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Hair: Too Much in All the Wrong Places, Too Little Where it Counts

Dr. Alyssa Dweck

Written by Dr. Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer

Dr. Alyssa Dweck

Written by Dr. Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer

If you’re like most women, you’ve probably had this unsettling experience at least once…You look in the mirror to put makeup on or apply face cream and yikes, you find coarse dark hair on your chin or more than just peach fuzz on your upper lip.   When it comes to facial hair and women, more is definitely not better!

So what causes excess facial hair in women?

Hirsuitism, or excess hair growth, can be as simple and harmless as a familial trait. Greek and Italian women, for example, will often note a familiar hair pattern passed down from generations of women in their families. In these instances, hair growth is not sudden in onset or rapid in growth but slow and stable throughout the years after puberty.

In other instances, over the counter supplements or medications might be to blame. Testosterone and other androgenic hormones can lead to unwanted hair growth, especially on the face and even the chest. Severity is dose dependent and usually reversible upon discontinuing the medication or supplement.

Some women actually suffer with distressing and unwanted hair growth due to a hormonal imbalance. Polycystic ovarian syndrome (PCOS) occurs when ovulation is limited or absent resulting in elevated testosterone levels, and you guessed it, unwanted hair growth. Facial hair, acne, irregular or abnormal menstrual habits and difficulty losing or maintaining weight are common symptoms of PCOS.

Less frequently, the adrenal glands (small glands that sit on top of the kidneys and regulate stress hormone levels) can secrete an abnormal amount of another male hormone called DHEAs, resulting in excess hair growth.  

Finally, and very commonly, women may experience facial hair growth during and after the menopausal transition. Yes, you can blame hormone imbalance for this too.

Needless to say, these symptoms can be distressing.  Thankfully, treatments are available; including cosmetic options (waxing, shaving, electrolysis or laser, depilatories), prescription medications aimed at the hair follicle, like VaniqaTM topical cream, or medications targeting hormone imbalance, including the birth control pill and spironolactone.

While a stray hair worthy of plucking is super annoying, it’s typically not dangerous. Rapid and excessive facial hair growth, on the other hand, warrants a quick trip to the gyno, dermatologist or endocrine specialist.

What about thinning or hair loss?

As if facial hair growth isn’t enough to deal with, women often report concerns about hair loss on their heads, so notable that it clogs the shower drain or comes out in clumps with combing.  Thinning, lackluster hair, and even bald spots can be super distressing.

Again, in certain instances, blame your genes! Some women will experience hair loss due to genetic propensity. It should come as no surprise that hormone changes during lactation, peri-menopause and menopause can cause hair changes including loss, as well. Once again, blame your hormones!  

Unfortunately, hormone replacement therapy is not indicated for your hair woes, although some women anecdotally report improvement. Poor diet devoid of adequate protein and nutritional deficiencies including anemia (low iron and iron stores) are at times the culprit to your bad hair day; dietary manipulation and supplementation can help. 

The thyroid gland is a small gland in the neck that regulates overall metabolism. Abnormal thyroid function effects hair and nails and can be diagnosed through blood testing and treated with medication.  

Medications including chemotherapy can cause hair loss; hair re-growth usually occurs when these meds are discontinued. 

Believe it or not, your tight ponytail might also be to blame for hair loss drama!  Loosen up that scrunchie to optimize hair growth.  

Fortunately, there is a lot of clinical research happening in the area of hair preservation and regrowth, so hopefully in-time, science will deliver even more options for women

Have a great “hair” day. 

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