If you have noticed more facial hair lately, it is worth finding out why before you focus on removing it, especially if the change was sudden or came with other symptoms. A few extra chin or upper-lip hairs are often harmless and linked to normal hormone shifts or family traits. But new growth can also come from conditions such as polycystic ovary syndrome (PCOS) or from certain medicines, and removing the hair does nothing to treat the cause.
The good news is that you do not have to choose between the two. Getting the cause checked and managing the hair can go together.
Common reasons facial hair increases
Facial hair responds to androgens, a group of hormones that everyone makes in different amounts. When androgen levels rise, or hair follicles become more sensitive to them, soft light hairs can turn coarse and dark. Doctors call this pattern in women "hirsutism." A different pattern, extra hair that is not tied to hormones and often appears in other places too, is called hypertrichosis.
Common reasons for more facial hair include:
- Normal life stages. Puberty, pregnancy and the years around menopause all shift hormone balance. Some women notice a few coarse chin hairs in midlife for this reason.
- Family background. According to MedlinePlus, from the National Library of Medicine, excess hair growth often runs in families. How much facial hair is typical also varies from family to family.
- Polycystic ovary syndrome (PCOS). MedlinePlus lists PCOS as a common cause of unwanted hair in women. It can also come with acne, irregular periods and trouble losing weight.
- Medicines. MedlinePlus lists several medicines that can increase hair growth, including testosterone, anabolic steroids, DHEA, glucocorticoids (steroid medicines), cyclosporine, minoxidil and phenytoin. If you think a medicine is involved, talk with the doctor who prescribed it. Do not stop it on your own.
- Less common conditions. These include thyroid disorders, Cushing syndrome and congenital adrenal hyperplasia. Rarely, a growth on an ovary or adrenal gland that makes hormones is the cause. These are uncommon, which is why a doctor looks at the whole picture rather than the hair alone.
Signs that call for a medical evaluation, not hair removal alone
Hair removal handles what you can see. These signs suggest it is time to also look at what is happening underneath. MedlinePlus advises contacting a health care provider when hair grows rapidly, when other male-pattern traits appear, or when you are concerned a medicine is causing it.
Book an evaluation promptly if:
- The hair is growing quickly, or the change happened over a few months rather than years.
- You also notice acne, a deeper voice, more muscle mass, thinning scalp hair in a male pattern, an enlarging clitoris or smaller breasts.
- Your periods have become irregular or stopped, and you are not pregnant.
- You recently started a new medicine or supplement.
- You see darker, velvety skin in body folds such as the neck or underarms.
- A child develops new facial or body hair or other early signs of puberty. A child's pediatrician should hear about this too.
None of these signs means you have a specific condition. They simply mean the hair is worth talking about with a doctor before you treat it as a cosmetic issue.
How a dermatologist evaluates hair disorders
Dermatologists diagnose and treat conditions of the skin, hair and nails, and unwanted hair growth falls within that. A visit usually starts with questions:
- When did you first notice the change, and how fast is it happening?
- Which areas are involved: chin, upper lip, jawline, neck, chest or elsewhere?
- What is your menstrual history, if that applies to you?
- What medicines and supplements do you take?
- Has anyone in your family had similar hair growth?
The exam looks at the pattern, color and texture of the hair, and for related signs such as acne, scalp hair thinning or changes in skin color.
When hormones may be involved, the evaluation often includes blood tests. MedlinePlus lists tests such as thyroid-stimulating hormone, testosterone and DHEA-sulfate as possible parts of a workup. Some patients are also cared for together with a primary care doctor, gynecologist or endocrinologist. Because the right next step depends on what the exam shows, ask the office before your visit how testing and any coordination with your other doctors would work in your case.
Bay Ridge Dermatology treats hair and nail disorders as part of its medical dermatology care and sees patients of all ages, from children to older adults.
Hair-reduction options once the cause is addressed
Once you know what is behind the growth, or know there is no medical concern, you can choose how to manage the hair itself. Treating an underlying cause may slow new growth, but hairs that have already turned coarse may still need removal.
Common options include:
- Shaving, tweezing, threading, waxing and hair-removal creams. These are quick and inexpensive but temporary. MedlinePlus notes that shaving does not increase hair growth, though it can make hair look thicker as it grows back. Creams can irritate the skin.
- Prescription treatment. A doctor may discuss prescription options that slow facial hair growth or act on hormones. These are decisions to make with your doctor.
- Electrolysis. A fine probe uses electric current to destroy individual hair follicles. It works on any hair color but treats one hair at a time over many sessions.
- Light-based treatment. Laser and intense pulsed light (IPL) target the pigment in dark hair. They work best on dark hair and do not work on white, gray, red or light blonde hair.
Does IPL work on facial hair? IPL can reduce coarse, dark facial hair over a series of sessions, particularly on lighter to medium skin tones. It does not reduce light or white hair, and hormone-driven facial hair can keep coming back, so maintenance sessions are common. The American Academy of Dermatology notes that laser hair removal is not considered permanent on a woman's face, and IPL works on the same pigment-targeting principle. Individual results vary.
At Bay Ridge Dermatology, in-office hair reduction is offered with IPL, through the practice's cosmetic services. IPL is a cosmetic treatment and is not covered by insurance. The practice offers complimentary cosmetic consultations: a no-cost conversation about your goals and whether IPL fits your skin and hair, with no obligation to book. The practice accepts most insurance plans for medical care. Whether a visit about a hair disorder is covered depends on your plan, so check with your insurer or call the office.
When to see a dermatologist
See a dermatologist if your facial hair is new, increasing quickly or comes with any of the signs above, or if you simply are not sure what is causing it. It also makes sense to be seen before starting light-based hair removal if you have darker skin, a skin condition in the area, or take a medicine that makes your skin sensitive to light. And if hair removal has left you with ingrown hairs, bumps, irritation or dark spots, a dermatologist can help with those too.
If you would like the cause looked at, you can book online or call (347) 497-4984. Mandarin and Cantonese care is available with Kerry Ly, PA-C; ask for her when booking. Directions and hours are on the contact page.
This article is general information, not medical advice. For advice about your own skin, see a dermatologist.