Treatment of Hirsutism - Overview
Once your physician has determined the cause of your hirsutism, having ruled out any underlying pathology, you may want to undergo treatment to remove any unwanted hair. Current therapies involve the administration of antiandrogens and newer topical medications, as well as a variety of physical applications.
While there is still no permanent method of hair removal, any one or a combination of the following treatment options can be used to improve the cosmetic outcome.
The more common hair removal treatments include:
- Oral hormonal blockade
- Topical enzyme blockade
- Physical removal (e.g., shaving, waxing, plucking, electrolysis)
- Bleaching agents
- Chemical depilatories
- Laser assisted removal
Antiandrogen treatments include cyproterone acetate (progesterone-like and antigonadotropic), spironolactone (antimineralocorticoid), flutamide (pure androgen receptor blocker), and finasteride (5 alpha-reductase inhibitor). These treatments have been studied in hirsutism and show varying degrees of efficacy. However, spironolactone, flutamide and finasteride are known to be teratogenic – or able to disturb the growth and development of an embryo or fetus. So, they must be used in conjunction with a pregnancy-prevention plan if you are of child-bearing age.
Cyproterone acetate is effective in treating PCOS-related hirsutism, used either alone or in combination with ethinyloestradiol as an oral contraceptive. If used alone, cyproterone acetate can cause menstrual cycle disturbances. When used in combination with ethinylestradiol, menstrual cycles are not affected.
The antidiabetic drug metformin has also shown efficacy in treating symptoms of hirsutism in women with PCOS. It is prescribed for hirsutism and continues to be studied.
Topical Enzyme Treatment
The only prescription agent that carries FDA approval for the treatment of hirsutism in women is topical eflornithine 13.9% (Vaniqa®). It is a cream applied to the skin, usually twice a day. It can be combined with other treatments to enhance their effectiveness. Topical eflornithine HCl is effective against all causes of excessive facial hair, regardless of hair colour.
Other, non-drug related treatments available in a clinic or through home-based kits include electrolysis, laser therapy, waxing, bleaching, shaving and tweezing, all of which have different levels of efficacy and safety.
Treatment of Hirsutism: