Removing Unwanted Excess Hair – Diagnosis and Treatment

Diagnosis

When evaluating unwanted hair growth, especially when it appears in a male pattern (such as on the face, chest, or back in women), doctors begin by taking a detailed medical history and performing a physical exam.

They ask about the onset, pattern, and rate of hair growth, as well as any related symptoms like acne, irregular periods, or weight gain.

Hormone Testing

Doctors may order blood tests to check for elevated androgen levels, such as testosterone or dehydroepiandrosterone sulfate (DHEA-S). High levels of these hormones can lead to conditions like:

• Hirsutism
• Acne or oily skin
• Scalp hair thinning
• Menstrual irregularities

Elevated androgens are often associated with polycystic ovary syndrome (PCOS), the most common cause of hirsutism in reproductive-aged women.

Imaging and Further Evaluation

Depending on symptoms and lab results, doctors may also:

• Assess for other hormonal conditions like congenital adrenal hyperplasia or Cushing’s syndrome.
• Perform a pelvic exam or abdominal ultrasound to evaluate the ovaries and uterus.
• Order imaging (such as CT scans or MRIs) to check for adrenal or ovarian tumors in rare cases.

Treatment

Medicine Options

Doctors often suggest medications when simple hair removal methods do not work. Hair grows slowly, so it can take up to six months to see changes.

Here are some common medicines:

• Hormonal Contraceptives: Birth control pills, patches, or rings can help balance hormones. These methods work best for women not planning to get pregnant. Some side effects include feeling sick or having headaches.
• Medicines That Block Androgens: Anti-androgens stop certain hormones from causing extra hair growth. It might take a few months to notice results. Patients may notice changes in their periods or need to use birth control because of possible effects on a baby.
• Topical Treatments for Facial Hair: Prescription creams help slow the growth of new facial hair. You apply this cream to the face twice a day. It does not remove hair that is already present but makes new hairs grow more slowly. You can combine it with procedures such as laser therapy for better results.

Medicine Type	Main Use	Possible Side Effects	Time to See Results
Oral contraceptives	Hormonal balance	Nausea, headache	6 months or more
Anti-androgens	Block androgen effects	Irregular periods	6 months or more
Ornithine decarboxylase inhibitor	Slow facial hair growth	Skin irritation	Several weeks/months

Hair Removal Procedures

Some people choose longer-lasting procedures to reduce hair. Dermatologists or clinics usually perform these treatments.

Two main options are:

Laser Therapy

Laser hair removal uses strong light to stop hair from growing. It works best for people with darker hair and lighter skin.

Several sessions may be needed. Risks include changes in skin color, blistering, or mild irritation. People should discuss the best laser type for their skin with a doctor.

Electrolysis

Electrolysis treats each hair follicle with a tiny electric current to destroy the root. This method can help people with light or white hair, where lasers may not work well.

The process can be uncomfortable, but a numbing cream might help. Several treatments are usually needed for the best results.

Procedure	Best For	Number of Sessions	Possible Risks
Laser therapy	Dark hair, light skin	Multiple	Skin discoloration, irritation
Electrolysis	Blonde, white, or fine hair	Multiple	Pain, redness, swelling

Some clinics also offer IPL (intense pulsed light), which is similar to laser treatment and may help with permanent hair reduction.

Self-Care

Managing unwanted hair at home can be simple with a few common techniques.

Plucking uses tweezers or threading and works well for small areas like the eyebrows or a few stray facial hairs. This method removes the hair from the root, but the hair will usually grow back.

Shaving is a quick option for larger areas, including legs and underarms. Using an electric razor or a traditional razor with shaving cream helps reduce irritation and cuts.

Shaving needs to be repeated often since it only removes hair at the skin’s surface. Waxing removes hair from bigger areas such as the arms or legs. Warm wax is spread on the skin, then pulled away to remove hairs from the root.

Waxing can cause some temporary discomfort, redness, or irritation, but lasts longer than shaving.

Depilatory creams are available in gels, creams, or lotions from stores. Users apply the cream, wait a few minutes, then wipe it away to dissolve the hair.

This method can sometimes lead to skin irritation, so it is important to test on a small area first.

For people who want to make hair less noticeable, bleaching is an option for facial or other fine hair. Bleaching lightens dark hair so it blends in with the skin, but may cause irritation for sensitive users.

The table below highlights key points about each method:

Method	Main Use	Pros	Cons
Plucking	Small areas, few hairs	Precise	Can be slow, regrowth
Shaving	Large areas	Fast, easy	Short-lasting, often
Waxing	Medium to large areas	Longer results	May hurt, redness
Depilatory Cream	Various areas	Painless, simple	Possible irritation
Bleaching	Fine, light facial/body hair	Less visible hair	Skin sensitivity

People often treat the face, legs, underarms, and even ear hair. No self-care method makes hair grow faster or thicker. Each method must be repeated to maintain results.

Getting Ready for Your Visit

Questions Your Healthcare Provider Might Ask

During the appointment, the doctor will ask about your symptoms and personal health history.

For example, the doctor may ask:

• When did your symptoms start?
• Have you noticed any changes in your menstrual cycles, such as missed or irregular periods?
• Have you experienced recent weight gain?
• Do you have new or worsening acne?
• Have you noticed changes in breast size?
• Has your voice changed?
• Are you planning a pregnancy in the near future?

Bring a written record to help you share all important details.

Tip: Make a list of these changes and updates, so you don’t forget anything during your visit.

What to Bring:

Item	Description
Health Information	List other health problems and any changes in your menstrual cycle or sex drive.
Medication List	Write down all medicines, vitamins, and supplements with exact doses.
Questions	Prepare topics to discuss with the doctor or endocrinologist.

Suggestions for Questions to Ask the Doctor:

• What could be causing my symptoms?
• Are there other possible conditions to consider?
• What tests do I need?
• Will this condition last a long time, or is it temporary?
• What treatments do you recommend? Are there other options?
• Should I see a specialist, such as an endocrinologist?

Ask all your questions, even if they seem simple.