At Supersmooth, we see customers from all walks of life, with a minority group being women with hirsutism caused by polycystic ovary syndrome (PCOS).
Hirsutism is the excessive growth of facial or body hair on women. Often, the hair grown is coarse and dark and appears on places where women don’t typically have hair, such as the chest, face, lower abdomen, upper legs and back. Hirsutism is a symptom commonly associated with medical disorders that result from high levels of a male sex hormone known as androgens. PCOS is one such condition; it is where the ovaries produce abnormal amounts of androgens, resulting in complications like excessive hair growth, irregular periods and infertility. Currently, PCOS affects about 10% of women and is the most common cause of hirsutism.
Apart from excessive hair growth, patients with hirsutism can also develop other signs including:
- Deep voice
- Acne
- Increased muscle mass
- Balding
- Decreased breast size
- Enlarged clitoris
The good news is that hirsutism is fairly common and often improves with treatment, but prompt medical attention is important as delaying treatment would affect the efficacy of results, including that of cosmetic therapy.
Understanding normal hair growth
Understanding how normal hair growth works will help you understand hirsutism a little better. Hair grows from follicles located deep in the skin — as long as these follicles are not completely destroyed, hair will continue to grow. This is why results from most hair removal methods don’t last for very long as only the shaft is removed and not the follicle.
We carry approximately 50 million hair follicles on our body, with one fifth of that amount located on the scalp. The thickness of hair largely depends on ethnic origin and of course genetics. For example, people of Mediterranean descent generally have more hair than Asians and American Indians. But regardless of ethnic or genetic variation, excessive hair due to those non-hormonal causes primarily appears on the arms, legs and feet, unlike hirsutism, which affects the chest, abdomen and face.
The effect of androgens on hair
Adults have two types of hair — vellus hair and terminal hair. Vellus hair is generally fine, colourless and short, while terminal hair is long, coarse and dark. Most women have vellus hair on their chest, face and back, thereby giving the impression of “hairless” skin on those areas. However, androgens can cause vellus hair to change to terminal hair — this process is what happens in women with PCOS, resulting in thick and excessive hair growth.
What is the best way to remove unwanted hair from hirsutism?
If you have hirsutism due to PCOS, your physician should recommend appropriate treatment including therapy to block the production of androgens. After which, it is up to the patient to decide how they want to remove the remaining excess hair, be it through temporary (e.g. shaving, waxing) or permanent hair removal methods (e.g. lasers). Often, we see patients combining medical therapy with mechanical methods of hair removal such as electrolysis or laser hair removal.
Laser hair removal is more expensive than electrolysis but it is generally faster, less painful and requires fewer sessions. When done appropriately, patients can expect up to a 70% reduction in hair density within 3-6 months of treatment. We recommend darker skinned women with PCOS to opt for Super Hair Removal (SHR). SHR works by the same mechanics as laser hair removal, except it uses an 810nm-powered diode laser that powers in a low-fluency pulse emission, which is gentler on darker skin. A 2020 study on laser treatment in hirsutism showed that not only is the diode laser system better tolerated by darker skin types, 91% of patients saw a 65-75% reduction in hair density 3-8 months after treatment.
Considering IPL? Read our article on IPL vs laser hair removal.
What can I expect from treatment?
In order for cosmetic removal of hair to be successful, it has to be done with hormonal treatment; the problem causing the hair growth has to be managed. Generally, about 6 months of hormone therapy is required to slow down the rate of hair growth, but it has to be ongoing. When combined together with cosmetic therapy, patients often see the best results.
Many women with PCOS or hirsutism hesitate to seek treatment because of embarrassment or shame, but rest assured that our clinic is a safe space. Our diverse client base includes transgenders and amputees with folliculitis, so we’re no stranger to minority groups. If you have hirsutism and are considering seeking hair removal treatment with us, don’t be afraid to reach out.
References
- Bhat, Y. J., Bashir, S., Nabi, N., & Hassan, I. (2020). Laser Treatment in Hirsutism: An Update. Dermatology practical & conceptual, 10(2), e2020048. https://doi.org/10.5826/dpc.1002a48
- Lee C. M. (2018). Laser-assisted hair removal for facial hirsutism in women: A review of evidence. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology, 20(3), 140–144. https://doi.org/10.1080/14764172.2017.1376099
