Materiały źródłowe

• #1 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Hirsutism treatment requires patience because hair follicles have a life cycle of approximately six months. Most medications must be taken for six months before a noticeable improvement occurs. In the meantime, the existing hair can be mechanically removed or bleached, and some females continue to use these methods in combination with medication. […] The treatment of PCOS may also involve lifestyle changes including weight loss, treatment of infertility, diabetes, and risk factors for cardiovascular disease. […] Several methods can be used to physically remove or lighten excess hair so that it is less noticeable. These methods can be used in conjunction with medication. […] Electrolysis and laser are both called „permanent hair reduction” techniques. However, for females with PCOS, hair will grow back after either treatment, unless medication to suppress hair growth is also taken (a birth control pill or antiandrogen).

• #2 Management of hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3830374/

  Treatment of insulin resistance, primarily by weight loss or using metformin or thiazolidinediones has been demonstrated to improve hyperandrogenemia and ovulatory function in many women with PCOS. […] These include androgen receptor blockers, such as spironolactone, flutamide, and cyproterone acetate. […] Spironolactone is a very effective agent for reducing hirsutism, regardless of the degree of hyperandrogenemia. […] Flutamide is effective treatment for hirsutism in doses of 500 mg daily. […] Cyproterone acetate is an effective agent for the treatment of hirsutism. […] Finasteride is useful for the treatment of hirsutism in women in doses of 5 mg per day. […] Shaving, bleaching, or chemical depilation may be useful to temporarily ameliorate unwanted hairs. […] Eflornithine hydrochloride 13.9% cream is approved by the Food and Drug Administration for the treatment of unwanted facial hair growth. […] Overall, although hirsutism is a frequent and distressing disorder often signaling an underlying endocrine disorder, a systematic approach to evaluation and the use of combination therapy will provide satisfactory treatment for most patients.

• #3 Hirsutism: What It Is, In Women, Causes, PCOS & Treatment

  https://my.clevelandclinic.org/health/diseases/14523-hirsutism

  Hirsutism is a condition that causes excess hair to grow on certain parts of your body. Treatment options include weight loss, medications and other hair removal options. […] Hirsutism can cause distress, but its treatable. […] Yes, hirsutism is treatable. Treatments include: […] Weight loss is often the first step in treating hirsutism. Losing even 5% of your body weight can lower your androgen levels and stop excessive hair growth. […] Birth control pills are the most common medication used to treat hirsutism. They lower androgen levels, regulate your menstrual cycle and prevent pregnancy. […] Androgen-suppressing medications can effectively treat mild cases of hirsutism by lowering the amount of androgens your body produces. […] If overactive adrenal glands cause your hirsutism, your healthcare provider may prescribe low-dose steroid medications.

• #4 Hirsutism – OBGYN | UCLA Health

  https://www.uclahealth.org/medical-services/obgyn/conditions-treated/hirsutism

  Hirsutism is often treated with a combination of approaches, including oral contraceptives with or without an antiandrogen, such as spironolactone, to lower levels or block actions of androgen on hair follicles. […] Medical therapy inhibits hair growth without eliminating hair already present. Therefore, medical therapy usually is combined with mechanical methods of hair removal, such as electrolysis or lasers. […] A successful management plan for unwanted hair addresses a woman’s own concerns and allows for an individualized strategy that balances time spent on mechanical hair removal with prevention of further hair growth through medical therapy.

• #5 Management of hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3830374/

  Although hirsutism is a frequent and distressing disorder often signaling an underlying endocrine disorder, a systematic approach to evaluation and the use of combination therapy will provide satisfactory treatment for most patients. […] The treatment of hirsutism should be undertaken using combination therapy, including: Androgen suppression, Peripheral androgen blockade, and Mechanical/cosmetic amelioration and destruction of the unwanted hairs. […] The most popular treatment for hirsutism are oral contraceptive (OC) medications, which suppress circulating luteinizing hormone (LH) and follicle-stimulating hormone (FSH), leading to a decrease in ovarian androgen production. […] Long-acting GnRH agonists (e.g. Luprolide Depot, 3.75 mg per month) have been found to be useful in ameliorating hirsutism and may be required to suppress the hypothalamic-pituitary-ovarian axis in severely androgenized or hyperinsulinemic patients.

• #6 SciELO Brazil – Hirsutism: diagnosis and treatment Hirsutism: diagnosis and treatment

  https://www.scielo.br/j/abem/a/t5GTrmpRNGJ7nDzYkqwtmpL/

  Hirsutism is a common clinical problem in women, and the treatment depends on the cause. […] Treatment of hirsutism should be based on the degree of excess hair growth presented by the patient and in the pathophysiology of the disorder. Treatment includes lifestyle therapies, androgen suppression, peripheral androgen blockage, and cosmetic treatments. […] Lifestyle therapies are first-line treatments in women with polycystic ovary syndrome, particularly if they are overweight. […] Physical methods of removing hair or making it less visible (shaving, plucking, waxing, bleaching) can be effective, and their use is reasonable either alone or as a supplement to drug therapy. […] Direct or mechanical methods of hair removal, including electrolysis and photoepilation (laser and intense pulsed light), are also referred to as permanent hair reduction techniques.

• #7 Approach to the management of idiopathic hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3279274/

  Hirsutism should be investigated and treated, not only to determine the underlying cause, but also because it can negatively affect women’s psychological well-being. […] An approach to treatment of hirsutism is outlined in Figure 1. […] Targeted counseling about self-image plays an important role in the treatment of hirsutism. Lifestyle modifications, such as physical exercise and dietary advice, can be recommended. […] When hirsutism is cosmetically distressing, moderate to severe, or widespread, a pharmacologic treatment should be offered. […] Drug treatment is limited to patients with hirsutism who do not wish to become pregnant in the short term. […] Oral contraceptives, topical eflornithine, and antiandrogens are common medications used to treat hirsutism. […] Antiandrogens such as spironolactone, cyproterone acetate, finasteride, and flutamide are recommended for patients with moderate to severe hirsutism.

• #8 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Hirsutism may be treated with pharmacologic agents and/or hair removal. Recommended pharmacologic therapies include combined oral contraceptives, finasteride, spironolactone, and topical eflornithine. […] Combined oral contraceptives are first-line therapy for women with hirsutism who are not trying to conceive and in whom cosmetic measures are ineffective. […] If patient-important hirsutism persists after six months of therapy with combined oral contraceptives, the addition of an antiandrogen should be considered. […] Photoepilation is the preferred treatment for most patients who desire permanent hair removal. […] If bothersome hirsutism persists despite cosmetic measures (e.g., shaving, plucking, waxing), pharmacologic treatment should be initiated, followed by direct hair removal methods if pharmacologic treatment does not yield satisfactory results.

• #9 Hirsutism: What It Is, In Women, Causes, PCOS & Treatment

  https://my.clevelandclinic.org/health/diseases/14523-hirsutism

  Hirsutism is a condition that causes excess hair to grow on certain parts of your body. Treatment options include weight loss, medications and other hair removal options. […] Hirsutism can cause distress, but its treatable. […] Yes, hirsutism is treatable. Treatments include: […] Weight loss is often the first step in treating hirsutism. Losing even 5% of your body weight can lower your androgen levels and stop excessive hair growth. […] Birth control pills are the most common medication used to treat hirsutism. They lower androgen levels, regulate your menstrual cycle and prevent pregnancy. […] Androgen-suppressing medications can effectively treat mild cases of hirsutism by lowering the amount of androgens your body produces. […] If overactive adrenal glands cause your hirsutism, your healthcare provider may prescribe low-dose steroid medications.

• #10 Hirsutism Causes, Symptoms, and Treatments

  https://www.upmc.com/services/womens-health/conditions/hirsutism

  Hirsutism treatment often focuses on hair removal, rather than on what’s causing the abnormal hair growth. […] Your doctor may prescribe: […] Contraceptive medication (birth control pill, hormone patches, or vaginal rings) Usually the first course of treatment. […] Antiandrogen medication can be added if the pill doesn’t improve your condition. […] If you have hirsutism and it bothers you even if your case is mild ask your provider for treatment options. […] Cosmetic hair management techniques include: […] Weight loss may improve unwanted hair growth. People with hirsutism and PCOS should consider making lifestyle changes to improve their overall health.

• #11

  https://www.delightmdaesthetics.com/hirsutism

  If you have been diagnosed with polycystic ovary syndrome (PCOS), maintaining a healthy weight can help regulate hormone levels and minimize hirsutism symptoms. […] A low-glycemic index diet focuses on consuming foods that have a minimal impact on blood sugar levels. This type of diet may be beneficial for individuals with PCOS, as it can help manage insulin resistance and potentially reduce hirsutism symptoms. […] When it comes to managing hirsutism, there are several professional treatment options available that can help reduce excessive hair growth and improve your overall appearance. […] It’s important to consult with a healthcare professional specializing in hormonal disorders or a dermatologist to determine the most suitable treatment plan for your specific situation. […] These medications work by blocking the effects of androgens, the hormones responsible for excessive hair growth. Spironolactone and flutamide are examples of anti-androgen medications that may be prescribed.

• #12 Evaluation and Treatment of Women with Hirsutism | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0615/p2565.html

  Hirsutism is a common disorder, often resulting from conditions that are not life-threatening. […] Pharmacologic and/or nonpharmacologic treatments may be used. Advances in laser hair removal methods and topical hair growth retardants offer new options. […] Treatment options for patients who have hirsutism can be divided into those measures targeting local manifestations of hirsutism and pharmacologic therapy aimed at the underlying causes. […] For patients with mild hirsutism, local measures such as shaving, bleaching, depilatories, and electrolysis may suffice. […] The need for rapid methods of hair removal has led to the development of laser therapy for hirsutism. […] Weight loss should be encouraged for obese patients, because this increases SHBG levels and decreases insulin resistance and the levels of serum androgens and luteinizing hormones.

• #13 Hirsutism: Symptoms, causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/182659

  If a specific cause of hirsutism becomes clear, the doctor may suggest appropriate treatment for that cause. […] If insulin levels are high, reducing them may lead to a reduction in hirsutism. […] Women who have a high body mass index (BMI) might find that a weight loss program reduces androgen levels and therefore the symptoms of hirsutism. […] Hirsutism can cause distress or embarrassment, but some cosmetic and medical treatments might help decrease androgen levels or their impact on hair follicles. […] Effective treatments for mild hirsutism include: plucking, shaving, waxing, chemical hair softeners, depilatory creams. […] Combination birth control pills, which contain both estrogen and progesterone, can also counter the effects of androgens and decrease the production of testosterone in the ovaries. Hirsutism may improve after 6 to 12 months of consistently taking birth control pills. […] Anti-androgen medicines work alone or in combination with birth control pills. […] Weight loss might also be helpful in reducing the levels of androgens in your body and, as a result, the amount of hirsutism you may experience.

• #14 Hirsutism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941

  Treatment of hirsutism with no sign of endocrine disorder is not necessary. For women who do need or seek treatment, it may involve treating any underlying disorder, developing a self-care routine for unwanted hair, and trying various therapies and medications. […] If cosmetic or self-care methods of hair removal haven’t worked for you, talk with your doctor about drugs that treat hirsutism. With these medications it usually takes up to six months, the average life cycle of a hair follicle, before you see a significant difference in hair growth. Options include: […] Oral contraceptives. Birth control pills or other hormonal contraceptives, which contain estrogen and progestin, treat hirsutism caused by androgen production. Oral contraceptives are a common treatment for hirsutism in women who don’t want to become pregnant. Possible side effects include nausea and headache.

• #15 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Hirsutism may be treated with pharmacologic agents and/or hair removal. Recommended pharmacologic therapies include combined oral contraceptives, finasteride, spironolactone, and topical eflornithine. […] Combined oral contraceptives are first-line therapy for women with hirsutism who are not trying to conceive and in whom cosmetic measures are ineffective. […] If patient-important hirsutism persists after six months of therapy with combined oral contraceptives, the addition of an antiandrogen should be considered. […] Photoepilation is the preferred treatment for most patients who desire permanent hair removal. […] If bothersome hirsutism persists despite cosmetic measures (e.g., shaving, plucking, waxing), pharmacologic treatment should be initiated, followed by direct hair removal methods if pharmacologic treatment does not yield satisfactory results.

• #16 Hirsutism: What It Is, In Women, Causes, PCOS & Treatment

  https://my.clevelandclinic.org/health/diseases/14523-hirsutism

  Hirsutism is a condition that causes excess hair to grow on certain parts of your body. Treatment options include weight loss, medications and other hair removal options. […] Hirsutism can cause distress, but its treatable. […] Yes, hirsutism is treatable. Treatments include: […] Weight loss is often the first step in treating hirsutism. Losing even 5% of your body weight can lower your androgen levels and stop excessive hair growth. […] Birth control pills are the most common medication used to treat hirsutism. They lower androgen levels, regulate your menstrual cycle and prevent pregnancy. […] Androgen-suppressing medications can effectively treat mild cases of hirsutism by lowering the amount of androgens your body produces. […] If overactive adrenal glands cause your hirsutism, your healthcare provider may prescribe low-dose steroid medications.

• #17 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Several medications are available for the treatment of hirsutism. These medications can decrease the amount of body hair, stop the growth of new hair, and decrease the growth rate and coarseness of existing hair. […] Combined estrogen-progestin contraceptive pills, rings, and patches lower the levels of androgens produced by the ovaries and adrenal glands. They are usually the first choice for the treatment of hirsutism, and between 60 and 100 percent of females with hirsutism will notice improvement when taking these medications. […] Antiandrogens are medications that directly decrease androgen production or block the action of androgens on the hair follicle. […] Over time, many females find that a multipronged approach that includes direct hair removal (such as laser), suppression of androgen production with estrogen-progestin contraceptives and androgen blockade with an antiandrogen (spironolactone) may produce the maximal reduction in bothersome hair growth.

• #18 Approach to the management of idiopathic hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3279274/

  Other drugs that have been reported to have been used for hirsutism include metformin, prednisone, ketoconazole, and gonadotropin-releasing agonists. […] Topical 13.9% eflornithine cream is used as monotherapy for mild facial hirsutism or as an adjunct to other pharmacologic therapies along with nonpharmacologic measures. […] The complex interplay of estrogens and progestins contributes to the variable effects of OCPs on hirsutism. Low-dose OCPs containing a neutral (low-androgenicity) progestin, such as desogestrel and norgestimate, or an antiandrogen, such as cyproterone acetate and the spironolactone derivative drospirenone, are considered first-line therapy for hirsutism. […] A combination of eflornithine cream and laser therapy has been shown to remove unwanted hair on the upper lip of women significantly better than laser therapy alone for up to 6 months.

• #19 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Combined oral contraceptives should be used as initial therapy for hirsutism in women who are not trying to conceive. […] If combined oral contraceptives are contraindicated or ineffective, the antiandrogens spironolactone, finasteride (Propecia), or dutasteride (Avodart) may be considered. […] The ornithine decarboxylase inhibitor eflornithine (Vaniqa) can be used as topical therapy for excessive facial hair. […] Numerous hair removal methods may be used to treat hirsutism. […] If patients desire a more permanent solution, photoepilation or electrolysis can be considered.

• #20 Hirsutism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941

  Anti-androgens. These types of drugs block androgens from attaching to their receptors in your body. They’re sometimes prescribed after six months on oral contraceptives if the oral contraceptives aren’t effective enough. […] The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone, CaroSpir). The results are modest and take at least six months to be noticeable. Possible side effects include menstrual irregularity. Because these drugs can cause birth defects, it’s important to use contraception while taking them. […] Topical cream. Eflornithine (Vaniqa) is a prescription cream specifically for excessive facial hair in women. It’s applied directly to the affected area of your face twice a day. It helps slow new hair growth but doesn’t get rid of existing hair. It can be used with laser therapy to enhance the response.

• #21 Hirsutism Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hirsutism

  We suggest testing for elevated androgen levels in all women with an abnormal hirsutism score. […] We suggest against testing for elevated androgen levels in eumenorrheic women with unwanted local hair growth (i.e., in the absence of an abnormal hirsutism score) because of the low likelihood of identifying a medical disorder that would change management or outcome. […] For most women with patient-important hirsutism despite cosmetic measures, we suggest starting with pharmacological therapy. […] For hirsute women with obesity, including those with polycystic ovary syndrome, we also recommend lifestyle changes. […] For the majority of women with hirsutism who are not seeking fertility, we suggest oral contraceptives as initial therapy for treating patient-important hirsutism. […] For most women with hirsutism, we suggest against antiandrogen monotherapy as initial therapy (because of the teratogenic potential of these medications) unless these women use adequate contraception.

• #22 Hirsutism Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/hirsutism

  If patient-important hirsutism remains despite 6 months of monotherapy with an oral contraceptive, we suggest adding an antiandrogen. […] We suggest against using insulin-lowering drugs for the sole indication of treating hirsutism. […] We suggest against the use of topical antiandrogen therapy for hirsutism. […] For women who choose hair removal therapy, we suggest photoepilation for those whose unwanted hair is auburn, brown, or black, and we suggest electrolysis for those with white or blonde hair. […] For women with known hyperandrogenemia who choose hair removal therapy, we suggest pharmacologic therapy to minimize hair regrowth.

• #23 Management of hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3830374/

  Treatment of insulin resistance, primarily by weight loss or using metformin or thiazolidinediones has been demonstrated to improve hyperandrogenemia and ovulatory function in many women with PCOS. […] These include androgen receptor blockers, such as spironolactone, flutamide, and cyproterone acetate. […] Spironolactone is a very effective agent for reducing hirsutism, regardless of the degree of hyperandrogenemia. […] Flutamide is effective treatment for hirsutism in doses of 500 mg daily. […] Cyproterone acetate is an effective agent for the treatment of hirsutism. […] Finasteride is useful for the treatment of hirsutism in women in doses of 5 mg per day. […] Shaving, bleaching, or chemical depilation may be useful to temporarily ameliorate unwanted hairs. […] Eflornithine hydrochloride 13.9% cream is approved by the Food and Drug Administration for the treatment of unwanted facial hair growth. […] Overall, although hirsutism is a frequent and distressing disorder often signaling an underlying endocrine disorder, a systematic approach to evaluation and the use of combination therapy will provide satisfactory treatment for most patients.

• #24 Hirsutism/Hair Loss and congenital adrenal hyperplasia

  https://caresfoundation.org/living-with-cah-hirsutism-hair-loss/

  If hirsutism persists even with adequate replacement therapy and oral contraceptives, drugs which block androgen action may be tried. […] Spironolactone is an androgen blocker which is also a weak diuretic (a drug that causes excess urination). […] Cyproterone acetate is another androgen blocker which is used in Europe and Australia but not approved in the United States. […] Contraindications for cyproterone acetate (mainly due to the estrogen action) are varicose veins, uterine fibroids, smoking and cardiovascular disease. […] Side effects for both spironolactone and cyproterone acetate can include breast tenderness, decreased libido (sex drive), fatigue, headaches, depression, weight gain and irregular periods. […] Flutamide, another anti-androgen medication, is no longer used by our center as other centers have reported two deaths tentatively associated with its use.

• #25 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  Spironolactone, in daily doses of 50-200 mg, blocks androgen receptors. Spironolactone also decreases testosterone production, making it additionally effective for hirsutism. […] With current systemic therapies for hirsutism, 6 months to a year of therapy is usually required before results are noticeable. Even then, only approximately one half to three quarters of patients show improvement. […] Finasteride is a 5-alpha-reductase inhibitor approved for the treatment of benign prostatic hyperplasia. […] Flutamide, an example of the newer therapies, is a potent nonsteroidal selective antiandrogen without progestational, estrogenic, corticoid, or antigonadotropin activity. […] Cyproterone acetate has been effective in the treatment of hirsutism. […] Both metformin and rosiglitazone improve insulin resistance and have been shown to be effective in lowering androgen levels and in treating hirsutism. […] Laser therapy has been shown not only to reduce unwanted hair but also to improve depression and anxiety in women with hirsutism. In many patients, hirsutism can be controlled just with laser, without using any drugs.

• #26 Management of Hirsutism

  https://www.skintherapyletter.com/hirsutism/management-hirsutism/

  Hirsutism is a relatively common condition affecting about 5%-10% of women of childbearing age. Herein, we present an overview of hirsutism with emphasis on its etiology and therapeutic options. […] The therapeutic options of hirsutism can be divided into systemic, topical, and dermato-cosmetic therapies. Patients should be informed that the response to systemic agents is slow; occurring over 3-6 months after therapy has begun. […] Oral contraceptive (OC) agents are considered to be the first-line therapy for hirsutism in premenopausal women. […] Spironolactone (Aldactone®, Pfizer), an aldosterone antagonist, has several actions including inhibition of the androgen receptor, suppression of adrenal androgen biosynthesis, and inhibition of the 5α-reductase enzyme. […] Cyproterone acetate (CA) is a progestin with antiandrogenic activity that interferes with the binding of dihydrotestosterone to the androgen receptor and inhibits the secretion of gonadotropin, thereby reducing ovarian and adrenal androgen production.

• #27 Hirsutism Dallas | Facial Hair in Women Plano | Androgen Production TX

  https://www.hairtx.com/hair-loss-procedures-dallas/hair-loss-disorders/disorders-of-hair-growth/hirsutism/

  Spironolactone has long been used to treat androgen excess by inhibiting cytochrome P450-related ovarian and adrenal steroidogenesis, 5-alpha reductase, and the androgen receptor. The usual dose of spironolactone is 100 to 200 mg daily depending on clinical assessment. Doses can be reduced after 6 to 12 months of therapy when a response is noted to 75 to 100 mg per day. Side effects of high blood potassium should be kept in mind in those with kidney disease or with excessive dietary ingestion of potassium. […] Cyproterone Acetate is a progestagen that can be used to treat hirsutism. Combining OCP 50 micrograms of ethinyl estradiol and 2 mg of cyproterone acetate (Dianette) and 50 mg of cyproterone acetate for prostate cancer are available in Europe and Canada. To treat hirsutism 25 to 100 mg of cyproterone acetate is given daily on days 5 to 15 of the menstrual cycle or with 50 micrograms of ethinyl estradiol on days 5 to 25 or during the first 10 days of the OCP cycle.

• #28 Hirsutism Dallas | Facial Hair in Women Plano | Androgen Production TX

  https://www.hairtx.com/hair-loss-procedures-dallas/hair-loss-disorders/disorders-of-hair-growth/hirsutism/

  Whereas cyproterone acetate is a partial androgen agonist-antagonist, flutamide is a pure anti-androgen that is twice as strong. Dosage for hirsutism is 125 to 250 mg a day. Because of the rare but serious side effect of liver toxicity, flutamide is the least often used anti-androgen. […] Five mg dosage of finasteride (Proscar) has been found to be effective in the treatment of hirsutism with the obvious caveat of risk of birth defects in reproductive-age women. The combination of 5 mg of finasteride and 2 mg cyproterone acetate/35 micrograms of ethinyl estradiol (Diane 35) for 2 weeks per month versus Diane 35 alone daily has shown improved effectiveness in hirsutism.

• #29 Hirsutism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941

  Anti-androgens. These types of drugs block androgens from attaching to their receptors in your body. They’re sometimes prescribed after six months on oral contraceptives if the oral contraceptives aren’t effective enough. […] The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone, CaroSpir). The results are modest and take at least six months to be noticeable. Possible side effects include menstrual irregularity. Because these drugs can cause birth defects, it’s important to use contraception while taking them. […] Topical cream. Eflornithine (Vaniqa) is a prescription cream specifically for excessive facial hair in women. It’s applied directly to the affected area of your face twice a day. It helps slow new hair growth but doesn’t get rid of existing hair. It can be used with laser therapy to enhance the response.

• #30 Hirsutism: What It Is, In Women, Causes, PCOS & Treatment

  https://my.clevelandclinic.org/health/diseases/14523-hirsutism

  These medications, including metformin and thiazolidinediones, reduce blood levels of insulin and androgens. […] Eflornithine skin cream is a topical product that you rub on your affected areas. It doesn’t remove hair, but it slows down how fast your hair grows. […] Electrolysis uses a tiny needle and a mild electrical zap to destroy your hair roots one by one. […] In laser hair removal, heat from a laser destroys cells that have a lot of pigment. […] Shaving is the most common method of hair removal. […] Hirsutism requires ongoing treatment. None of the treatments make the hair go away completely, but they help make your hair grow more slowly and decrease the amount of unwanted hair. […] Medications and treatments are available to limit your unwanted hair growth.

• #31 Hirsutism in Women (Excess Body Hair Growth) | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hirsutism-in-women-excess-body-hair-growth.html

  Hirsutism is excess hair growth on the body or face. […] Treatment depends on personal preference. Hair growth causes no physical harm. The decision to remove or reduce hair varies from person to person. […] Methods to remove or reduce unwanted hair include: Shaving. Hair will start growing back right away, so shaving needs to be repeated often. Depilatory lotion. This is a type of hair removal done with chemicals put on the skin. It softens hair above the skin so it can be wiped away. Waxing. Hot or cold wax can be used to pull out hair from the root. This treatment needs to be done every 2 to 3 weeks. Bleaching. Chemicals can lighten the color of the hair and make it harder to see. Electrolysis. A very thin needle is put into a hair follicle. Electricity is sent through the needle. This damages the hair follicle. This method is done over several sessions. This can reduce and remove hair for months or longer. Laser hair removal. A special laser is pointed at the skin. The light from the laser is absorbed by color (pigment) in the hair and destroys the hair. This works best on people with dark hair and light skin. This method is done over several sessions. This can reduce and remove hair for months or longer. Medicated cream. Skin cream with eflornithine can slow hair growth. Results show up in 6 to 8 weeks. The hair will regrow in about 8 weeks if you stop using the cream.

• #32 The Ultimate Guide to Hirsutism: Symptoms, Causes, and Treatment

  https://flo.health/menstrual-cycle/health/symptoms-and-diseases/hirsutism

  Oral contraceptives are often used to help reduce the level of testosterone in the body. […] Eflornithine cream, when applied directly to the areas where unwanted hair grows, slows down hair growth after hair removal. […] If you experience excessive unwanted hair, it’s a good idea to see your physician to determine the underlying cause. […] Early detection of hormone levels may make the condition easier to treat and can rule out other medical issues.

• #33 Hirsutism in Women (Excess Body Hair Growth) | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hirsutism-in-women-excess-body-hair-growth.html

  Other medicines can reduce the hormones that cause hair growth. It can take 6 months or longer for you to see results from these medicines. […] Medicines that can change hormones to affect hair growth include: Birth control pills. These are different kinds of hormone pills that prevent pregnancy. They can reduce the amount of androgens in your body. Most women will notice a change in body hair growth when taking birth control pills. Antiandrogen medicine. This type of medicine can reduce your body’s androgen levels. Or it may stop the effects of androgens on hair follicles. The most common type is spironolactone. The medicines can cause birth defects, so a woman must use birth control while taking them. […] Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

• #34 Management of hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3830374/

  Treatment of insulin resistance, primarily by weight loss or using metformin or thiazolidinediones has been demonstrated to improve hyperandrogenemia and ovulatory function in many women with PCOS. […] These include androgen receptor blockers, such as spironolactone, flutamide, and cyproterone acetate. […] Spironolactone is a very effective agent for reducing hirsutism, regardless of the degree of hyperandrogenemia. […] Flutamide is effective treatment for hirsutism in doses of 500 mg daily. […] Cyproterone acetate is an effective agent for the treatment of hirsutism. […] Finasteride is useful for the treatment of hirsutism in women in doses of 5 mg per day. […] Shaving, bleaching, or chemical depilation may be useful to temporarily ameliorate unwanted hairs. […] Eflornithine hydrochloride 13.9% cream is approved by the Food and Drug Administration for the treatment of unwanted facial hair growth. […] Overall, although hirsutism is a frequent and distressing disorder often signaling an underlying endocrine disorder, a systematic approach to evaluation and the use of combination therapy will provide satisfactory treatment for most patients.

• #35 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  Systemic therapies directed at hirsutism can be divided into those that decrease ovarian or adrenal androgen production and those that inhibit androgen action in the skin. The systemic therapies include glucocorticoids, oral contraceptives (OCs), spironolactone, flutamide, finasteride, cyproterone acetate (not available in the United States), and insulin sensitizers (metformin and rosiglitazone). […] Glucocorticoids (dexamethasone or prednisone), which suppress adrenocorticotropin hormone (ACTH)dependent adrenal androgen synthesis, have been used with variable success in women with adrenal hirsutism, as in congenital adrenal hyperplasia (CAH) or idiopathic adrenal hyperandrogenism. […] The drugs most widely used to suppress ovarian androgen production are OCs. They are probably the first choice for young women with hirsutism who do not want to become pregnant.

• #36 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Combined oral contraceptives should be used as initial therapy for hirsutism in women who are not trying to conceive. […] If combined oral contraceptives are contraindicated or ineffective, the antiandrogens spironolactone, finasteride (Propecia), or dutasteride (Avodart) may be considered. […] The ornithine decarboxylase inhibitor eflornithine (Vaniqa) can be used as topical therapy for excessive facial hair. […] Numerous hair removal methods may be used to treat hirsutism. […] If patients desire a more permanent solution, photoepilation or electrolysis can be considered.

• #37 Management of Hirsutism

  https://www.skintherapyletter.com/hirsutism/management-hirsutism/

  Flutamide is a pure nonsteroidal antiandrogen that acts as an androgen receptor blocker. […] Finasteride is a potent inhibitor of the type 2 isoenzyme of 5-α-reductase, which blocks the conversion of testosterone to 5-α-dihydrotestosterone. […] Metformin lowers hepatic glucose production and decreases insulin levels. […] GnRH agonists suppress luteinizing hormone, and to a lesser degree follicle stimulating hormone secretion, leading to a decline in ovarian androgen production. […] Glucocorticoids can be prescribed to women who have hirsutism that is due to nonclassic congenital adrenal hyperplasia, have a suboptimal response to OCs and/or antiandrogens, exhibit poor tolerance to OCs, or are seeking ovulation induction. […] Eflornithine hydrochloride cream 13.9% (Vaniqa®, Skin Mediea) has been approved by the US FDA for the reduction of unwanted facial hair in women.

• #38 Hirsutism and Hypertrichosis – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hair-disorders/hirsutism-and-hypertrichosis

  Oral contraceptives in standard doses often are the initial treatment for hirsutism caused by ovarian hyperandrogenism. Oral contraceptives reduce ovarian androgen secretion and increase sex hormonebinding globulin, thereby decreasing free testosterone levels. […] Antiandrogenic therapy is also used and can include finasteride or spironolactone. These medications are contraindicated in women of childbearing age unless contraception is used because they may feminize a male fetus. […] Corticosteroids are used when necessary to suppress adrenal androgen production. Gonadotropin-releasing hormone agonists can be used for severe forms of ovarian hyperandrogenism under the direction of a gynecologist or endocrinologist.

• #39 Hirsutism: Causes, Treatments for Excessive Hairiness in Women

  https://www.webmd.com/women/hirsutism-hair-women

  If you have more facial or body hair than you want, there are several ways you can remove it: […] Weight loss. If you’re not at a healthy weight and drop pounds, your body may make fewer male hormones. […] Shaving. You can remove unwanted hair easily with a razor or electric shaver. You may need to shave daily to avoid stubble growth. Some people get razor burn from shaving too often, but a soothing cream may help. […] Tweezing or threading. There are different ways to pluck hair from the root. You can use tweezers, or you can have areas threaded, which involves using a long, tight strand to loop around and remove each unwanted hair. These methods can cause pain and redness. […] Waxing. A quick way to remove lots of unwanted hair from the root is with melted wax. Often, you get this done in a salon. Wax is applied to the skin and then removed quickly. It can cause pain and redness.

• #40 Hirsutism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941

  Hair removal methods whose results may last longer than self-care methods and which may be combined with medical therapy include: […] Laser therapy. A beam of highly concentrated light (laser) is passed over your skin to damage hair follicles and prevent hair from growing (photoepilation). You might need multiple treatments. […] Electrolysis. This treatment involves inserting a tiny needle into each hair follicle. The needle emits a pulse of electric current to damage and eventually destroy the follicle. You might need multiple treatments.

• #41 Hirsutism | Altru Health System

  https://www.altru.org/health-library/conditions/hirsutism

  Topical cream. Eflornithine (Vaniqa) is a prescription cream specifically for excessive facial hair in women. […] Hair removal methods whose results may last longer than self-care methods and which may be combined with medical therapy include: Laser therapy. […] Electrolysis. This treatment involves inserting a tiny needle into each hair follicle. […] Self-care methods such as the following temporarily remove or reduce the visibility of unwanted facial and body hair. […] Plucking. Plucking is a good method to remove a few stray hairs, but is not useful for removing a large area of hair. […] Shaving. Shaving is quick and inexpensive, but it needs to be repeated regularly. […] Waxing. Waxing involves applying warm wax on your skin where the unwanted hair grows. […] Chemical depilatories are applied to the affected skin, where they dissolve hair. […] Bleaching lightens hair color, making it less noticeable on people with light skin.

• #42 Hirsutism | Altru Health System

  https://www.altru.org/health-library/conditions/hirsutism

• #43 Hirsutism in Women (Excess Body Hair Growth) | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions/hirsutism-in-women-excess-body-hair-growth

  Hirsutism is excess hair growth on the body or face. […] Treatment depends on personal preference. Hair growth causes no physical harm. The decision to remove or reduce hair varies from person to person. […] Methods to remove or reduce unwanted hair include: Shaving. Hair will start growing back right away, so shaving needs to be repeated often. Depilatory lotion. This is a type of hair removal done with chemicals put on the skin. It softens hair above the skin so it can be wiped away. Waxing. Hot or cold wax can be used to pull out hair from the root. This treatment needs to be done every 2 to 3 weeks. Bleaching. Chemicals can lighten the color of the hair and make it harder to see. Electrolysis. A very thin needle is put into a hair follicle. Electricity is sent through the needle. This damages the hair follicle. This method is done over several sessions. This can reduce and remove hair for months or longer. Laser hair removal. A special laser is pointed at the skin. The light from the laser is absorbed by color (pigment) in the hair and destroys the hair. This works best on people with dark hair and light skin. This method is done over several sessions. This can reduce and remove hair for months or longer. Medicated cream. Skin cream with eflornithine can slow hair growth. Results show up in 6 to 8 weeks. The hair will regrow in about 8 weeks if you stop using the cream.

• #44 Hirsutism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941

  Hair removal methods whose results may last longer than self-care methods and which may be combined with medical therapy include: […] Laser therapy. A beam of highly concentrated light (laser) is passed over your skin to damage hair follicles and prevent hair from growing (photoepilation). You might need multiple treatments. […] Electrolysis. This treatment involves inserting a tiny needle into each hair follicle. The needle emits a pulse of electric current to damage and eventually destroy the follicle. You might need multiple treatments.

• #45 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Hirsutism treatment requires patience because hair follicles have a life cycle of approximately six months. Most medications must be taken for six months before a noticeable improvement occurs. In the meantime, the existing hair can be mechanically removed or bleached, and some females continue to use these methods in combination with medication. […] The treatment of PCOS may also involve lifestyle changes including weight loss, treatment of infertility, diabetes, and risk factors for cardiovascular disease. […] Several methods can be used to physically remove or lighten excess hair so that it is less noticeable. These methods can be used in conjunction with medication. […] Electrolysis and laser are both called „permanent hair reduction” techniques. However, for females with PCOS, hair will grow back after either treatment, unless medication to suppress hair growth is also taken (a birth control pill or antiandrogen).

• #46 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Hirsutism may be treated with pharmacologic agents and/or hair removal. Recommended pharmacologic therapies include combined oral contraceptives, finasteride, spironolactone, and topical eflornithine. […] Combined oral contraceptives are first-line therapy for women with hirsutism who are not trying to conceive and in whom cosmetic measures are ineffective. […] If patient-important hirsutism persists after six months of therapy with combined oral contraceptives, the addition of an antiandrogen should be considered. […] Photoepilation is the preferred treatment for most patients who desire permanent hair removal. […] If bothersome hirsutism persists despite cosmetic measures (e.g., shaving, plucking, waxing), pharmacologic treatment should be initiated, followed by direct hair removal methods if pharmacologic treatment does not yield satisfactory results.

• #47

• #48 Tackle Hirsutism in PCOS Medically | PCOS | Blogs | Proactive For Her

  https://proactiveforher.com/blogs/pcos/tackle-hirsutism-in-pcos-medically/

  Anti-androgens: […] These drugs block androgens from attaching to their receptors in your body. […] The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone, CaroSpir). […] Finasteride: […] This is another medication that suppresses the small amount of male hormone that is present in your body. […] Topical creams: […] Eflornithine(Vaniqa) is a prescription cream specifically for excessive facial hair due to PCOS in women. […] Hair removal methods are more effective than self-care methods, especially when combined with medical therapy. […] Laser therapy: A beam of highly concentrated light (laser) is passed over your skin to damage hair follicles and prevent hair from growing (photoepilation). […] Electrolysis: […] This treatment involves inserting a tiny needle into each hair follicle.

• #49 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Hirsutism treatment requires patience because hair follicles have a life cycle of approximately six months. Most medications must be taken for six months before a noticeable improvement occurs. In the meantime, the existing hair can be mechanically removed or bleached, and some females continue to use these methods in combination with medication. […] The treatment of PCOS may also involve lifestyle changes including weight loss, treatment of infertility, diabetes, and risk factors for cardiovascular disease. […] Several methods can be used to physically remove or lighten excess hair so that it is less noticeable. These methods can be used in conjunction with medication. […] Electrolysis and laser are both called „permanent hair reduction” techniques. However, for females with PCOS, hair will grow back after either treatment, unless medication to suppress hair growth is also taken (a birth control pill or antiandrogen).

• #50 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  The treatment of hirsutism begins with a careful explanation about the cause of the problem and reassurance that the patient is not losing her femininity. Then, direct intervention, if possible, is instituted for the underlying disorder. If hirsutism persists (or the patient has idiopathic hirsutism), other cosmetic or systemic treatment may be necessary. In some cases, cosmetic measures may be sufficient. In others, the slow progress of systemic therapy may necessitate more immediate cosmetic treatment. The most effective strategy is to combine systemic therapy, which has a slow onset of effectiveness, with mechanical depilation (shaving, plucking, waxing, depilatory creams) or light-based (laser or pulsed-light) hair removal. […] Hirsutism requires a careful and systematic clinical evaluation coupled with a rational approach to treatment. Throughout this process, the patient must understand that, although diagnostic testing can be time consuming (and even inconclusive), it is sometimes essential for determining an effective intervention. In other cases, counseling and education may be all that is needed. For the patient who desires treatment, a wide variety of pharmacologic strategies are available. Informing the patient that current systemic therapy is imperfect is important. Furthermore, none of the drugs used to treat hirsutism have US Food and Drug Administration (FDA) approval for such use. Initiate therapy only in patients who give informed consent after a complete explanation of the potential benefits and risks of a particular treatment and alternative approaches.

• #51 SciELO Brazil – Hirsutism: diagnosis and treatment Hirsutism: diagnosis and treatment

  https://www.scielo.br/j/abem/a/t5GTrmpRNGJ7nDzYkqwtmpL/

  Oral contraceptives are considered to be the first line of drugs for the management of hirsutism; an anti-androgen is added if the clinical response is suboptimal after six months of therapy. […] For the majority of women with hirsutism who choose pharmacological therapy, we suggest estrogen-progestin contraceptives as initial therapy. […] Although anti-androgens are an effective therapy for hirsutism, their use is not suggested as monotherapy because of the potential adverse effects on a developing male fetus in the uterus. […] Monitoring should be carried out throughout the medical follow-up. The assessment of therapeutic responses should be evaluated by the patient herself, by declaring whether there was a decrease in the growth of hair or less need to use other methods to remove the hair.

• #52 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Several medications are available for the treatment of hirsutism. These medications can decrease the amount of body hair, stop the growth of new hair, and decrease the growth rate and coarseness of existing hair. […] Combined estrogen-progestin contraceptive pills, rings, and patches lower the levels of androgens produced by the ovaries and adrenal glands. They are usually the first choice for the treatment of hirsutism, and between 60 and 100 percent of females with hirsutism will notice improvement when taking these medications. […] Antiandrogens are medications that directly decrease androgen production or block the action of androgens on the hair follicle. […] Over time, many females find that a multipronged approach that includes direct hair removal (such as laser), suppression of androgen production with estrogen-progestin contraceptives and androgen blockade with an antiandrogen (spironolactone) may produce the maximal reduction in bothersome hair growth.

• #53 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics/print

  Antiandrogens are medications that directly decrease androgen production or block the action of androgens on the hair follicle. […] Over time, many females find that a multipronged approach that includes direct hair removal (such as laser), suppression of androgen production with estrogen-progestin contraceptives and androgen blockade with an antiandrogen (spironolactone) may produce the maximal reduction in bothersome hair growth.

• #54 SciELO Brazil – Hirsutism: diagnosis and treatment Hirsutism: diagnosis and treatment

  https://www.scielo.br/j/abem/a/t5GTrmpRNGJ7nDzYkqwtmpL/

  Oral contraceptives are considered to be the first line of drugs for the management of hirsutism; an anti-androgen is added if the clinical response is suboptimal after six months of therapy. […] For the majority of women with hirsutism who choose pharmacological therapy, we suggest estrogen-progestin contraceptives as initial therapy. […] Although anti-androgens are an effective therapy for hirsutism, their use is not suggested as monotherapy because of the potential adverse effects on a developing male fetus in the uterus. […] Monitoring should be carried out throughout the medical follow-up. The assessment of therapeutic responses should be evaluated by the patient herself, by declaring whether there was a decrease in the growth of hair or less need to use other methods to remove the hair.

• #55 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  Spironolactone, in daily doses of 50-200 mg, blocks androgen receptors. Spironolactone also decreases testosterone production, making it additionally effective for hirsutism. […] With current systemic therapies for hirsutism, 6 months to a year of therapy is usually required before results are noticeable. Even then, only approximately one half to three quarters of patients show improvement. […] Finasteride is a 5-alpha-reductase inhibitor approved for the treatment of benign prostatic hyperplasia. […] Flutamide, an example of the newer therapies, is a potent nonsteroidal selective antiandrogen without progestational, estrogenic, corticoid, or antigonadotropin activity. […] Cyproterone acetate has been effective in the treatment of hirsutism. […] Both metformin and rosiglitazone improve insulin resistance and have been shown to be effective in lowering androgen levels and in treating hirsutism. […] Laser therapy has been shown not only to reduce unwanted hair but also to improve depression and anxiety in women with hirsutism. In many patients, hirsutism can be controlled just with laser, without using any drugs.

• #56 Hirsutism Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/121038-treatment

  Spironolactone, in daily doses of 50-200 mg, blocks androgen receptors. Spironolactone also decreases testosterone production, making it additionally effective for hirsutism. […] With current systemic therapies for hirsutism, 6 months to a year of therapy is usually required before results are noticeable. Even then, only approximately one half to three quarters of patients show improvement. […] Finasteride is a 5-alpha-reductase inhibitor approved for the treatment of benign prostatic hyperplasia. […] Flutamide, an example of the newer therapies, is a potent nonsteroidal selective antiandrogen without progestational, estrogenic, corticoid, or antigonadotropin activity. […] Cyproterone acetate has been effective in the treatment of hirsutism. […] Both metformin and rosiglitazone improve insulin resistance and have been shown to be effective in lowering androgen levels and in treating hirsutism. […] Laser therapy has been shown not only to reduce unwanted hair but also to improve depression and anxiety in women with hirsutism. In many patients, hirsutism can be controlled just with laser, without using any drugs.

• #57 Approach to the management of idiopathic hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3279274/

  Hirsutism should be investigated and treated, not only to determine the underlying cause, but also because it can negatively affect women’s psychological well-being. […] An approach to treatment of hirsutism is outlined in Figure 1. […] Targeted counseling about self-image plays an important role in the treatment of hirsutism. Lifestyle modifications, such as physical exercise and dietary advice, can be recommended. […] When hirsutism is cosmetically distressing, moderate to severe, or widespread, a pharmacologic treatment should be offered. […] Drug treatment is limited to patients with hirsutism who do not wish to become pregnant in the short term. […] Oral contraceptives, topical eflornithine, and antiandrogens are common medications used to treat hirsutism. […] Antiandrogens such as spironolactone, cyproterone acetate, finasteride, and flutamide are recommended for patients with moderate to severe hirsutism.

• #58 Hirsutism Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/hirsutism

  Treatment for hirsutism depends on whether there is an underlying cause, and how severe the hair growth is. For example, if medications are making it worse, you can ask your doctor if you can switch medications. A tumor on the ovaries or adrenal glands can be removed surgically. Overweight women with hirsutism may want to lose weight so their bodies will make less testosterone. […] If your doctor cannot find a cause, you can try a combination of self care and hair-removal techniques. Psychological support may also help because hirsutism is often a frustrating and embarrassing condition. […] The U.S. Food and Drug Administration (FDA) has not approved any medications to treat hirsutism. However, some drugs may lower androgen production and reduce hair growth. It can take 6 months or longer for the medications to produce noticeable changes in hair growth. They must be taken long term to keep symptoms under control. These medications include:

• #59 Management of hirsutism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3830374/

  Treatment of insulin resistance, primarily by weight loss or using metformin or thiazolidinediones has been demonstrated to improve hyperandrogenemia and ovulatory function in many women with PCOS. […] These include androgen receptor blockers, such as spironolactone, flutamide, and cyproterone acetate. […] Spironolactone is a very effective agent for reducing hirsutism, regardless of the degree of hyperandrogenemia. […] Flutamide is effective treatment for hirsutism in doses of 500 mg daily. […] Cyproterone acetate is an effective agent for the treatment of hirsutism. […] Finasteride is useful for the treatment of hirsutism in women in doses of 5 mg per day. […] Shaving, bleaching, or chemical depilation may be useful to temporarily ameliorate unwanted hairs. […] Eflornithine hydrochloride 13.9% cream is approved by the Food and Drug Administration for the treatment of unwanted facial hair growth. […] Overall, although hirsutism is a frequent and distressing disorder often signaling an underlying endocrine disorder, a systematic approach to evaluation and the use of combination therapy will provide satisfactory treatment for most patients.

• #60 Management of Hirsutism

  https://www.skintherapyletter.com/hirsutism/management-hirsutism/

  Hirsutism is usually a benign, but extremely distressing condition. Although several treatment options exist, we recommend the use of OCs with antiandrogenic activity as first-line therapy for the majority of premenopausal women. An antiandrogen can be added if the response to OCs is suboptimal after 6 months of use. Laser/photoepilation are the preferred direct hair removal methods. Logical combinations tailored to the individual clinical profile can accomplish the best results in most patients.

• #61 Hirsutism – OBGYN | UCLA Health

  https://www.uclahealth.org/medical-services/obgyn/conditions-treated/hirsutism

  Hirsutism is often treated with a combination of approaches, including oral contraceptives with or without an antiandrogen, such as spironolactone, to lower levels or block actions of androgen on hair follicles. […] Medical therapy inhibits hair growth without eliminating hair already present. Therefore, medical therapy usually is combined with mechanical methods of hair removal, such as electrolysis or lasers. […] A successful management plan for unwanted hair addresses a woman’s own concerns and allows for an individualized strategy that balances time spent on mechanical hair removal with prevention of further hair growth through medical therapy.

• #62 Natural Solutions to PCOS Hair Growth (Hirsutism) — Kirsten Oddy Nutrition

  https://www.kirstenoddy.com/health-articles/natural-solutions-to-pcos-hair-growth-hirsutism

  While this blog post is aimed at natural approaches for managing hirsutism, its important for you to understand the different options available. […] If you’ve been to your GP and received a PCOS diagnosis and want help managing hirsutism, its likely you would have been offered one of two medications: The Oral Contraceptive Pill or Spironolactone. […] Another option is using a prescription hair removal cream such as Vaniqa which works by stopping new hair growth at the follicle. […] Adding in carefully selected, targeted supplementation can be a fantastic tool in helping to reduce excess facial hair. Some supplements that may help with hirsutism include: Zinc, Reishi mushroom, Magnesium, and Omega 3. […] If weight loss is one of your preferences, the evidence shows that just a 5% reduction in body weight could help to improve PCOS symptoms, including hirsutism. […] Together we will get to the root cause of your symptoms and you will leave with all the tools and knowledge to manage your PCOS for good!

• #63 SciELO Brazil – Hirsutism: diagnosis and treatment Hirsutism: diagnosis and treatment

  https://www.scielo.br/j/abem/a/t5GTrmpRNGJ7nDzYkqwtmpL/

  Oral contraceptives are considered to be the first line of drugs for the management of hirsutism; an anti-androgen is added if the clinical response is suboptimal after six months of therapy. […] For the majority of women with hirsutism who choose pharmacological therapy, we suggest estrogen-progestin contraceptives as initial therapy. […] Although anti-androgens are an effective therapy for hirsutism, their use is not suggested as monotherapy because of the potential adverse effects on a developing male fetus in the uterus. […] Monitoring should be carried out throughout the medical follow-up. The assessment of therapeutic responses should be evaluated by the patient herself, by declaring whether there was a decrease in the growth of hair or less need to use other methods to remove the hair.

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