Excess Hair Growth on Face: Hirsutism and PCOS

PCOS is a common endocrine disorder that impacts 1 in 10 people assigned female at birth. There are various symptoms and signs of PCOS, one of which is hirsutism, particularly on the face.

What is hirsutism?

Hirsutism is defined as the presence of terminal hair (i.e. longer, thicker, and darker hair that grows on the head) on areas of the body like the face, chest, back and stomach in people assigned female at birth. Excess hair growth in PCOS is a common feature.

What causes excess hair growth in PCOS?

The prevalence of hirsutism in PCOS ranges from 70 to 80%. In comparison to the range of 4% to 11% in people assigned female at birth in the general population.

In people with PCOS, androgen levels (hormones like testosterone) are higher than in the general population. This is likely because levels of insulin are higher in people with PCOS. High circulating insulin levels contribute to ovarian testosterone production. Testosterone switches on hair growth in some areas of the body, primarily the face, tummy and legs.

How can excess hair on the face be treated or managed in people with PCOS?

PCOS facial hair treatment can range from medication to hair removal techniques.

Medication for PCOS facial hair

Hormonal birth control, specifically the combined contraceptive pill, is a recommended treatment for PCOS. The combined contraceptive pill contains oestrogen and progesterone. The mini-pill is not a suitable treatment for hirsutism. The oestrogen in the pill slows the production of testosterone in the ovaries. Blood testosterone levels can drop by half, as the adrenal gland still makes testosterone.

Anti-androgens are a form of medication that can help with hirsutism and alopecia in people with PCOS. There are two types of anti-androgens: testosterone receptor blockers and conversion blockers.

Speak to your healthcare professional, doctor or endocrinologist if you’re interested in taking medication for PCOS facial hair.

Cosmetic hair removal for PCOS facial hair

One PCOS facial hair treatment for hair on the face and chin includes cosmetic hair removal. This may include IPL (intense pulsed light) treatment which can be done at home. It can be an effective treatment for removing hair from the face of people with PCOS and hirsutism. But, it is important to note that for people with PCOS, hair is much more likely to grow back, and a lot more IPL sessions are needed.

Supplements for PCOS facial hair

Inositol, an insulin sensitiser, could be a helpful supplement for facial hair in people with PCOS. Inositol may help with insulin resistance, which in turn lowers testosterone levels in the body. Lower testosterone levels may result in a reduced incidence of hirsutism and other hyperandrogenism symptoms like acne, oily skin and hair loss.

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