Facial hair: family trait or enocrine imbalance?



DEAR DR. DONOHUE: My daughter, 22, has a mustache and whiskers on her chin. She tells me she has hair around her nipples, too. She is upset about this. What’s the cause, and what can be done for her? – C.P.

ANSWER: Lots of women have hair in places that are common to male hair growth – the upper lip, the face, the chin, the breasts, the upper and lower back, the upper arms and the upper legs. This might be only a family trait, or it might be due to an overproduction of male hormones or an unusual sensitivity to the action of male hormones. Women do make these hormones normally (and men make female hormones). The ovaries and the adrenal glands are the sites of male hormone production in women.

High on the list of causes for increased male hormone production by women is polycystic ovary syndrome. Its signs are: large ovaries studded with cysts, male pattern hair growth, diminution or cessation of menstrual periods, obesity, infertility and abnormal blood sugar. Women do not have to have all those signs to qualify as having the syndrome. The visible manifestations might be quite unimpressive. But all women with the syndrome have a high blood level of testosterone and a high level of FSH, a hormone that stimulates the ovaries to produce testosterone.

Many medicines are used for polycystic ovary syndrome. Birth-control pills restore normal female hormone status. The water pill spironolactone blocks the action of testosterone.

Your daughter should see a gynecologist who can check her hormone levels and guide her in the choice of treatments if her levels are abnormal. Polycystic ovary syndrome is only one cause of hormone imbalance.

If her hormones are normal, then she has many options for hair removal. Vaniqa cream is one. Bleaching the hair and chemical hair removers are two others. Electrolysis and laser treatments, depending of the extent of hair growth, are also possible choices.

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