Treating PCOS Symptoms – Unwanted Hair (Hirsutism)
Hirsutism is the excessive growth of what is termed “sexual hair” (dark course hair). It is brought about by the conversion of immature hair known as vellus hair to adult sexual hair by androgens.
Some individuals by virtue of their genetics/racial background normally have more dark, sexual hair. PCOS by virtue of elevated androgen production is often associated with hirsutism. Treatment of hirsutism, therefore involves suppression of androgen levels.
- Birth control pill – the most potent suppressor of ovarian androgens.
- Metformin decreases insulin levels, insulin stimulates ovarian androgen production.
- Steroids – suppresses adrenal androgen production, which is often increased in PCOS patients.
- Peripheral androgen blockers, spironolactone and flutamide act by blocking the action of androgens on the hair follicle/skin receptors.
Temporary hair removal including shaving, plucking and waxing carries the risks of irritation and infection. Vaniqa cream can be used topically twice a day to slow the growth of facial hair, but it requires continued use.
Permanent hair removal involves repeated laser therapy or electrolysis to destroy the hair follicle. Laser therapy may be used when large areas of the body are affected, it may not have the permanent affect that electrolysis does. There is no point in proceeding with either laser or electrolysis therapy until androgen production has been suppressed medically. Often it takes up to six months to suppress new dark hair growth. After permanent removal of hair, continued medical suppressive therapy is usually required to prevent new growth.