Hirsutism Non-pharmacological therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Non-pharmacologic medical therapies for hirsituism include [[lifestyle]] modification and some [[cosmetic]] measures. [[Lifestyle]] modifications are majorly for [[polycystic ovary syndrome|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. | |||
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===Lifestyle Modification=== | ===Lifestyle Modification=== | ||
*The main reason of hirsutism is [[polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]]. The main [[lifestyle]] modifications that can be suggested to [[PCOS]] patients are as followings: | *The main reason of hirsutism is [[polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]]. The main [[lifestyle]] modifications that can be suggested to [[PCOS]] patients are as followings: | ||
** | **Decreasing weight | ||
**[[Exercise]] | **[[Exercise]] | ||
**[[Diet]] | **[[Diet]] | ||
| Line 31: | Line 31: | ||
**The method consisted of introducing a tiny needle to each [[hair follicle]], emitting a high electrical pulse and destroy the [[hair follicle|hair bulb]]; stopping the hair growth. | **The method consisted of introducing a tiny needle to each [[hair follicle]], emitting a high electrical pulse and destroy the [[hair follicle|hair bulb]]; stopping the hair growth. | ||
**The procedure is very effective, but painful. Therefore, topical [[Lidocaine|pain relievers]] may be used before the procedure.<ref name="pmid22171681">{{cite journal |vauthors=Blume-Peytavi U |title=An overview of unwanted female hair |journal=Br. J. Dermatol. |volume=165 Suppl 3 |issue= |pages=19–23 |year=2011 |pmid=22171681 |doi=10.1111/j.1365-2133.2011.10632.x |url=}}</ref><ref name="pmid22335316">{{cite journal |vauthors=Bode D, Seehusen DA, Baird D |title=Hirsutism in women |journal=Am Fam Physician |volume=85 |issue=4 |pages=373–80 |year=2012 |pmid=22335316 |doi= |url=}}</ref><ref name="pmid7673501">{{cite journal |vauthors=Richards RN, Meharg GE |title=Electrolysis: observations from 13 years and 140,000 hours of experience |journal=J. Am. Acad. Dermatol. |volume=33 |issue=4 |pages=662–6 |year=1995 |pmid=7673501 |doi= |url=}}</ref> | **The procedure is very effective, but painful. Therefore, topical [[Lidocaine|pain relievers]] may be used before the procedure.<ref name="pmid22171681">{{cite journal |vauthors=Blume-Peytavi U |title=An overview of unwanted female hair |journal=Br. J. Dermatol. |volume=165 Suppl 3 |issue= |pages=19–23 |year=2011 |pmid=22171681 |doi=10.1111/j.1365-2133.2011.10632.x |url=}}</ref><ref name="pmid22335316">{{cite journal |vauthors=Bode D, Seehusen DA, Baird D |title=Hirsutism in women |journal=Am Fam Physician |volume=85 |issue=4 |pages=373–80 |year=2012 |pmid=22335316 |doi= |url=}}</ref><ref name="pmid7673501">{{cite journal |vauthors=Richards RN, Meharg GE |title=Electrolysis: observations from 13 years and 140,000 hours of experience |journal=J. Am. Acad. Dermatol. |volume=33 |issue=4 |pages=662–6 |year=1995 |pmid=7673501 |doi= |url=}}</ref> | ||
*''' | *'''Thermolysis''' | ||
**This method is so much faster, but less effective. | **This method is so much faster, but less effective. | ||
**The current used in this procedure is alternating high frequency, heating up the [[hair follicle|follicle]]. | **The current used in this procedure is alternating high frequency, heating up the [[hair follicle|follicle]]. | ||
**The extreme heating of the [[hair follicle|follicle]] destroys the bulb and pauses the hair growth. | **The extreme heating of the [[hair follicle|follicle]] destroys the bulb and pauses the hair growth.<ref name="Franks2012">{{cite journal|last1=Franks|first1=Stephen|title=The investigation and management of hirsutism|journal=Journal of Family Planning and Reproductive Health Care|volume=38|issue=3|year=2012|pages=182–186|issn=1471-1893|doi=10.1136/jfprhc-2011-100175}}</ref> | ||
*'''[[Laser therapy]]''' | *'''[[Laser therapy]]''' | ||
**Using [[Laser]] for damaging the [[hair follicle]] and pausing its growth through the skin | **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. | **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. | **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]].<ref name="pmid11722446">{{cite journal |vauthors=Lanigan SW |title=Management of unwanted hair in females |journal=Clin. Exp. Dermatol. |volume=26 |issue=8 |pages=644–7 |year=2001 |pmid=11722446 |doi= |url=}}</ref> | **In patients with tanned or dark [[skin]], it may lead to [[skin]] burn and also [[hyperpigmentation]].<ref name="pmid11722446">{{cite journal |vauthors=Lanigan SW |title=Management of unwanted hair in females |journal=Clin. Exp. Dermatol. |volume=26 |issue=8 |pages=644–7 |year=2001 |pmid=11722446 |doi= |url=}}</ref><ref name="pmid9681347">{{cite journal |vauthors=Dierickx CC, Grossman MC, Farinelli WA, Anderson RR |title=Permanent hair removal by normal-mode ruby laser |journal=Arch Dermatol |volume=134 |issue=7 |pages=837–42 |year=1998 |pmid=9681347 |doi= |url=}}</ref> | ||
**Here is the choice of specific [[laser]] for different types of the [[skin]]/[[hair]] complexion:<ref name="pmid14660273">{{cite journal |vauthors=Goh CL |title=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 |journal=J Dermatolog Treat |volume=14 |issue=4 |pages=243–7 |year=2003 |pmid=14660273 |doi=10.1080/09546630310004171 |url=}}</ref> | |||
{| class="wikitable" | |||
!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|intense pulsed light (IPL)]] | |||
|- | |||
|Light [[skin]]/white [[hair]] | |||
|[[intense pulsed light|IPL]] + [[radiofrequency]] | |||
|} | |||
====Transient hair removal==== | ====Transient hair removal==== | ||
Different transient [[hair]] removal methods which can be used in home also, include:<ref name="pmid20840269">{{cite journal |vauthors=Escobar-Morreale HF |title=Diagnosis and management of hirsutism |journal=Ann. N. Y. Acad. Sci. |volume=1205 |issue= |pages=166–74 |year=2010 |pmid=20840269 |doi=10.1111/j.1749-6632.2010.05652.x |url=}}</ref><ref name="pmid11722446">{{cite journal |vauthors=Lanigan SW |title=Management of unwanted hair in females |journal=Clin. Exp. Dermatol. |volume=26 |issue=8 |pages=644–7 |year=2001 |pmid=11722446 |doi= |url=}}</ref><ref name="pmid22335316">{{cite journal |vauthors=Bode D, Seehusen DA, Baird D |title=Hirsutism in women |journal=Am Fam Physician |volume=85 |issue=4 |pages=373–80 |year=2012 |pmid=22335316 |doi= |url=}}</ref> | |||
*'''Pluking''' | *'''Pluking''' | ||
**For small bunch of [[hair]] it can be used by means of a tweezers. | **For small bunch of [[hair]] it can be used by means of a tweezers. | ||
| Line 47: | Line 64: | ||
*'''Shaving''' | *'''Shaving''' | ||
**This procedure is the fastest and also inexpensive method of hair removal. | **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. | **But since the [[hairs]] been cut only at the [[skin]] surface, it has to repeat regularly. | ||
*'''Waxing''' | *'''Waxing''' | ||
**The procedure is to use warm wax on the hairy skin surface and wait until the wax become hard. | **The procedure is to use warm wax on the hairy skin surface and wait until the wax become hard. | ||
| Line 54: | Line 71: | ||
*'''Chemical depilators''' | *'''Chemical depilators''' | ||
**These topical solutions are as gels, lotions, or creams. | **These topical solutions are as gels, lotions, or creams. | ||
**The first step is to spread the solution on the skin. | **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. | **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. | **Regarding the formulation of the depilators, they may lead to [[irritation]] and [[allergy]]. | ||
*'''Bleaching''' | *'''Bleaching''' | ||
**In this method, the main purpose is to bleach the hairs color, instead of removing them. | **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. | **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. | **Regarding the formulation of the [[bleach|bleaches]], they may lead to [[irritation]] and [[allergy]]. Therefore, it is suggested to test on a small [[skin]] area first. | ||
==References== | ==References== | ||
Revision as of 13:33, 10 October 2017
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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
- The main reason of hirsutism is polycystic ovary syndrome (PCOS). The main lifestyle modifications that can be suggested to PCOS patients are as followings:
- Decreasing 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
- 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
- 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]
| 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
- Shaving
- 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
- ↑ 1.0 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.
- ↑ 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 4.2 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.
- ↑ 7.0 7.1 Lanigan SW (2001). "Management of unwanted hair in females". Clin. Exp. Dermatol. 26 (8): 644–7. PMID 11722446.
- ↑ 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.