Hair removal in hirsutism
Patients with hirsutism can and do use physical means to remove terminal hair growth on the face, but medical assessment should be done prior to proceeding with expensive methods such as electrolysis or laser. Conditions such as hyperandrogenemia associated with congenital adrenal hyperplasia, prolactinemia or polycystic ovarian syndrome should have medical treatment instituted first to prevent further vellus to terminal transformation since both electrolysis and laser generally target only terminal hairs. Although electrolysis may initially seem more time consuming and expensive than laser, the final judgment must be determined by comparison of total treatment time, spread out over what duration of time, at what total cost and, of course, the potential for permanent versus transient hair removal. Well controlled comparative trials for the same body site in the same patient are needed to determine relative efficacy and cost of the various hair removal methods. Further information regarding the biology of hair growth as pertains to hair removal and a more detailed discussion of the various methods of hair removal will be published in an article by Elise A. Olsen in an upcoming issue of the Journal of the American Academy of Dermatology.
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