Excess Facial Hair in Women: A Cosmetic Problem or Something More?

Melanie Kingsley, MD, a dermatologist at Indiana University Health, explains what can trigger facial hair growth and the best ways to remove it.

In many cases, excess facial hair is simply a normal part of aging for women. “Your estrogen level starts to decline, which alters the balance of estrogen and testosterone in your body,” Dr. Kingsley explains. “As a result, you end up with relatively more testosterone, which can cause facial hair growth.”

But if your facial hair is so coarse and dark that it almost looks like you have a beard or mustache, you may have hirsutism, a condition that affects 5 percent of women in the U.S. “Women with hirsutism experience excessive hair growth in places where men normally have it, such as the face, stomach, back, and chest,” Dr. Kingsley says. “The hair often appears suddenly, which helps distinguish it from the gradual growth you see as you age.”

Hirsutism can be genetic, and it can also be a side effect of some medications such as testosterone, anabolic steroids, and cyclosporine. But in some cases it may indicate an underlying condition, so it’s important to see your doctor to get evaluated. Hirsutism is often seen in women with polycystic ovarian syndrome and adrenal gland disorders such as Cushing’s syndrome.

The good news is that no matter what’s causing your excessive facial hair, there are a variety of ways to remove it. Here, Dr. Kinglsey discusses the pros and cons of each.

Waxing kits and depilatories. You can find several affordable options at your local pharmacy that are specifically designed for facial hair, or you can get waxed at a spa. The downside is that this is a fairly high-maintenance option. “You also can’t use retinoids if you wax or apply depilatories because you can burn your skin,” Dr. Kingsley says.

Dermaplaning. This procedure, in which your dermatologist or aesthetician uses the edge of a scalpel to exfoliate your skin, also removes peach fuzz. It sounds a little scary, but it’s actually painless and you only have to do it once a month. Dermaplaning is not unlike shaving, but don’t be tempted to do this at home with a razor. “Shaving isn’t a good idea, especially for those with hirsutism, because you’ll end up with stubble as the hair grows back,” Dr. Kingsley explains.

Vaniqa. This prescription cream slows the growth of unwanted facial hair and can be used in conjunction with other forms of hair removal. Just be aware that you have to use it diligently to see results, says Dr. Kingsley: “Vaniqa is very effective, but you have to apply it twice a day every day or the hair grows back. It’s a commitment.”

Electrolysis. Though electrolysis has become less popular since the development of laser hair removal, it may be the better choice for some women. “Electrolysis is preferred for women with gray, white, blonde, or red hair—shades that don’t respond well to lasers,” Dr. Kingsley says. Unfortunately, it’s a lot more time-consuming because your doctor has to insert a very fine probe into every hair follicle to destroy the root with an electronic current. It can be more painful than laser hair removal (your face has to be numbed), and you may need anywhere from 15 to 30 treatments to get the results you’re looking for. On the plus side, the effects are more permanent. “No technique is 100 percent, but electrolysis gives the longest-lasting results,” Dr. Kinglsey says.

Laser hair removal. Those with dark hair may opt for laser hair removal, which has the added benefits of less pain, fewer treatments (typically 4 to 8, plus some touch-ups), and shorter sessions. Women with dark skin should take extra care, however, since laser hair removal can cause hyperpigmentation. “Make sure your provider is using a laser with a wavelength that’s meant for darker skin,” Dr. Kingsley says. It’s best to have both laser hair removal and electrolysis performed by a dermatologist to avoid risks such as pigment changes and scarring.

-- By Jessica Brown


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