Hair Growth (Hypertrichosis)

Hypertrichosis or excessive facial hair is a problem that many women with brown skin encounter. Although you may not realize it, hair follicles cover your entire face and the rest of your body as well (with the exception of the lips, palms and soles). In most of the areas of your body the hair that grows from the follicle is very thin, fine and hardly noticeable (vellus hair). In other areas, the hair is thicker, darker and more noticeable (terminal hair). In hypertrichosis, the amount of terminal hair on the face is abnormally excessive.

Facial hair growth is most often hereditary. If you suffer from hypertrichosis, it is likely that your mother, aunts or sisters also have excessive facial hair. For women of Indian and Pakistani descent, hypertrichosis is characterized by thick facial hair growth. For women of African descent, increased facial hair growth can lead to ingrown hairs (pseudofolliculitis barbae) and dark discolorations (post-inflammatory hyperpigmentation). For Latina women, the facial hair may appear as peach fuzz or as thick, darker hair.

Although excessive hair growth is in most cases hereditary, there are a few situations and conditions in which the growth reflects an underlying process or abnormality such as:

  • Aging
  • Obesity
  • Pregnancy
  • Menopause
  • Hypothyroidism (under-active thyroid)
  • Multiple sclerosis
  • Anorexia nervosa
  • Head injury
  • Polycystic ovary syndrome (also associated with irregular periods and severe acne)

In addition, some medications may cause excessive hair growth. The hair growth may not be limited to the face, but may occur in other areas of the body as well. These medications include:

  • minoxidil (for hypertension)
  • diazoxide (for hypertension)
  • phenytoin (for seizures)
  • cyclosporin (to prevent transplantation rejections)
  • streptomycin (an antibiotic)
  • acetazolamide (for glaucoma)

There are many ways to temporarily remove unwanted facial hair. There are products that will dissolve, lighten, remove, and even alter the production of facial hair. And of all of the different management methods available, not one of them can permanently remove hair. Common hair removal methods are outlined below.

Plucking
The hair is pulled from the follicle with a tweezer. This method is commonly used to remove chin hairs or hair on the neck. However, as the hair is plucked, it breaks below the surface of the skin and pierces the hair follicle, causing damage and inflammation beneath the surface of the skin. This leads to bumps (pseudofolliculitis barbae) and dark marks (post inflammatory hyperpigmentation) and because of this, it is not a recommended method of hair removal in these areas.

Shaving
A method used by women “as the last resort” for dense, thick facial hairs. Shaving is often performed several time a week and can irritate the skin. Shaving also commonly produces hairs with sharp pointy ends that curve, pierce the skin and produce an ingrown hair.

Cutting
The best method for removing those occasional hairs that crop up on your chin or neck. Cut the hair with a mustache scissors or a small pair of scissors. This is preferable to plucking hairs in these areas and will prevent ingrown hairs. Take extra care not to cut your skin.

Depilatory (Hair removal creams)
Depilatories contain the chemicals barium sulfide or calcium thioglycolate that dissolve the hairs at the surface of the skin. However, these chemicals may be harsh on the skin and lead to redness, irritation and burning. Use the product exactly as directed and be sure to test it first. If irritation develops at any time, discontinue use. This method is best for small areas of hair growth.

Waxing
Wax is usually applied in a salon to the upper lip area, and the hair is removed with the wax. On the face, the upper lip is a common site for waxing. This method is generally well tolerated and is quick and keeps you hair-free for weeks at a time. Burning of the skin with the hot wax is a possible side effect.

Sugaring
This ancient hair-removal technique dates back to the civilization of Mesopotamia, Egypt and Greece. The method uses a sugar and lemon juice mixture with strips to remove hair from the roots. Though less painful than waxing, it may cause irritation.  It is performed in a salon although at home kits are available (www.shobhathreading.com).

Electrolysis
This method involves the use of an electric current to destroy hair follicles. A needle is inserted into the hair follicle and a current destroys the hair and follicle. It takes time—often repeat visits over months or years—and is more expensive than many methods. In women with curved follicles, it may be technically difficult to insert the needle into this type of follicle. Finally, electrolysis has the advantage of giving long-term results, but it may cause redness and scarring of the skin.

Laser hair removal
Laser hair removal targets the hair follicle with a beam of light which heats and destroys the hair and the follicle. Since a large area can be done, it requires far fewer visits than electrolysis. Results are long-term, although it is possible for some hair to re-grow. However, this method can remove pigment from skin of color or cause dark areas on the skin. It is also critically important that the hair removal laser be performed by a dermatologist knowledgeable about brown skin. The long pulse Diode and Alexandrite Lasers are preferable for skin of color because they have a less harmful effect on the skin.

Prescription cream
Eflornithine HCl Cream, 13.9% (Vaniqa) is a cream that is applied to the skin that retards hair growth at the root level by blocking a hormone that causes hair to grow. Studies demonstrate that about 58 percent of women who use it are less bothered by the facial hair on the lip and under the chin. Though Vaniqa is the only prescription cream proven to reduce the growth of facial hair in women, it does not stop the growth. Women using Vaniqa will still need to use an additional hair removal method. But since Vaniqa slows hair growth, women may find that they are removing hair less often. Dermatologists sometimes suggest using Vaniqa along with laser hair removal. Although it is generally well tolerated, in some women, Vaniqa can cause irritation and bumps.

Bottom Line

There are many different methods to remove facial hair. It is important to try different methods until you find the one that works best for you. You may also find that you will change the method of removal from time to time. Finally, check with your doctor to make sure that you do not have an underlying health problem that may be contributing to you facial hair growth.

Hair Removal Chart

METHOD

WHERE TO DO IT

BODY PART(S)

BENEFITS

RISKS

Plucking At home / salon Eyebrow, lip Simple, precise
lasts a week or more
Mild pain
Shaving At home Underarms, legs Simple, fast, last days Irritation, ingrown hairs, hyperpigmentation
Depilatory At home Lip, chin, bikini, underarms, legs Simple, fast, lasts
a week or more
Irritation, messy
Waxing At home / salon Lip, brow, chin, underarms, bikini, legs Fast, lasts several weeks Irritation, pain, ingrown hairs
Sugaring At home / salon Lip, brow, chin, underarms, bikini, legs Fast, lasts several weeks Irritation, pain
Electrolysis Salon / office Lip, brow, chin, underarms, bikini, legs Long-term, sometimes permanent results Pain, scarring, hyperpigmentation, repeated re-growth
Lasers Salon / Derm. Office Lip, brow, chin, underarms, bikini, legs Long-term, often
permanent results
Irritation, burning, hyperpigmentation or hypopigmentation
Vaniqa Prescription Lip, chin, underarms, arms, legs Long-term results Irritation, bumps

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