Given the huge number of cosmetic options available to women, it’s not uncommon that women self-medicate by tweezing, lasering or waxing their unwanted hair for years before they approach someone on their health care team. It’s only when the most expensive options fail, or the burden of procedures starts to outweigh the relief, do women approach their doctor.
Facial hair in women is a major signal that something is going awry under the surface, and requires prompt attention by your medical practitioner.
Facial hair follicles can undergo remarkable (irreversible) changes in women, with the type of hair grown altering from soft and light to coarse and dark(1). The change is usually brought on by hormone imbalance and insulin issues; meaning that the majority of unwanted hair growth in women can be connected to the metabolic syndrome of PCOS.
Excess production of androgens (testosterone and DHEA) in PCOS can alter hair follicles in women, which changes the type of hair that grows in the follicle to be much more ‘masculine’. This typically happens in areas associated with more male-pattern hair growth (chin, neck, upper lip, back, chest).
Not only does excess androgens change the type of hair that follicles on the face produce, it shortens the lifespan of scalp hairs, leading to excessive hair loss, especially in typical ‘male’ pattern baldness regions.(2)
Women with unwanted hair growth should have a complex health history taken to discuss menstrual cycle changes, past or current fertility issues, success or failure with weight management. Each of these areas of health can point to hormonal imbalances that may be triggering hair growth, and will point to options for managing symptoms.
Lab work such as free testosterone, DHEA and DHT (“Bad” Testosterone) should be considered as part of a work-up for women with unwanted hair growth, as well as measurements of weight, waist circumference and insulin sensitivity. More serious conditions should also be ruled out by your practitioner, especially if the changes you have experienced are sudden or severe.
There are many strategies for dealing with unwanted (and uninvited!) hair growth in women, but every case should start with an appropriate work up to be sure you’re working on the right targets. Dietary changes and supplements to support PCOS-related hormone changes are the mainstay of treatment, and are published in the standards of care for most medical communities as the first line therapy to consider. Some medications have success in controlling symptoms, and foods such as spearmint(3), zinc(4) and green tea(5) should be included daily to help reduce and even reverse changes to the terminal hair follicle. Topical options do exist, and can be prescribed by your ND and compounded at a pharmacy.
If you are struggling with unwanted hair growth, note the severity, when it started and track your cycle before making an appointment with your practitioner to discuss your options.
- Kopera D, Wehr E, Obermayer-Pietsch B. Endocrinology of Hirsutism. Int J Trichology. 2010;2(1):30–5.
- Mihailidis J, Dermesropian R, Taxel P, Luthra P, Grant-Kels JM. Endocrine evaluation of hirsutism. Int J Womens Dermatol. 2017 Feb 16;3(1 Suppl):S6–10.
- Akdoğan M, Tamer MN, Cüre E, Cüre MC, Köroğlu BK, Delibaş N. Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism. Phytother Res PTR. 2007 May;21(5):444–7.
- Jamilian M, Foroozanfard F, Bahmani F, Talaee R, Monavari M, Asemi Z. Effects of Zinc Supplementation on Endocrine Outcomes in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res. 2016 Apr;170(2):271–8.
- Pazyar N, Feily A, Kazerouni A. Green tea in dermatology. Skinmed. 2012 Dec;10(6):352–5.