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.
Hi I was told I had pcos in the past however I have recently been to dr and had tests done that claim I don’t show signs of pcos but I have high testosterone and SHBG levels,
My hair growth is horrendous I will pluck or shave in morning and have course black hairs by the afternoon I’m worried about spending so much $$ on IPL treatments etc I’m looking into finding a at home laser removal but hard to know what ones are going to work or not. I’m so tired of being told there’s nothin I can do about it without spending thousands on clinics for a treatment that could potentionally not work for me, my self esteem is at an all time low there must be an easier less expensive way out their somewhere right?
Sorry to hear about this, Sarah.
Home laser hair removal machines vary in their effectiveness. For some people they work really well, others are non-responsive and many are somewhere in-between. (More information here:- http://hairfreelife.com/truth-home-laser-ipl-hair-removal-kits/)
If you have dark hair and fairly light colored skin, then it might be worth giving it a try.
I would recommend the Tria 4x if the area affected is quite small, however if you need to cover large areas of your skin then you’ll need a device with a larger head size – perhaps the Boots SmoothSkin or Silk’n SensEpil. More information here:- http://hairfreelife.com/the-best-home-laser-hair-removal-device-round-up-review/
If the area where you’re experienced growth is quite small then electrolysis might also be worth considering. This is the only method of permanent hair removal currently available (laser is marketed as permanent hair reduction, not removal) but the process is usually quite costly, can’t be done at home, and involves removing hairs on a one by one basis. More information here:- http://hairfreelife.com/electrolysis-facts-misconceptions/
Have you done research regarding increase or darkening of facial hair after laser or ipl treatments.
This seems to be happening and its scary.
Sorry to hear that you’re experiencing this.
We have an article that looks at three scientific studies pertaining to hypertrichosis (paradoxical laser hair removal that stimulates hair growth) here:- https://hairfreelife.com/can-laser-hair-removal-stimulate-hair-growth/
According to the research, It is actually possible, but tends to only occur in a minority of cases.
I am 4 treatments into IPL therapy (2 week intervals until now) using a cheaper Sanitas model bought from Lidl in the UK.
So far, the most notable difference has been in areas where I’ve never waxed/plucked – bikini line, armpits, and upper lip.
Other areas (legs which I’ve epilated in the past, albeit a few years ago, and neck/chin which I plucked daily) have yet to show any major difference.
However, one HUGE benefit (slightly outweighed by the fact that I can now only shave – no more waxing/plucking/epilating between IPL sessions) is that my skin has really improved on my neck, chin, and jawline. Where I was plucking every day (throughout the day, and would still have new prickly hairs by evening time) my skin had become quite scarred and ingrown hairs were a bit of an issue. Now, even though shaving means regrowth in these areas is prickly by the afternoon (so if I’m going out in the evening I shave twice a day), my skin overall looks so much better. Obviously, if IPL doesn’t work long term, I’ll probably go back to plucking, but I’m definitely going to give IPL a good go first, as it’s done a world of good so far. My device recommends 2 years total treatment time to ensure all hair follicles are treated. This seems like ages, but I think it’s worth it if it works as I can do the treatments at home in my own time, it’s painless (only mild heat occasionally, and unlike waxing there’s no horrible hairy period because you have to shave before treatment.