Excess body hair (hirsutism) is relatively common — affecting up to 10% of women. It’s caused by raised androgen levels, like testosterone. And the main underlying cause is PCOS. There are a range of treatments available to remove any unwanted hair.

What’s considered excess hair growth?

It’s natural to have body hair, but you might consider your hair growth excessive if you have very thick and dark hair on your:

  • face — like on your upper lip, chin, and neck
  • nipples
  • stomach
  • lower back
  • buttocks 
  • legs

This condition is called hirsutism and is thought to affect about 10% of women. The most common cause of hirsutism is polycystic ovary syndrome (PCOS).

Getting a PCOS diagnosis involves checking your hormone levels for excess androgens (male sex hormones that men and women both have) — like testosterone. You can do this at home with a PCOS blood test.

Why does PCOS cause excess hair growth?

PCOS is a condition that affects your hormone levels — often causing you to produce an excess of androgens. Androgens are hormones, like testosterone, that are responsible for the presentation of more ‘male’ characteristics, including dark and thick facial and body hair. 

Higher levels of androgens stimulate your hair follicles, which is what increases your hair growth. Other common signs that your androgen levels might be raised include oily skin, acne, irregular periods, and thinning hair on your scalp

How to treat hirsutism

It’s not necessary to remove excess body hair, but some people find it affects their self-esteem and mood. So there are a range of treatment options to remove unwanted hair.

First, it’s important to understand the underlying cause of excess hair growth. A blood test can check if your testosterone levels are raised. Or your GP might organise an ultrasound scan to check if you have polycystic ovaries. 

In the case of PCOS, lifestyle changes can help to treat the underlying condition — which might help manage your hair growth. For example, a small amount of weight loss can significantly improve PCOS symptoms (if you’re carrying excess weight).  

Specific hair removal treatments

  • laser hair removal — a light source heats and destroys hair follicles
  • electrolysis — an electric current stops hair growth
  • eflornithine — a prescription cream that slows down the growth of facial hair after 4-8 weeks of treatment
  • medication prescribed by your doctor — for example, the oral contraceptive pill can help block androgen production

Tweezing, shaving, threading, waxing, hair removal creams, and bleaching are other options.

Thriva podcast | S3 E6: Testosterone
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References

Lee, C. M. (2018). Laser-assisted hair removal for facial hirsutism in women: A review of evidence. Journal of Cosmetic and Laser Therapy, 20(3), 140-144.

National Health Services (2018). Polycystic ovary syndrome: treatment. Retrieved 7 April 2021 from https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/

National Health Services (2018). Excessive hair growth (hirsutism). Retrieved 7 April 2021 from https://www.nhs.uk/conditions/hirsutism/

Sachdeva, S. (2010). Hirsutism: evaluation and treatment. Indian journal of dermatology, 55(1), 3.