There are a variety of factors that impact the growth of hair. Understanding the cause of the hair growth will enable the electrologist to proceed with the most effective course of treatment.
Causes of unwanted hair growth can be divided into 3 categories:
TOPICAL
• Forcibly removed hair often grows back stronger, as thesemethods (such as tweezing, waxing, sugaring, threading etc.) tear out the lower follicular area, stimulating the blood supply, resulting in stronger, more determined re-growth.
• Application of some steroid creams to the skin, for instance for conditions such as acne and eczema.
• Irritation caused by a plaster cast – though once removed, hair usually disappears over time
HEREDITARY OR GENETIC
Some clients may describe a family tendency toward excess hair, in which case the cause can clearly be attributed to inherited genes. Others may be pre-disposed to acquiring hair at a particular time in their life, where there is no previous family history – this is considered where all other avenues of investigation have failed to reveal a cause. Racial background has a strong influence on the presence of hair in certain areas.
SYSTEMIC
Hair growth can be caused by a hormone disturbance or a bodily influence – this is referred to as ‘systemic’.
Hormones are natural substances transported in the blood, they act as chemical messengers targeting specific cells and tissues in the body. Typically, hormones do the following:
• Regulate growth and development
• Help to keep the body in a constant steady state, i.e. homoeostasis
• Help to cope with stress
• Help to regulate how the body processes food to produce energy
All women have low levels of male hormones, made in the ovaries as an intermediate step in making female hormones. Sometimes, the levels can become imbalanced and this can manifest as excess hair growth.
Systemic (hormonal disturbance) causes of hair growth can be divided into two categories: primary (normal) and secondary (abnormal) causes.
NORMAL CAUSES
There are certain stages in a woman’s life when hormones become imbalanced naturally:
• Pregnancy: women may experience sudden onset of hair growth, which can disappear just as suddenly after birth. Pregnant clients can still proceed with treatment if desired (e.g. to boost self-esteem), provided they are not contra-indicated.
• Menopause: at this time androgen levels (male hormones) become disproportionally high compared to the falling levels of female hormones and new hair may develop, or existing hair may become darker. Electrolysis can eradicate a follicles ability to produce hairs, or, in cases where hormone output is not adjusted, manage the growth.
• Puberty: some pubescent females will develop a growth of darker, but usually fine, excess hair, e.g. on the upper lip and neck. This usually disappears once hormones become balanced and is not cause for concern. However, if self-conscious about this, girls may seek electrolysis treatment. Treatment of this hair is highly successful and is far preferable to other methods of hair removal which will exacerbate the problem. For girls under 16 years of age, parental or GP permission must be sought prior to commencing treatment and a parent/guardian should accompany the client on each visit.
• Stress: the endocrine system is responsible for producing and distributing hormones; it is very finely balanced and affects all other bodily systems, particularly metabolism. Stress increases adrenalin levels, which in turn affect other hormone levels – in extreme cases, prolonged stress can cause a manifestation of unwanted hair. The best solution is to remove the source of stress, though electrolysis treatment will help alleviate anxiety caused by the hair itself.
• Drugs/Medication: certain drugs stimulate hair growth. Medication containing hormones may cause hair to grow in a masculine pattern, see examples below. Where a medication clearly causing unwanted hair growth must be taken for life, permanent hair removal may not be achievable, but electrolysis can be used to manage the growth.
DRUGS AND UNWANTED HAIRGROWTH
The following are some drugs where instances of unwanted hair growth are reported as a side effect. Please note, only a small minority will be affected by these drugs and caution should be exercised before attributing blame to the drug:
HORMONES
- Oral contraceptives – if hair growth has arisen since starting them
- Oestrogen or progesterone therapy (Provera)
- Cortisone (Cortisyl)
- Prednisone and its derivatives (Deltacortril, Prednisolone, Precortisyl, Prednesol)
- Dexamethasone (Decadron)
- Topical steroid creams (Hydrocortisyl, Betnovate)
- Testosterone (Restandol, Sustanon, Testoviron Depot)
- Clomiphene (Clomid, Scrophene – both are fertility stimulators)
- Thyroid hormones (Synthrosis, Eltroxin)
- Growth hormone (Norditrophin)
ANTI CONVULSANTS
- Clonazepam (Rivotril)
- Carbamazepine (Tegretol, Temporol)
- Phenytoin (Epanutin)
ANTI DEPRESSANTS
- Fluoexetine (Prozac)
- Clompramine (Anafranil)
- Sertraline (Lustral)
- Venlafaxine (Efexor)
- Bupropion (Wellutrin)
- Trazadone (Molipaxin)
TOPICAL SKIN PREPARATIONS
- Topical steroids (as above)
- Topical anti-bacterial (Neosporin)
- Topical anti-fungus (Nizoral, Daktarin)
MISCELLANEOUS
- Roaccutane – anti-acne agent
- Fenfluramine – weight loss agent (Ponderax)
- Minoxidil – blood pressure reducer and hair growth stimulator (Regaine)
SECONDARY/ ABNORMAL CAUSES
Abnormal causes are where there is an imbalance of hormones caused by a glandular disorder or disease, such as:
• Cushings Syndrome
• Adrenogenital Syndrome
• Achard Thiers Syndrome
• Stein Leventhal Syndrome, better known as Polycystic Ovary Syndrome – the most likely abnormal disturbance to be encountered in electrolysis clients
POLYCYSTIC OVARIES (PCOS)
This condition can affect any woman of reproductive age, where the ovaries contain many small cysts, lying just under the surface of the ovary, made up of the remains of egg follicles that have not grown large enough to release an egg. Polycystic ovaries tend to produce too much male hormone, which can cause hair to grow in a more male pattern. Excess male hormones (androgens) also increase the activity of the sebaceous glands, sometimes causing acne. Other symptoms include heavy, irregular or no periods. In severe cases, drug therapy is administered to block the production of male hormones, which, in conjunction with electrolysis therapy, has very favourable results.
It is estimated that up to 20% of women have polycystic ovaries to some extent and it can be hereditary. Being overweight can affect the balance of hormones and trigger or exacerbate the symptoms of polycystic ovaries. Often, an electrologist is the first person to be alerted to the symptoms of POS; while they should never diagnose the problem, they should suggest that the client consult their doctor for advice.
CONGENITAL ADRENAL HYPERPLASIA
This term is used to describe a group of inherited adrenal gland disorders (Adrenogenital Syndrome). Patients with this condition lack a specific enzyme needed for the adrenal glands to make the necessary cortisol and aldosterone hormones within the body. The lack of these two hormones means that the body instead produces excess androgen, the male sex hormone and early or inappropriate appearance of male characteristics can be present. Roughly 1 in 10,000-80,000 individuals are affected.
ACHARD-THIERS SYNDROME
This condition mostly affects postmenopausal women and comprises diabetes mellitus, deep voice, hirsutism or hypertrichosis, clitoral hypertrophy and adrenal cortical hyperplasia or adenoma. Patients often also have amenorrhoea, hypertension and osteoporosis.
