Tope is a beautiful woman in her early 40s, everything about her seems to be fine except she has to shave her chin every other day. She first noticed the chin hairs in her early 30s. They appear to be growing more and covering a wider surface area and appear worse when she is going through tough times. She has plucked the hair a couple of occasions using tweezers, this tends to keep her chin hair free for about 2 to 3 weeks, but one time she was in a hurry to tweeze so she didn’t cleanse skin first, so she developed lots of bumps and vowed never to tweeze again. Her friend recommended threading, painful though but the smooth chin lasted 2 to 3 weeks too.
Then one day her friend asked if she was feigning a deeper voice or if her voice was indeed deepening. These symptoms went on for some time. She eventually decided to see a doctor when her period became irregular, almost absent and she wondered if she had become menopausal before 45 years old. The pregnancy test was negative; comprehensive medical history revealed her mom and grandmom had facial hairs too. Physical examination showed an overweight young lady whose side and front hair on the head are rapidly receding, with under chin shaving stubbles. She was also wider around the shoulders compared to the hips like that of a man (she had all her children via Caesarean Section). She wears a size 20 shirt on a size 16 pair of trousers. She also has hairs on her abdomen, but her armpit and pubic region are sparsely populated. Laboratory tests showed she had a slight hormone imbalance, moderately high fasting blood sugar and moderately high blood pressure.
Her doctor recommended a lifestyle modification – she has to exercise 60 minutes a day, six days a week or take 10,000 steps a day which she will monitor using a pedometer. She had a 3-week meal plan, this comprised of small frequent meals each day and some dietary supplements. She was also taught deep breathing exercises by her physiotherapist to aid sleep and stress management.
On her next appointment six weeks later, she had lost more than 5 kg, her blood sugar was within normal range, and her chin hairs had reduced in appearance. And her energy levels soared. She is to continue current management, see her doctor every three months or as the need arises. By the 6th month her period had regularized, so she wasn’t menopausal in her 40s, thankfully.
Why do women have facial hairs?
Did you know all women have hair on their faces and almost everywhere on the body, except on the nails and eyeballs? But this facial hair is usually very light in texture and often not visible. In some cases, women may have excessive facial and body hair; this condition is known as hirsutism. The difference between normal and excessive facial hair is in the dissimilarity in texture. The normal facial hair is called fuzz or peach. This excessive facial hair is similar to the hair you find on a man’s face. On its own, this condition is not dangerous to the woman’s health in any way but in some cases, it may by a symptom of certain health conditions. The commonest cause of hirsutism is hormone imbalance. Did you know women produce a little male sex hormone and men also produce a small female sex hormone estrogen? When these hormones are produced in excess, they cause problems which range from female facial hairs, dude boobs in males to infertility.
Stress and sex hormones are produced from the cholesterol pathway in the human body. Therefore excessive fat and stress would affect the sex hormone production. Sometimes when a woman is stressed over an extended period of time, her period may be delayed, she may notice a few strands of hair on her chin or if she had some hairs already, more will appear.
Thus for some women, just exercising and eating healthy may cause the hairs to fall off and not grow again, or regrow when she goes back to her unhealthy lifestyle. There are also some simple, useful home remedies and dietary supplements that are helpful.
Unfortunately, there are some cases where your doctor will have to take a detailed medical history, examine you, send for some lab tests before a proper diagnosis can be made. The good thing is, lifestyle modifications works in almost all the cases. Apart from hirsutism, additional symptoms may include – deepening voice, oily face, acne, irregular or no periods.
What causes excessive facial hair in women?
- High level of androgen (testosterone)
Excessive facial hair is usually caused by excessive male hormones –testosterone/androgens in the female body. Every female body produces androgen (5-10% of androgen levels produced by men) at low levels. In the female body, testosterone levels may rise at puberty and during menopause.
In men, androgens help in the development of the reproductive system. It is responsible for sperm production and also helps in the deepening of a man’s voice. In women, testosterone can be linked to the sex drive. The male testicles primarily secrete this hormone. In women, the testosterone is secreted by the adrenal glands and the ovaries.
- Polycystic ovary syndrome (PCOS)
Polycystic ovaries are ovaries with a lot of cysts formed from by a large number of harmless follicles. These follicles are under-developed sacs in which the female eggs develop. In PCOS, these sacs are often unable to release an egg, which means that ovulation doesn’t take place.
The cause of PCOS is not known, but it may due to genetics, related to high blood sugar, thus the detailed medical history in a bid to find causes of hirsutism. PCOS may be related to abnormal hormone levels in the body, including high levels of insulin.
- Excessive production of stress hormones
Extreme pressure, causes the adrenal glands to become overactive, pumping out stress hormones and androgens in greater quantities. Any condition that causes increased production of androgens or stress hormones in women leads to the formation of facial and body hairs.
- Minoxidil medication
Some medications like minoxidil, which is prescribed for high blood pressure, can cause male pattern facial hairs in females.
Treatment of excessive facial hair in women
There is an available medical care for excessive facial hair whether or not it resulted from a severe disorder. Treatment usually involves removing the excess hair, slowing down its growth or stopping it from coming back. The main treatments are:
- Temporary or permanent hair removing techniques
- Eflornithine cream – a prescription cream that can help slow down the growth of facial hair
- Drug therapy
Some anti-androgen medications and contraceptive pills can normalize your hormone levels. Use of such medication provides you with a long-term solution for excessive facial hair. Six months after you start taking the prescribed contraceptive or anti-androgen medication, you will begin to observe improvements.
Some of these medications work by blocking the effect testosterone has on the hair follicle. An example of such a drug is Aldactone, and when this drug is taken in its required dosage, it can effectively treat excessive facial hair in women. This medication was traditionally used for the treatment of high blood pressure. Spironolactone, as it is commonly called is now used even more for the treatment of excessive facial hair in women than high blood pressure. The disadvantage of this drug is that it can cause dehydration.
Prevention of excessive facial hair in women
There are no known medical ways to prevent excessive facial hair in women. However, doctors recommend that women who are overweight or that have polycystic ovary syndrome should try and control their weight as obesity can influence the production of hormones in the female body. Maintaining healthy weight can correct the level of androgens in the body and reduce the chances of getting excessive facial hair.