There are a number of different treatments that can remove the excess hair in women with hirsutism, and help stop it coming back.
The main treatments are:
Hair removal methods
There are also several additional medicines that may be prescribed by a specialist if the above treatments haven't helped.
Hair removal methods
There are a number of ways to remove or disguise excess hair. Some can be tried at home, while more specialist treatments are carried out in clinics.
Your GP can advise you about the hair removal options available. You may need to try a number of methods to find one you prefer.
Home hair removal techniques
Home hair removal techniques are relatively inexpensive, although they need to be carried out regularly because the results are only temporary.
The main techniques are:
- shaving – quick and easy, and won't make the hair grow back quicker or thicker, but may irritate your skin and there may be unpleasant stubble growth between shaves
- bleaching – can make dark hair look better in the short term, but may irritate your skin and isn't effective if you have dark skin
- waxing, plucking or threading – can reduce regrowth if done regularly, but can be painful and may cause inflammation of the hair follicles (folliculitis) and, occasionally, scarring
- hair removal (depilatory) creams – can remove hair from large areas of skin without leaving stubble behind, but can irritate the skin and should be tested on a small area at first
- epilators (electrical hair removal devices) – can remove hair from large areas relatively easily, but can be painful and cause folliculitis
Specialist hair removal techniques
Specialist hair removal techniques may have longer-lasting results than the techniques you can try at home, although they're rarely available on the NHS and can be expensive.
The main treatments are:
- electrolysis (where electricity is used to destroy hair follicles) – can be a permanent solution, but may require several treatments; can also be painful and may cause scarring or changes to your skin colour
- laser hair removal (where powerful beams of light are used to destroy hair) – can remove hair for longer periods than home removal methods, but the results aren't permanent; side effects can include redness, darkening or lightening of the skin, and scarring
Eflornithine cream is a prescription medicine applied twice daily that can help treat excessive hair growth on the face and under the chin.
It can be prescribed for both premenopausal women and menopausal women, but isn't suitable for women who are pregnant, breastfeeding or under the age of 19.
The cream helps slow down hair growth and can be used alongside the hair removal methods mentioned above.
You should notice an effect within eight weeks. Treatment will be stopped if no benefit is seen after four months.
If eflornithine cream does work, you'll usually need to continue using it, as hair growth will return within eight weeks of stopping treatment.
Side effects of eflornithine cream can include:
- mild acne
- skin redness
- a burning or stinging sensation
- dry, itchy skin
For hirsutism affecting large areas of the body, your GP may prescribe oral contraceptives or co-cyprindiol (Dianette).
Co-cyprindiol is a type of combined contraceptive pill that can treat excess hair growth by blocking the effects of male hormones (androgens) in the body. It's only suitable for premenopausal women with hirsutism.
The pills are taken once a day in cycles lasting 21 days, followed by a seven-day break before you start the next cycle. It may take around six months to see an effect.
Once your excess hair growth has improved, you'll be advised to stop taking the pills after a further three or four months because continuous long-term treatment increases your risk of developing a blood clot.
If your hirsutism returns after you stop taking the tablets, your GP may recommend starting treatment again or changing to a different combined contraceptive pill.
Common side effects of co-cyprindiol include:
Your GP may refer you to a specialist if the treatments above aren't suitable or don't work. There are several additional medications a specialist can prescribe if necessary.
- anti-androgens (medicines that suppress androgens) – such as cyproterone acetate and spironolactone
- finasteride – a type of medication that works by preventing testosterone (an androgen) from turning into a stronger form of testosterone inside your body's cells
- insulin-sensitising medication (medicines that make your body more sensitive to insulin) – metformin and pioglitazone
- gonadotrophin-releasing hormone (GnRH) analogues (man-made hormones) – such as goserelin and leuprorelin
Many of these medicines are unlicensed for the treatment of hirsutism.
This means they haven't undergone clinical trials for this use, but your doctor believes they're likely to be effective. They will discuss the possible benefits and risks with you.