Hirsutism Non-pharmacological therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Pharmacologic medical therapies for hirsituism include oral contraceptives, androgen receptor blockers, 5-alpha reductase inhibitors, gonadotrophin-releasing hormone (GnRH agonist), adrenal suppressive glucocorticoids, insulin-sensitising agents, and biological modifiers of hair follicular growth. Treatment options are systemic therapy and topical therapy.
Non-pharmacological Therapy
Lifestyle Modification
- The main reason of hirsutism is polycystic ovary syndrome (PCOS). The main lifestyle modifications that can be suggested to PCOS patients are as followings:
- Loosing weight
- Exercise
- Diet
- Smoking cessation
- Smoking cessation can be encouraged, because of lowering probability of side effects from hirsutism pharmacological therapy, such as cardiovascular events resulting from oral contraceptive pills (OCPs).[1]
- The main effects that lifestyle modification may have are including:
- Lowering of free testosterone
- Reduction of androgen production by the ovaries
- Reduction of serum insulin
- Increase in sex hormone binding globulin (SHBG)
- Improvement in fertility
- Improvement in quality of life
- Raising self-esteem[2][3][4]
Cosmetic Measures
- There are various means of cosmetic treatment for hirsutism, they are including:
Permanent hair removal
- Electrolysis (galvanic electrolysis, thermolysis, or a combination of both)
- The method consisted of introducing a tiny needle to each hair follicle, emitting a high electrical pulse and destroy the follicle; stopping the hair growth.
- The procedure is very effective, but painful. Therefore, topical pain relievers may be used before the procedure.[3][4][5]
- Laser therapy
- A beam of highly concentrated light (laser) is passed over your skin to damage hair follicles and prevent hair from growing. You might need multiple treatments.
- You might develop skin redness and swelling after laser therapy. Laser therapy for hair removal is expensive and carries a risk of burns and skin discoloration, especially in people with tanned or dark skin.
1. shaving, chemical depilatories, bleaching, plucking, tweezing or threading, and waxing (Bode 2012; Escobar-Morreale 2012; Lanigan 2001); 2. electrolysis in the form of galvanic electrolysis, thermolysis, or a combination of both (Blume-Peytavi 2011; Bode 2012; Escobar-Morreale 2012; Richards 1995); and 3. laser and photo epilation (Escobar-Morreale 2012; Haedersdal 2011; Lanigan 2001; Sadighha 2009). The review will not include treatment with laser and photoepilation alone because they are covered in another Cochrane review (Haedersdal 2006).
- Bleaching, shaving, depilating agents, plucking, waxing treatments.
- Electrosurgical methods include electrosurgical epilation and Laser therapy which can remove unwanted hair for some women specially for women with dark hair and light skin.[6]
Light-source-assisted hair reduction (photoepilation) is a common method in the treatment of unwanted hair and is more effective than shaving, waxing and electrolysis.[7]
| Skin/hair color | Choice of photoepilation device |
|---|---|
| Light skin/dark hair | Relatively short wavelength |
| Dark skin/dark hair | Relatively long wavelength or IPL(intense pulsed light) |
| Light/white hair | IPL + radiofrequency |
References
- ↑ Escobar-Morreale HF (2010). "Diagnosis and management of hirsutism". Ann. N. Y. Acad. Sci. 1205: 166–74. doi:10.1111/j.1749-6632.2010.05652.x. PMID 20840269.
- ↑ Koulouri O, Conway GS (2008). "A systematic review of commonly used medical treatments for hirsutism in women". Clin. Endocrinol. (Oxf). 68 (5): 800–5. doi:10.1111/j.1365-2265.2007.03105.x. PMID 17980017.
- ↑ 3.0 3.1 Blume-Peytavi U (2011). "An overview of unwanted female hair". Br. J. Dermatol. 165 Suppl 3: 19–23. doi:10.1111/j.1365-2133.2011.10632.x. PMID 22171681.
- ↑ 4.0 4.1 Bode D, Seehusen DA, Baird D (2012). "Hirsutism in women". Am Fam Physician. 85 (4): 373–80. PMID 22335316.
- ↑ Richards RN, Meharg GE (1995). "Electrolysis: observations from 13 years and 140,000 hours of experience". J. Am. Acad. Dermatol. 33 (4): 662–6. PMID 7673501.
- ↑ Franks, Stephen (2012). "The investigation and management of hirsutism". Journal of Family Planning and Reproductive Health Care. 38 (3): 182–186. doi:10.1136/jfprhc-2011-100175. ISSN 1471-1893.
- ↑ Dierickx CC, Grossman MC, Farinelli WA, Anderson RR (1998). "Permanent hair removal by normal-mode ruby laser". Arch Dermatol. 134 (7): 837–42. PMID 9681347.
- ↑ Goh CL (2003). "Comparative study on a single treatment response to long pulse Nd:YAG lasers and intense pulse light therapy for hair removal on skin type IV to VI--is longer wavelengths lasers preferred over shorter wavelengths lights for assisted hair removal". J Dermatolog Treat. 14 (4): 243–7. doi:10.1080/09546630310004171. PMID 14660273.