The Truth About Long Term Hair Removal Treatments for Hirsutism
Hirsutism in its mildest form may not be noticeable and therefore not a significant problem for everyone suffering from it. It can, however, cause issues regarding self-esteem, embarrassment and depression when noticeable.
Hair removal treatments such as laser hair removal and electrolysis can be very helpful in getting rid of the unwanted hair, but is it possible to rely just on these methods when treating hirsutism hair?
This article reviews what hirsutism actually is, and the results of several clinical trials comparing treatments on hirsute patients.
What is hirsutism?
Hirsutism is the appearance of hair growth in a male pattern on the female body. This is mainly caused by a hormonal imbalance due to genetics, illness or syndromes such as Polycystic Ovarian Syndrome (PCOS) or Cushing’s Syndrome.
PCOS creates a hormonal imbalance that causes an excess of androgen hormones to circulate in the body which can then cause the appearance of hair on the face, neck, chest and back.
Mild hirsutism may not be too noticeable, but moderate to severe hirsutism, with its black, coarse hair, can cause distress and severe self-esteem issues.
How can hirsutism be treated?
There are several ways that hirsutism can be treated more or less successfully, but this can only be determined on a case by case basis with a doctor.
Birth control and hormone therapy medication can help regulate hormones while a combination of permanent and/or semi permanent hair removal treatments such as electrolysis and laser hair removal treatment can help regulate the growth of excessive hair.
These treatments can be used in conjunction with a hair regrowth reduction topical cream such as Eflornithine cream (Vaniqa®).
Electrolysis is currently the only form of permanent hair removal approved by the FDA, and is also the most effective treatment for those suffering from the excess hair that comes with hirsutism. It is however an invasive procedure that is done hair by hair which makes it great for small areas such as the upper lip or chin, but not so practical for larger areas.
For larger, denser areas, it is more beneficial to opt for laser hair removal treatment as the procedure is able to attack more than one hair at a time.
Both treatments can be used with hair regrowth reduction creams such as Eflornithine cream (Vaniqa®).
While both treatments are very effective forms of semi permanent to permanent hair reduction and removal, individuals suffering from hormone imbalance induced hirsutism must keep in mind that the hair may grow back at some point in time when the medication is stopped or there is another reason for hormonal changes such as pregnancy, menopause or illness.
Results of clinical trials
Study 1 - IPL for Indian Patients with Hirsutism
New intense pulse light device with square pulse technology for hirsutism in Indian patients: a pilot study
Genetically, women of South Asian, European and Middle Eastern ancestry are more likely to show signs of hirsutism. This is the first study of the results of Intense Pulse Light (IPL) hair removal treatments on Indian women with skin tones ranging from III to V on the Fitzpatrick scale.
- 12 women were treated with an IPL device with square pulse technology
- results were measured over 6 sessions
The average satisfaction rate with the hair removal was measured at 69.6%; with 83% satisfied with the treatment, 66% demonstrating excellent results and 16% good results.
No side effects or adverse reactions were noted.
This study concludes that IPL is safe to use and effective as a hair removal device on Indian women.
Subsequent studies would need to be made to determine the longevity of removal and regrowth.
Study 2 - The Efficacy and Safety of Finasteride with IPL
A randomized double blind, vehicle controlled bilateral comparison study of the efficacy and safety of finasteride 0.5% solution in combination with intense pulsed light in the treatment of facial hirsutism
This study was created to determine the effectiveness of the use of topical finasteride cream in conjunction with IPL treatments.
Finasteride is an inhibitor aimed to inhibit conversion of testosterone to dihydrotestosterone, and therefore reduce the appearance of hirsutism.
- The study involved 77 individuas
- The study involved 77 randomized subjects
- Over 6 months either topical finasteride or a placebo was applied to both sides of the chin twice a day
- Each individual underwent IPL treatment with radiofrequency (RF) three times, at monthly intervals
- An additional treatment was administered after 6 months
After 6 months it was concluded that hair density was reduced by about 50% when the IPL treatment was used in conjunction with topical finasteride cream.
The study concludes that topical finasteride cream is effective when used in combination with IPL treatment for up to 6 months.
Study 3 - Single or Combination Laser Treatment Comparison
Comparison between sequentional treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism
This study aimed to research whether using diode and alexandrite lasers sequentionally would be more effective than using alexandrite lasers alone. Both types of lasers are safe and effective to use on dark-skinned patients (above IV on the Fitzpatrick scale).
- This study was performed on 111 women between the ages of 15 and 45.
- 57 patients were treated with 4 sessions using an alexandrite laser (two months apart)
- 54 patients were treated with two sessions using an alexandrite laser (two months apart) and two sessions using a diode laser (two months apart).
No significant differences were noted when the two lasers were combined.
Study 4 - Long-Pulsed Diode Laser vs IPL
Hair removal in hirsute women with normal testosterone levels: a randomized controlled trial of long-pulsed diode laser vs. intense pulsed light.
This study was performed on a group of women with hirsutism, all with normal testosterone levels (natural or medically normalized).
The aim of the study was to determine whether long-pulsed diode laser was more effective than IPL or vice versa.
- 31 women were treated 6 times with both laser and IPL treatments on opposite sides of the face, over a 6 month period
- Results were noted after 1 month, 3 months and 6 months
While the study noted a large decline in hair regrowth with both IPL and LPDL (77%, 53% and 40% for IPL and 68%, 60% and 34% for LDPL at 1, 3 and 6 months, respectively), after a 6 month follow up there was no real difference between the effectiveness of both treatments.
The study concluded that while both treatments are effective, in the long run the hair does return.
Study 5 - Hair Removal and Quality of Life
Unwanted facial hair removal with laser treatment improves quality of life of patients
This study aimed to determine that laser hair removal treatment can significantly improve the quality of life of people suffering from hirsutism.
- 70 patients received 3 sessions of laser treatment over 3 months
- Each participant filled out the Dermatology Life Quality Index (DLQI) questionnaire before the first treatment and after the last treatment.
The DLQI score went from 9.42 +/- 5.99 to 3.12 +/- 3.40 after laser treatment, showing that laser hair removal treatment can significantly improve the quality in life of hirsute women.
Study 6 - Treatment of Mixed Hirsutism
Mixed form of hirsutism in an adolescent female and laser therapy
Finally, the last study I looked at took one women suffering from hirsutism, oligomenorrhea, and obesity and determined that she was suffering from several conditions including PCOS.
Her other conditions were treated with medication and her hirsutism was successfully treated with laser hair removal treatments.
The results of this study aimed to prove that before hirsutism can be treated successfully the underlying conditions must be determined.
I would suggest that, as only one individual was included in this particular study it cannot be cited as scientifically proven by this case alone. However it does indicate how important it is for anyone suffering from hirsutism to seek advice from their GP initially.
What can we Conclude?
While hirsutism can be genetic, or a side effect of an illness or a syndrome, it is something that can cause degradation in the quality of life of women who suffer from it.
There are many ways to regulate and remove the growth of hirsute hair in women, such as hormone therapy, medication, semi permanent and permanent hair removal tools and growth inhibiting creams. However, it is important to detect the underlying issues that cause hirsutism before it can be treated successfully.
Clinical studies have proved the effectiveness of laser hair removal and IPL, but without follow up treatment and/or medication, the effectiveness wears off sooner or later and there is a high possibility that hair will grow back.
- New intense pulse light device with square pulse technology for hirsutism in Indian patients: a pilot study
- A randomized double blind, vehicle controlled bilateral comparison study of the efficacy and safety of finasteride 0.5% solution in combination with intense pulsed light in the treatment of facial hirsutism
- Comparison between sequentional treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism
- Hair removal in hirsute women with normal testosterone levels: a randomized controlled trial of long-pulsed diode laser vs. intense pulsed light.
- Unwanted facial hair removal with laser treatment improves quality of life of patients.
- Mixed form of hirsutism in an adolescent female and laser therapy.