Concerned about trying to grow hair? Well, far more people are concerned about removing unwanted hair growth! The medical term for excessive hair growth is hirsutism. The appropriate choice for hair removal is going to depend upon several factors ranging from how much hair is present; where the unwanted hair is, as well as obvious financial considerations. If you are a male with hair covering your chest and back vs. a woman with some hair on your upper lip, your choice of treatments will likely vary.

While many patients presume they have a hormonal imbalance that leads to their excessive hair growth, this is not typically true. Often heredity or a natural increased sensitivity to normal hormonal levels of testosterone are to blame. Certainly some patients do indeed have a hormonal imbalance, often due to polycystic ovary disease and screening may be performed. A few rare skin diseases are also associated with hirsutism such as porphyria cutanea tarda (PCT).

CHEMICALS CAN BE A GIRL'S BEST FRIEND

One easy method to try to remove hair growth above the lip is to use an OTC depilatory such as Nair or Neet. Chemical depilatories are very popular and usually quite easy to use. However, they are made for tougher areas of the body such as the legs. So it is VERY IMPORTANT that you perform a test spot according to the package directions particularly if you plan to use one on your unwanted facial hair. Depilatories dissolve the hair and you must rinse the product off either at the recommended time or if you are feeling stinging or burning.

Do you find that chemical depilatories work well for a while, but that eventually you are experiencing increasing irritation? Mild topical steroid creams like Cortaid 1% Hydrocortisone Anti-Itch Cream applied prior to using the depilatory can help alleviate this problem at least for a time. You can get a prescription from your doctor for appropriate low dose prescription strength steroid creams, too. Once you find that there is simply too much irritation from this method of hair removal, it's time to consider other options. If you have a darker skin tone, remember that irritation may cause unwanted skin discoloration that is equally undesirable on the face. Pay attention to what your skin is telling you.

BLEACHING

Several bleaches are out there on the market for use on unwanted facial hair. I tried several during college. The major problem with bleaching outside of the irritation: women with hair above the upper lip may find that they don't end up with an invisible moustache, they instead end up with a heavy blonde moustache that looks more abnormal than what they began with! If this is happening to you, take my word; this is highly noticeable. Find a reliable method for removing the hair instead.

WAXING AND WANING

Waxing is great for removing hair particularly if you are looking for results that can last for a few weeks. There is most definitely an art to waxing that leads many women to see their esthetician. Now there is an easy and safe method for home waxing called Poetic Waxing Kit. It is very important that you use the pre-waxing cleanser and lotion before waxing and then reapply the lotion after waxing. Waxing can allow you to treat either widespread areas like the legs or torso or you can treat very small well-defined spots such as the brows or above the upper lip. This will help prevent the formation of hair bumps, folliculitis and tearing of the skin.

Dermatologists often recommend avoiding waxing because of the low risk of developing problems like folliculitis, ingrown hairs or burning the skin from overly hot wax. Because of this I was a waxing virgin, having never tried waxing. But I am continually asked about waxing and decided it was time to look into what was the best way to wax and which product I was most comfortable recommending. So braving the unknown, I was confronted with a variety of waxing agents. I am happy to comfortably recommend Poetic Waxing Kit that seems to be very easy and effective. As always, follow the directions! There IS a method to the madness.

A warning to Accutane patients: AVOID waxing with any product while on Accutane and for 30 days after coming off the medication. Accutane can make your skin much more fragile and lead to tearing of the skin when removing a wax. I am often asked about if it is safe to use topical vitamin A products such as Retin A and waxing. While there is certainly a cross over theory that topical vitamin A products could cause similar concerns as Accutane, I have not personally had any patients have this problem. Obviously, if you are using a topical vitamin A product, be more observant about this issue.

SHAVE IT ALL OFF

Simply shaving it off with a "Daisy" razor every morning takes just a few seconds, but I find a lot of resistance to this procedure from women. I think there is something psychological about having to resort to something historically considered a "male" method of hair removal. However, you won't grow a masculine moustache (it is physiologically impossible) and while you may have to shave daily, it is quick and easy.

POP A PILL

Sometimes that hair growth just doesn't want to respond to routine forms of removal or you may have a hormonal imbalance due to conditions like Poly Cystic Ovary Disease. There are prescription pills that help diminish hair growth such as Spironolactone and Tagamet. I have found that Spironolactone, a diuretic, has thrown off enough of my patient's menstrual cycles or made them light headed enough that they don't often care for this medicine. But it is effective and can help cut down on acne due to excessive testosterone levels as well. Tagamet, a drug used for ulcers, also helps cut down on hair growth. Both are prescription drugs and you need to discuss these options with your dermatologist. Neither medication makes the hair fall out, so you do have to remove the hair until you start to see results.

LASERS

If you have dark hair and light skin, you are the ideal candidate for hair laser treatment. Otherwise, it's likely that you're not. One way to try to circumvent this is to ask the laser surgeon if they use Meladine All Natural Melanin Enhancer, a temporary hair dye that helps improve laser results by up to 90%. Meladine is applied to blonde, gray or light hair and darkens it so that the laser works more effectively. Let me start out by saying that I do not personally do laser hair removal, so I am not an authority on this procedure. I am only going to give you some highlights here about the process. There are several lasers marketed to physicians for this process. It has become a competitive field for laser manufacturers. After attending a meeting that reviewed many of the lasers, it was my impression that while some machines might have certain benefits, I think that an experienced laser operator is your best bet at getting a good result. The process of laser hair removal usually requires approximately 3 initial treatments.

Marketed as painless, laser hair removal is painful enough that the use of topical anesthetics like EMLA and at times some oral sedation are used. Although laser hair removal is not considered permanent, it does cut down on the amount of overall hair growth and much of the future hair growth is a finer texture and lighter color, which is appreciated by the patient. Maintenance is usually required to keep the hair under control. Another benefit of laser is that any area can be treated, such as the bikini area, chest, back, shoulders, etc.

Laser therapy certainly isn't cheap. I have heard quotes in the Kansas City area of $1500.00 for the initial 3 treatments. I would presume it might be higher elsewhere in the country as cosmetic procedures are typically less costly in the Midwest.

THINGS THAT GO BUMP IN THE NIGHT

Are you prone to hair bumps, bikini bumps, folliculitis, ingrown hairs, no matter what you do? Try products such as Neova After Shave Therapy after shaving or hair removal. The copper peptides are very healing and soothing.

If you're shaving, and prone to folliculitis or acne, the use of Whish Shave Crave - Lemongrass with Whish Original Body Brush to help reduce the amount of ingrown hairs. Follow this up with Neova After Shave Therapy or Whish Flawless Ingrown Hair Serum. If you are using Whish Flawless Ingrown Hair Serum, that's great, but I would not apply it immediately after shaving, it may cause some unpleasant stinging.

If you develop an ingrown hair, GENTLY extract the hair from the follicle and allow it to straighten out. You can use Rubis Swiss Cross Slant Tweezer to help with this. Do NOT go forcefully yanking it out, all you will end up with is more inflammation down in the hair bulb and perhaps some remnant broken hair as well.

Should you find you have folliculitis despite your best efforts, B. Kamins Medicated Acne Gel with 10% Benzoyl Peroxide can help treat this quite effectively. The use of prescription Azelex is also helpful and a good reliable topical agent for anyone with chronic issues. Rarely do I find the need to have to prescribe an oral antibiotic for a raging case of folliculitis due to hair removal.

MAKE UNWANTED HAIR "VANIQA"

A new prescription drug called Vaniqa helps prevent hair growth in the first place. It's FDA approved for unwanted facial hair in women. Vaniqa takes a good 8 weeks to work. That's the time frame it takes all of the hair follicles to rotate through their growth cycle. Remember, Vaniqa stops unwanted hair growth, it does not remove the hair that is present. You still need to perform your favorite method of hair removal during this time frame. Eventually you will notice that you need to remove hair less frequently until the hair growth has stopped completely. If you stop your Vaniqa, the hair will start regrowing in about 8 weeks. While it's only meant to be used for areas on the face, I have no doubt that it will find its way into "off label" uses on other areas of the body.

Smooth skin is always in and so is your dermatologist! If you are experiencing problems with excessive hair growth, you shouldn't hesitate to discuss this with your physician. There are definitely steps you can take to improve the situation.

Thank you for taking the time to read my newsletter. I hope you have found it informative.

Audrey Kunin, M.D.

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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