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

Non-pharmacologic medical therapies for hirsituism include lifestyle modification and some cosmetic measures. Lifestyle modifications are majorly for polycystic ovary syndrome (PCOS) patients, include decreasing weight, exercise, diet, and smoking cessation. Cosmetic measures are classified as permanent methods, such as electrolysis or laser therapy, and transient home methods, such as pluking, shaving, waxing, chemical depilators, and bleaching.


Non-pharmacological Therapy

Lifestyle Modification

Cosmetic Measures

  • There are various means of cosmetic treatment for hirsutism, they are including:

Permanent hair removal

  • Electrolysis
    • The method consisted of introducing a tiny needle to each hair follicle, emitting a high electrical pulse and destroy the hair bulb; stopping the hair growth.
    • The procedure is very effective, but painful. Therefore, topical pain relievers may be used before the procedure.[3][4][5]
  • Thermolysis
    • This method is so much faster, but less effective.
    • The current used in this procedure is alternating high frequency, heating up the follicle.
    • The extreme heating of the follicle destroys the bulb and pauses the hair growth.[6]
  • Laser therapy
    • Using Laser for damaging the hair follicle and pausing its growth through the skin
    • It may take several sessions of treatment to get rid of the hairs, completely.
    • The most prevalent side effects are skin irritation and inflammation after the sessions of laser therapy.
    • In patients with tanned or dark skin, it may lead to skin burn and also hyperpigmentation.[7][8]
    • Different lasers for hair removal are including:[9]
      • 694-nm ruby laser
      • 1064-nm Q-switched Nd: YAG laser
      • 755 nm long-pulsed alexandrite
      • 800-nm diode laser
    • Here is the choice of specific laser for different types of the skin/hair complexion:[10]
Skin/hair color  Choice of photoepilation device
Light skin/dark hair  Relatively short wavelength 
Dark skin/dark hair  Relatively long wavelength or intense pulsed light (IPL)
Light skin/white hair  IPL + radiofrequency

Transient hair removal

Different transient hair removal methods which can be used in home also, include:[1][7][4]

  • Pluking
    • For small bunch of hair it can be used by means of a tweezers.
    • Can not apply to large areas of hair.
  • Shaving
    • This procedure is the fastest and also inexpensive method of hair removal.
    • But since the hairs been cut only at the skin surface, it has to repeat regularly.
  • Waxing
    • The procedure is to use warm wax on the hairy skin surface and wait until the wax become hard.
    • Then, puling the hardened was abruptly removes the hairs for a long time and in a large area.
    • Minor side effects, such as skin irritation or inflammation are expected.
  • Chemical depilators
    • These topical solutions are as gels, lotions, or creams.
    • The first step is to spread the solution on the skin.
    • Then, these solutions will breaking down the proteins in the shaft of the hairs; therefore, hairs become removed from skin surface level.
    • Regarding the formulation of the depilators, they may lead to irritation and allergy.
  • Bleaching
    • In this method, the main purpose is to bleach the hairs color, instead of removing them.
    • Decoloration of the hair makes the hairs invisible and prevent the need to remove them complete.
    • Regarding the formulation of the bleaches, they may lead to irritation and allergy. Therefore, it is suggested to test on a small skin area first.



References

  1. 1.0 1.1 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.
  2. 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. 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. 4.0 4.1 4.2 Bode D, Seehusen DA, Baird D (2012). "Hirsutism in women". Am Fam Physician. 85 (4): 373–80. PMID 22335316.
  5. 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.
  6. 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.
  7. 7.0 7.1 Lanigan SW (2001). "Management of unwanted hair in females". Clin. Exp. Dermatol. 26 (8): 644–7. PMID 11722446.
  8. 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.
  9. Sanchez LA, Perez M, Azziz R (2002). "Laser hair reduction in the hirsute patient: a critical assessment". Hum. Reprod. Update. 8 (2): 169–81. PMID 12099632.
  10. 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.



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