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Doctors' Answers to "Frequently Asked Questions" - Hair Growth

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Aldactone & Hair  Growth [posted 11/25/98]
Question: I am a 31 year old healthy, active and slightly overweight female and have been on oral contraceptives for several years (Loovral) I have small amounts of facial hair and dark body hair - it seems to be a family trait as my 2 sisters and mother have similar problems. I have been checked for hormonal imbalances and diabetes and there was no cause found for the hair growth. My doctor says that this is not abnormal - that a lot of similar hair growth occurs with for no diagnosable problem other than heredity. It isn't a major problem just annoying. She prescribed 50mg of Aldactone daily to try to reverse the effects of the hair growth. I only took the Aldactone for 1 month and my husband and I decided that we are ready to start planning for children. The doctor says that I be off of birth control and Aldactone for 3 months before we can try to get pregnant. All of the information I have found stated that there has not been adequate testing of the affects of Aldactone on pregnancy. How long does Aldactone stay in your system and what are the possible complications if I were to get pregnant before the 3 months is over? What effect can birth control pills have in this equation? I have discontinued taking both prescriptions (about 1 month ago) and am taking prenatal vitamins (for 2 months).

Answer: The reason to use Aldactone is the estrogen like effect that it produces (blocking facial hair growth). However, there is no reason to assume that high levels of estrogen would do anything to a pregnancy. Most patients are counseled to start to get pregnant as soon as you are off the birth control. It should not last in your system more than a week or two and I'm not sure what his/her goal is in the waiting period.

Sudden Onset of Pubic Hair Growth [posted 11/19/98]
Question:  My wife is 38 years old. During the last 5 years her pubic hair has extended to her inner thighs. It is now about 1.5" into her thighs and as thick as her regular pubic hair. She has no other medical conditions, has never had children and is not taking any medication or contraceptives. What could be the reason for this growth?

Answer: Two possibilities, first familial-so if the same thing happened to her mother probably no big deal. Secondly, overproduction of testerone. This is seen in several medical syndromes and needs to be evaluated. Treatment commonly is spironolactone to reduce/eliminate the hair propagation.

Body Hair [posted 7/17/98]
Question: Since the birth of my 4 1/2 month old, I have noticed more body hair. I am breastfeeding my son. Can you give me some information on why I would be having more body hair now.

Answer: Have you noticed that you have more or less? Either could be the case if there is an endocrine disturbance post delivery. If you can breast feed, it would argue against anything important, but will need a full endocrine evaluation.

Hair Density
Question: Does shaving affect the actual thinkness of facial hair?

Answer: Shaving has no effect on hair density. If it did bald men would shave hourly. Hair depends on your genetic heritage and the sex steroids present in your system. Neither the amount or type of shaving will have any effect on the amount of hair present. Different methods of hair removal focus on pulling the hair out by the root(waxing, tweezing etc.) or damage to the hair root(electrolysis, lazer treatment etc.).

Facial Hair growth in women
Question: I am a 21 year old healthy female. I have been noticing numerous amount of hair growth on my whole face, surrounded by the mouth and my cheeks area. Is there any resolution you think I can do to control this hair growth?

Answer: There are two types of facial hair syndromes with women. First are endocrine disorders. These usually are marked by irregular or missing periods, weight gain and masculine changes(deeper voice, change of pubic hair distribution, bigger muscles, etc.) Secondly, are familial hair problems(your mother, sister, grandmother had similar hair distribution). Initial treatment is usually a drug called spironolactone assuming the endocrine evaluation is normal. There are new ruby laser treatments being used by plastic surgeons which will completely ablate the hairs-it is expensive but works and is permanent.

Hair transplants
Question: I am a female and was burned when I was 6 months old on the right side, top part of my head. No hair has ever grown here. Is there a hair transplant that would be of use to me? I'm 42 now and the bald spot is the size of a 50 cent piece.

Answer: I'd discuss this with a plastic surgeon. For a small area, depending on the location, excision might work. Transplantation of hair plugs is also effective if excision is not an option. This should be fairly easily fixed depending on the size and location of the denuded area.

Rate of hair growth
Question: I am of African decent, and the growth rate of my hair compared to others is very slow, I've been growing my hair for a year now, and people whom I started before now have longer hair than I do. Is there something I can do to enhance the growth rate of my hair?

Answer: Hair and nail growth is very individual. However, a low thyroid can occasionally cause slow growth. Get this checked out. If this is normal I wouldn't be too concerned.

Facial Hair Growth
Question: I am a 26 years old male. I don't have much hair in my face and chest although I am very hairy in the other parts of my body. All my family's males are very hairy. I visited an endocrinologist and he found my testosterone level to be normal. He said giving me testosterone has a lot of side effects, such as breast enlargement and shrinkage of testicles. The problem is not that I don't have hair at all, but they are very very tiny hair pieces that have not increased by shaving.

Answer: The amount and distribution of ones hair growth is mainly dictated by your parents. In particular by your father and your mother's father. Facial hair is very similar to hair in other parts of the body. There doen't seem to be any way to induce hair growth which will last. Use of rogaine on the face should work, but must be performed every day or the effect will begin to vanish.

Fastin & Hair Growth
Question: I have experienced hair thinning/loss for the past 7 years. I am now 29. I noticed the thinning after a 3 month period of taking Fastin for weight reduction. Recently I was prescribed prednisone for an allergic reaction to an unknown source. Something I noticed immediately was growth of my frontal hairline. I also took tagamet and atarax during the 2 week period of the allergic reaction. Could one or a combination of these drugs be causing my hair growth? Would it be sensible to request my physician to continue this treatment to regrow my hair?

Answer: The only drug the potentially would have an effect is the Prednisone. This can cause hair growth when the loss is due to inflammation(not the typical male type balding). The other medications would have no effect. A better question is what caused the loss of hair. There is a fairly significant work up including biopsy which will be necessary to answer this question.

Female Facial Hair
Question: I am a 34 year old female, healthy as far as I know. I have one problem, hair. I have begun to get dark whisker-like hairs growing from my chin and neck. This is very embarrassing, and I don't know why it has started, any help for me?

Answer: There are two types of facial hair in women. The first is associated with masculinizing tumors and there is usually a change in pelvic hair, chest hair etc. in a male pattern. Women's pelvic hair usually doesn't go the umbilicus(belly button) men's usually does. Secondly, if women in your family have this problem you probably are cursed with it. There are two options. First, treatment with spirolactone(usually a mild diuretic) will usually result in a decrease in hair. Secondly, laser treatment with a ruby laser will permanently remove the hair. This usually takes 2-3 sessions and unfortunately is not usually covered by insurance. The cost varies with the area;but, is $2-3000 in most plastic surgeon or dermatologists offices.
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