Physician. 2003 Jun 15;67(12):2565-2572.