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Much of this information was gathered from Dr. Sara Rosenthal's recent book Women and Unwanted Hair, as well as Sheila Godfrey's
Principles and Practice of Electrical Epilation. While this information is no substitute for consulting a physician, we are dedicated to helping everyone learn about unwanted hair. This page discusses different aspects of unwanted hair and targets females. Many men also deal with unwanted hair, we are by no means ignoring their issues. For more information, please contact your physician. Need more information on removal? Schedule a consultation with one of our hair removal experts!
Hair That Is "Not Supposed to Be There"
Excessive hair growth can be identified by many different terms. You have probably run across the term Hirsutism, perhaps Hypertrichosis, and even superfluous hair. In many resources these terms are used interchangeably but there are important distinctions.
Excessive hair (key word here is excessive) on the face, especially around the chin, upper lip, breasts or chests, or basically hair on a woman that matches a male hair pattern on a female body is known as hirsutism. Men can have hirsutism when their hair is truly excessive in hormonally dependent areas. A woman with hormonal issues and a full male pattern beard would be said to have hirsutism.
Hypertrichosis is basically excessive hair on men or women that tends to be in places that are outside the pattern areas described above.
Someone who has a cast on their leg who grows unusually large patches of hair under the cast could be said to have Hypertrichosis
Superfluous hair or garden variety “unwanted hair” is considered such whenever it appears on areas of the body that are considered to be
either culturally unacceptable, or unattractive. It isn't an abnormal amount or location when considering the makeup of the whole population, it is just undesirable for a woman to have a noticeable light mustache. The color of the unwanted hair is also key; the darker it is, the more visible—which makes it more of a problem for dark haired women than for fair haired women. If you are dark haired, for example, the fine hair on the upper lip or around the hairline may feel abnormal but it’s not; it’s merely visible. And even though excessive hair growth on the face or male-patterned hair growth on the body is considered “abnormal” in women, it’s actually very, very common.
Common Causes of Abnormal Hair Growth
Too much androgen secretion: Many women secrete too much androgen as a result of conditions such as Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Disease (PCOD), which affects 6-10 percent of the general female population and accounts
for half of all hormonal disorders affecting female fertility. Because androgen levels are out of whack, PCOS sufferers can develop abnormally excessive facial or body hair. For more information on PCOS, visit www.PCOSupport.org.
Genetics: Some clinicians will cite “racial” or “familial” genes as a cause of hirsutism, but this isn’t an authentic cause per se. Having said that, if you’re of Mediterranean descent, you are more likely to experience noticeable or “unwanted” hair growth than a blonde Scandinavian woman may.
Stress: In response to stress, your adrenal glands pump out “stress hormones” that speed up your body. But since your adrenal glands also make androgen, increased stress can also increase circulating androgens in your bloodstream, which can cause hirsutism.
Obesity: Certain body types (wherein more of the weight is carried in the upper body) are more susceptible to hirsutism because they are associated with insulin resistance. Also, fat cells can make androgen just as they can make estrogen.
Overactive adrenal glands: This is a side effect of tumors resulting from certain pituitary diseases, such as Cushing’s Disease (for more information, visit the National Adrenal Disease Foundation at www.medhelp.org/nadf). Cushing’s Disease and PCOS are
often accompanied by irregular periods.
Oversensitive hair follicles: Some of us are genetically wired with hair follicles that are simply more sensitive to androgens.
Side effects of certain drugs: Many drugs can cause either androgen secretion and hirsutism, or the opposite—hair loss or alopecia. As a general rule, when taking either a prescription or an over-the-counter drug, be sure to ask about common side effects.
Insulin Resistance & Diabetes: This is when your cells stop responding to the insulin your pancreas makes. Too much insulin can actually cause hirsutism.
Too much sugar in the diet: Seriously.
Thyroid disorders: Certain thyroid disorders could cause hirsutism. Once your thyroid problem is treated, however, it’s likely no new hairs will be stimulated to grow.
Rare endocrine disorders: An increase in androgen levels can result from a number of very rare endocrine diseases, such as Hyperandrogenic-Insulin Resistant-Acanthosis Nigricans (Hairan) Syndrome.
Hormonal Treatment for Unwanted Hair
Much unwanted hair growth occurs as a result of hormonal imbalances, which are correctable. Please consult your doctor about abnormal hair
and treatment options. While hormone therapy will not make the hairs you already have disappear, it can stop the growth of new hairs. Be
sure to ask your doctor about common side effects of each of the following therapies before you say “yes” to hormone therapy.
Oral contraceptives (OCs): The most common form of hormone therapy used to treat hirsutism, OCs tend to improve what are called “androgen-related side effects,” such as acne and unwanted facial hair. That said, too much progestin, which is synthetic
progesterone, can also cause these kinds of side effects. If your acne and/or unwanted facial hair predates your use of OCs, you may
notice a marked improvement; however, if these “symptoms” occur after you’ve started an oral contraceptive program, you may be
on the wrong pill, and should consult with your doctor about alternatives
Spironolactone: This is a diuretic that appears to counteract the effects of androgen hormones in the skin. Frequently called an antiandrogen drug, spironolactone is not recommended if you’re at risk for osteoporosis.
Cortocisteroids: These will prevent your adrenal gland from making androgens, but they’re not recommended as a first-line hormone therapy for hirsutism.
GnRH analogs: GnRH (gonadotropin releasing hormone) analogs are normally used in fertility treatment and—because they come with many menopausal-type side effects—should be reserved for more severe cases of hirsutism where OCs are not appropriate.
Natural progesterone therapy: If birth control is not an issue, this may be an appropriate means of correcting an underlying hormonal imbalance. For more information, see Natural Progesterone: The Natural Way to Alleviate Symptoms of Menopause, PMS, and Other Hormone-Related Problems by Anna Rushton, Shirley A. Bond and John Lee.
Removing Unwanted Hair
The following are methods most people consider once an underlying hormonal problem causing excessive, unwanted hair growth has been ruled out, or dealt with.
Tweezing: Tweezing is the cheapest method of removal, and is generally considered appropriate for eyebrows, since you may want to alter their shape from time to time and allow the hairs to grow back. "However, tweezing can cause scar tissue to form and can also stimulate the hairs to grow back stronger and coarser. Avoid using tweezers on sparse facial hair or as a way of removing large areas of unwanted hair on the legs and underarms."--Dr. Sara Rosenthal, Women and Unwanted Hair
“Tweezer-like” Products: Although these devices are relatively cheap and convenient, the hair removal is temporary and, like regular
tweezing, stimulates the hair follicle to grow stronger hair.
Shaving: The problem with shaving for women is where they are shaving and where, on their bodies, stubble is socially and culturally
acceptable. Shaving facial hair, for example, is stigmatizing; shaving underarm hair is not. In light of this, experts understand if women refrain from shaving the face if it doesn’t feel right, but they do not discourage shaving if the goal is to remove the hair without stimulating the roots. And if the goal is to permanently remove the hair, shaving is a better option than waxing, tweezing or sugaring if you’re having electrolysis treatment because of the potential skin damage associated with these alternate methods.
Waxing: Waxing is basically large scale tweezing. It removes the hair for long periods of time without producing stubble. With the exception of hair that has been hormonally stimulated, hair that is waxed on areas such as the lower leg or underarm, may sometimes grow back finer. However, like tweezing, waxing can negatively stimulate the roots and hair follicles on areas like the chin, breast, abdomen, and upper lip in women.
Sugaring: Sugaring is the exact same as waxing; it is also a large-scale tweezing method.
Threading: This is an ancient technique popular in places like India and the Middle East. It involves the use of a regular thread to remove hair from the surface of the skin. It is a variation on tweezing.
Hair Removal Creams: These creams (also called depilatories) remove surface hair but they tend to have less of an effect on the follicle than methods like tweezing. Think of them as a chemical shave. And while they don’t provide a permanent solution, the hair may take longer to grow back than it would if you were shaving, and hair doesn’t grow back as stubbly.
Bleaching: Bleaching kits do not remove hair at all, but can lighten the dark, fine hairs of the upper lip or arm to conceal hirsutism. Use with caution as on some hair colors, it make it catch the light and ends up making it more noticeable, almost shiny.
Home Electrolysis Kits: These tend not to live up to their claims, nor do any “patch” devices you may have come across on the home
shopping network; both end up actually “tweezing” out the hairs instead of removing them via electrolysis. Hair is just not a conductor of electricity, sorry. The good news is the DC battery that powers home electrolysis kits is not strong enough to do any real damage to your skin.
Laser: Laser treatment for hair removal is gaining popularity, but its success is really dependent on the hair and skin pigment. If have darker skin, the pigment in your skin will likely interfere with the laser beam’s reach. Similarly, if you’re fair-haired, the laser will likely be unable to grasp the pigment in your hair. This is an adequate method if you’re fair skinned, but dark haired. However, its permanence is not guaranteed and can not be legally represented as permanent. It usually works well on large areas like a man's back or full beard removal. Make sure you are having laser treatments done by a well trained practitioner with plenty of experience, not just a "certified" technician, certification can be as simple as a 4 hour course on how to operate the machine. Visit the FDA Laser Facts page for more information.
Electrolysis: Electrolysis is the only permanent method of removing hair, but it does require a time commitment. The electrologist uses a very fine filament or needle, placing it alongside the hair shaft and into the hair follicle. A mild electric current then destroys the hair-growth cells within the follicle. The process is charged by units of time and, unfortunately, doesn’t come dirt cheap like shaving does. We frequently have clients say they thought it would be much more expensive and that is why they hadn't come in sooner, it is definitely an investment you are making in yourself. If you are dealing with unwanted hair frequently then it is very worthwhile to investigate it to see what your actual costs will be. An hour of body waxing in our area costs a little more than electrolysis for an hour. Remember when you are done with electrolysis, you are done with the hair. As with any method, your results will be largely determined by the skill of your practitioner. Shop around and don't hesitate to set up consultations at several places and decide which works best for you.
The disclaimer: The healthier you are, the harder it is to remove hair. Hair is a product of circulation. If you are healthy, active, and have good circulation it will take longer to remove the hair permanently or semi-permanently. This applies to ALL hair removal methods.
Why should I choose electrology over temporary or long lasting hair removal methods?
Laser vs. Electrology:
While laser promoters compare laser to electrology it is actually not a permanent form of hair removal. Only a few laser
devices have been cleared to claim a permanent reduction in hair by the FDA. Intense Pulsed Light (IPL) though often
called laser, is NOT a true laser and not approved by the FDA to claim any efficacy. Electrology is cleared for permanent
removal of hair. Additionally, laser hair removal has not been evaluated for long-term safety of the patient's skin and
health--new research is showing prolonged exposure to laser is capable of changing skin cells at the genetic level. Please
access the FDA website on laser use for more information.
Essentially, laser is radiation that targets the pigmented cells in hairs. It also takes a series of treatments (generally 6-8
spaced out every 6 weeks or so) as all hair is not present at one time. Clients shave prior to treatment, the laser is applied
to the skin and heats the pigmented cells charring the moisture out of the hairs. The hairs slough/fall out on their own over
the next few days or weeks. Skin looks sunburned after treatment and must be protected from the sun. The best results are
very dark hair and very light skin. Darker skin tones or tanned skin must be treated with extreme caution as laser is attracted
to pigment and may require bleaching and sun avoidance for 6 weeks prior to and following treatment if it can be treated at
all. White, gray, and some red hairs are unaffected by laser. Laser does have potential to work with electrolysis. One could
argue laser would be well used to initially clear large areas like legs or backs and then follow up with electrolysis as the hair
grows back in following a series of laser treatments.
Do make sure your laser technician has appropriate training. There is no regulation for laser training. Yes, you read that
right. A Dr. can take anyone of you and "train you" in her/his office without any program requirements. You too could take
a weekend course and be a certified laser technician (CLT) and use the Allied Health Association "Rent a Medical Director"
program and not have a doctor on site at all. Each state varies, some don't even require a medical director--not even one in
name only! Treatments are only as good as your technician/operator in any hair removal method, but for safety reasons this is
especially important here given the larger expense of treatments and potential for tissue damage.
Waxing, Sugaring, Nads, Epilady or Threading vs. Electrology:
Waxing, Sugaring, Nads, and threading will remove all of the visible hair by ripping it out by the root. Except in the cases of
threading and "hard" wax, the outer layer of skin is often removed when the hair is removed. It can result in skin
problems including ingrown hair, scarring, pigment changes, and bruising. To keep your skin clear, (and contrary to
advertising claims) all of these methods must be done frequently forever. You must also wait until hair is at least 1/4" to
1/2" (about 3 weeks of growth) long for the wax/sugar/Nads "glue" to adhere to the removal strip.
Research has shown that any method that rips hair out by the root such as waxing, sugaring, and Nads type products can
actually increase hair growth in hormonally dependent areas such as the upper lip, chin, breasts, and abdomen! This is not
such an issue on areas like eyebrows and legs, wax away.
Tweezing vs. Electrology:
Tweezing is easy to do and inexpensive too. However hair can become coarser from the repeated tweezing and skin
problems including ingrown hair, pigment changes, and scaring can result. Obviously it is not a permanent solution to
unwanted hair. NEVER tweeze the upper/lower lip, chin, breasts, or abdomen! You are stimulating growth in these areas.
The hair will become thicker and darker. NEVER tweeze out ingrown hairs. You will make the situation worse. The hair
will distort further and you will have a bigger lesion the next time it grows in, really, trust us. Stop performing self-surgery,
we mean it.
Shaving vs. Electrology:
Shaving is inexpensive and easy. However, the hair does grow back quickly and feels coarse as it is cut off leaving a blunt
tip. Shaving DOES NOT increase hair growth in any way. Seriously, this is the biggest myth in hair removal. Hair is dead
above the skin surface. Anything you do at this level does not affect hair growth. Shaving is a safe temporary method of
removal for basically anywhere.
Depilatories vs. Electrology:
Depilatories are essentially a chemical shave. Many find that this method lasts longer than a regular shave. It will remove the hair by dissolving it with a chemical. This can result in a chemical burning of the skin if you are not careful about patch testing and respecting timing.