Hair Removal

Hair: You can color it, curl it, straighten it, braid it, cut it, etc., but what about unwanted hair? If you have unwanted noticeable hair above your upper lip, chin, neck, toes, belly, or back you can probably relate. Having to deal with the embarrassment of unwanted hair is no joke. Depending on the amount of extra hair you have, it can range from being mildly annoying to severely distressing.

What causes unwanted hair?

Girls make both “male” (aka androgens) and “female” (aka estrogen/progesterone) hormones, but the amount of male hormones is normally low. If the levels are too high or your body is sensitive to the normal levels, excess hair can grow. This extra hair tends to be coarse and dark. The medical word for too much or unwanted dark hair is “hirsutism.”

Heredity: “Heredity” refers to things about your body that are inherited, or passed along from generation to generation. Individuals of Mediterranean descent often have darker and thicker hair on their arms, legs, upper lips, toes, etc. Hirsutism can also run in families.

Female endocrine disorders such as PCOS (short for Polycystic Ovary Syndrome) can cause hirsutism. Individuals with PCOS make extra amounts of “male” hormones called “androgens”. Although everyone makes both female and male hormones, people who are assigned female at birth with PCOS make more of the androgens (male hormones). One type of androgen called testosterone (pronounced test-toss-ter-own) is mostly to blame for excess hair in individuals with PCOS.

Sometimes the cause of extra or unwanted hair is unknown.

What are the options for dealing with unwanted hair?

There are a variety of hair removal methods ranging from temporary to permanent. The methods vary in effectiveness and cost.

Over-the-counter creams such as depilatories work by dissolving the proteins that make up hair. The average cost of this type of product is a few dollars per application. They are the least effective of the temporary hair removal options and can have annoying side effects including skin irritation.

Shaving is basically trimming or cutting the hair. It doesn’t affect hair growth at all. In fact, it’s a myth that shaving hair causes it to grow back thicker. When a hair is cut off it grows back without the fine point, making it feel thicker. It doesn’t cost much, but shaving can cause ingrown hairs, which can lead to “folliculitis” (inflammation of a hair follicle), ranging from a few red bumps on the skin to a severe rash. To avoid problems, you should always shave in the direction that the hair grows, don’t repeat strokes, and wet the hair or use a shaving cream before you begin.

Tweezing is the cheapest method of hair removal, but it can take a lot of time and it can hurt, so it’s not a good option for large areas. If you use a decent pair of tweezers, you can pull out the hair at the root, but the hair will eventually grow back at the same thickness. Sometimes girls can develop an irritation where they tweeze which can become infected.

Dermaplaning is a new method of removing hair from the face.  Trained professionals use an exfoliating blade or scalpel (sharp blade) to skim the surface of your skin, removing dead skin cells and hair from your face. When done by a trained professional, the method is safe, pain free, and effective at removing access hair from the face. As with any hair removal, it’s super important to apply sunscreen daily, as hair removal places you at a higher risk for sunburns.

Waxing is considered an older method, but it’s come a long way. Now, there are roughly 7 different types of waxes. Warm soft wax, warm hard wax, cold soft wax, pre-made wax strips, fruit wax, sugar wax, and chocolate wax. Sugar wax is the oldest form of waxing and it’s created with water, sugar, and lemons. It is known as the most sensitive form of wax, making it great for sensitive areas like the face and groin. Warm hard wax adheres to only the hair and doesn’t require strips. Some people feel a sting for a couple of seconds when the wax is pulled off of the skin. Although fairly inexpensive to do at home (a few dollars per application), waxing is best done in a salon or spa where the temperature of the wax is controlled so there’s less of a chance of burning your skin, which can cause scarring. Since waxing removes the entire hair root, your skin may get pink or red and feel tender. You should apply a good moisturizing lotion after each.

Laser treatments can be pricey and take 6-8 sessions on average for 80% improvement in hair reduction. This method destroys the hair, not the root. The hair doesn’t come out right away, but it eventually falls out. This method lasts a longer time but the hair eventually grows back.

Electrolysis is the only permanent hair removal method, because it destroys the hair follicles. This procedure needs to be done weekly and it can take a couple of years for permanent hair removal. Therefore, it can be very costly. Hair color and skin type affect the success of both electrolysis and laser hair removal.

Bleaching hair isn’t the same as removing it, but it’s a popular and inexpensive way to make dark hair on places such as the face, arms, and neck less noticeable. Be aware though, that bleach is a chemical which can cause irritation and burns.

Medications that lessen hair growth: All of the options listed below require a prescription. All of the oral medications take 6-9 months for you to see an improvement.

• Birth control pills are typically prescribed to treat PCOS. The Pill is used to make the menstrual cycle regular and balance the hormones. The levels of androgens (the male hormones linked with excess hair growth) are lowered.
• Metformin is a medicine that is often prescribed to help lower insulin levels in people with PCOS. High levels of insulin stimulate the ovaries to make androgens, so by decreasing these levels, hair growth can be lessened, but not as much as with the Pill.
• Spironolactone is another medication that is often used to treat hirsutism. It works by blocking androgen hormones from working. Possible side effects can include; irregular periods, frequent urination, loose bowel movements, rash, dry mouth, tiredness, and headaches. The side effects are temporary and go away when spironolactone is stopped. Vaniqa® (Eflornithine) is a topical cream that requires a prescription. It works by slowing the rate of hair growth. It’s safe to use with oral contraceptives. The cost of the cream may vary depending on your health insurance coverage but is usually not covered. Vaniqa® is recommended for small areas such as the upper lip, chin, and side burns, but would not be practical for use on large areas of the body. You have to use it every day for it to work. Once you stop using it, the hair will grow back.

Is it safe to remove unwanted hair?

Having to get rid of unwanted hair is definitely something you’d rather not have to deal with, but there are safe ways to make it go away, at least temporarily. It’s still very important to be aware that certain methods of hair removal are NOT SAFE for all skin types and colors. You’ll need to talk with your health care provider first and then test a small area before applying the hair removal product on larger areas. Be aware as well, there are a lot of “at home remedies” that may be unsafe as well. If you have any questions, ask your health care provider!

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.