Hirsutism Non-pharmacological therapy

Hirsutism Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Hirsutism from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Echocardiography or Ultrasonography
Treatment
Medical Therapy Pharmacological therapy Non-pharmacological therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Hirsutism Non-pharmacological therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hirsutism Non-pharmacological therapy
CDC on Hirsutism Non-pharmacological therapy
Hirsutism Non-pharmacological therapy in the news
Blogs on Hirsutism Non-pharmacological therapy
Directions to Hospitals Treating Hirsutism Non-pharmacological therapy
Risk calculators and risk factors for Hirsutism Non-pharmacological therapy

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).
• 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

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.
• 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.
• 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.

• • Here is the choice of specific laser for different types of the skin/hair complexion:

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:

• 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.