The Best Methods for PCOS Hair Removal
PCOS Hair Growth and How to Remove It
This post falls under one of the symptoms of PCOS that many find too embarrassing to talk about. Well guess what ladies? I’m here to be your guide to the humiliating because I’ve been there and I want you to know that I UNDERSTAND. I understand how absolutely mortifying it is to find unwanted hair on parts of your body that hair should not be growing. I understand that the internet is permanent and me writing this may even be making people uncomfortable right now (LOL even I’m a bit uncomfortable). But the reality is that if we don't talk about it then how are we going to tackle the problem or even feel comfortable in our own skin?
So here we go, let's get awkward. Together. Well, hopefully. Don't leave me here in my own weird discomfort... PLEASE.
So here's the question of the century, at least for women with PCOS. Why does PCOS cause hair growth in the first place? All of this has to do with these little hormones called androgens - otherwise known as the estrogen precursors. This may be surprising to some who think of androgens as male hormones, but in fact, both men and women naturally have these in their bodies.
In women, androgens are produced in the adrenal glands and in fat cells. When women with PCOS (or women in general as a matter of fact - women without PCOS can develop this issue too), have too much of these androgens (specifically: Testosterone, Androstenedione (A4), Dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S), Androstenediol (A5), Androsterone, Dihydrotestosterone (DHT)) in their bodies, it can cause a condition known as hirsutism. (4) I've always found this word kind of ironic because for some reason it reminds me of "her" and "hair" at the same time. Not sure if that was some ironic joke created on purpose by the word gods, but you have to admit it is kind of funny (sometimes you have to laugh or you'll cry, right?).
Hirsutism can arise in women without PCOS because all you need is a dash of extra androgen production and voila - you've got hair. This means, that if you have an androgen-secreting tumor, Cushing's Syndrome, or other type of adrenal issue, hirsutism can arise. Some medications can also cause hirsutism. (3) Now, because most of you reading this have likely already been diagnosed with PCOS, it's probable that PCOS is at the root of the androgen production and hirsutism. However, I already know some of you are opening other web browsers as you read this and are googling "symptoms of Cushing's Syndrome" or "What is Cushing's Syndrome" because that is totally something I would do.
Before we get into the nitty gritty of this post, I want to talk about one more thing - the exciting topic of hair growth cycles. Hair follicles have a life cycle of approximately six months. (2) Why is this important and relevant? In order to see a noticeable difference in hair growth when treating hirsutism, any hirsutism medication must be taken for at least a full six months - the same amount of time as the hair growth cycle. I realize six months is A LONG time, but I've included lots of options below for you to try while you're waiting for those six months to roll by. Or, if you prefer not to take a medication, you can use these methods for the foreseeable future.
Just to be clear, many of the methods of hair removal that I’m going to discuss in this post are temporary. In order to tackle hirsutism head on, it's necessary to use a mixture of different methods (lifestyle, self-care, medical, etc) to get the best results. I will also discuss a few permanent methods for those who are interested in learning more. But, my main intention in writing this post is to cover what has worked for me and others in removing specific areas of PCOS-related hair growth. I’ll also cover some troubleshooting for problems I’ve run into while attempting hair removal in these areas.
So here we go, here are all the ways to get bare in 2019. I thought about naming this post HAIR TORTURE 101, because honestly that’s how I feel about many forms of hair removal. But, to us ladies that suffer from PCOS-related hair growth, the pain is SO worth the reward. So let’s dive right in, it’s gonna get hairy…(sorry, I just couldn’t help myself).
Bleaching
Ok, so bleaching isn't quite a method of hair removal but it is SO much better than actually removing each individual hair while your tender skin cries out in pain. I thought I'd add it here just as a reminder that it IS an option. So as a quick way to get us started...here are the pros and cons of bleaching.
Pros:
No pain
Good bleach can actually lighten fine hairs enough for them to remain invisible (for a short while)
No pain
No pain
You get the idea....
Cons:
Nasty chemical smell
Redness and sensitivity to bleaching agent
Being vulnerable to blackmail photos of you with bleach on your lip while you wait for it to do it's magic (I speak from experience)
Thick and darker are harder to bleach
Not permanent
Does not actually remove hair
Well, no pain is still a huge pro in my book. On to the next method!
Shaving
We are all familiar with this form of hair removal, in fact, it’s probably one of the most commonly used ways that we remove hair. I’m not going to go into the mechanics here since we all know how to use a razor. For me, this is a great way to remove hair from my legs and armpits - but I can’t use a razor anywhere else on my body or else I will get severe razor burn.
I’m talking red bumps that will scar, ingrown hairs that won’t heal for weeks. Not just your run of the mill “oh that’s uncomfortable” razor burn. I’ve found that a lot of other women with PCOS also have sensitive skin and can’t use a razor on any other body part except for on their legs. To be honest, if I shave my armpits more than once every three days (and they really need to be shaved every day), then I get razor burn there too. It’s either razor burn or me trying to do arms at the gym without showing my pits too much….quite an interesting decision wouldn’t you say?
I’m curious if you ladies have the same issues with shaving that I do? I’d love to hear your comments below!
Plucking
The next way that we can remove hair is to pluck it. We tend to reserve plucking for the eyebrows (usually between waxing sessions), but I’ve found it to be an effective way to get rid of sparse dark hairs that show up on unwanted parts of the body. For me, this is usually my arms, my neck, or my under-chin area. Sometimes, I’ll even get them on my cheeks or my stomach as well. When my PCOS symptoms were a lot worse, my hair growth was also a lot worse. I was getting sporadic hair growth all over my body and the hairs seemed to pop-up almost overnight. Is it just me or does anyone else’s hair grow EXTREMELY quickly? I’m not just talking about the hair on my head but my entire body! Ugh. It’s like I pluck something and I swear I look in the mirror a day later and there that sucker is again. Some hairs I’ve gotten so used to them that I’ve thought about naming them...makes them seem less malicious somehow. Like ‘oh hey Henry how are you today?” or “Whaddup Irene how’s the view from down there”? Ok I’m weird, but when you have a condition like PCOS sometimes you just gotta laugh or you’ll cry. AM I RIGHT?!
Anyways, back to plucking. I’ve heard that some ladies have had lots of luck with epilators on their faces, cheeks, or upper lips. Personally, these little devices kinda freak me out. That’s just me being totally honest. But, it’s quick and easy and you can remove the hair yourself at home. If you don’t know what an epilator is, check it out here.
Waxing
Waxing. What is there to say about waxing? It hurts, it works, it lasts for about 4-6 weeks. I used to be all about waxing, but over time I’ve found better alternatives (see the next section on Sugaring). Because my skin is so sensitive, the heat from the wax along with the fact that all of my hairs are being simultaneously pulled out at once can leave my poor skin red and sometimes even bleeding. In fact, I have some horror stories about hot waxing that would probably make you cry a little (see below for that fun anecdote).
If you are pro-wax, I’d recommend waxing for areas on the body where hair grows close together (many women with PCOS mention their stomachs or backs as areas of concern). It also lasts longer than shaving and removes a larger area of hair at once than plucking could. Waxing works pretty well for most areas so long as you’re careful of any sensitivity to heat and make sure to exfoliate regularly when the hair starts to grow back in.
As a note for ALL hair removal methods: exfoliating regularly will prevent ingrown hairs. Please exfoliate so you don’t have to deal with these nasty buggers!
I’ll share one with you with a word of caution - I had my eyebrows done at a waxing and nail salon that I had been going to for some time. The woman doing my brows did not pay attention to the temperature of the wax before she put it on my skin and I felt it burn my upper brow pretty bad. When she ripped it off it ripped off a layer of my skin as well and I was left wearing a nice scab above my brow for a few weeks after. To this day, I have a small scar there and cannot grow hair in that area. I actually have to put castor oil to help the hair growth so that my brows are the symmetrical. ALWAYS make sure your esthetician checks the temperature before waxing you.
After that wonderful tale and to save some time and money, I decided to order my own waxing kit on Amazon. I DIY only for the small areas that will sometimes annoy me, but not enough to actually go in for a wax. I DO NOT mess with my brows - there is no way I'm touching the arch that my incredible brow artist has worked for months (years?) to achieve. I DO, however, wax my upper lip (thanks lady at the nail salon for letting me know this is a problem whenever I get my nails done) and other areas of my body like my underarms, etc. Why, you ask, do I sometimes wax my underarms? (Is that weird? LOL.) Remember in the shaving section when I was discussing razor burn? Well, I realized that if I just waxed my underarms myself then the whole issue goes away. WORD OF CAUTION: Wax is hot. Your armpits are sensitive. BE CAREFUL. I've definitely burnt my pits a few times and it's not fun. I still think that if you have the grit to pull out all those thick, tiny hairs from your pits - it is SO worth not having to shave.
Sugaring
YAY! My favorite method and the one I use on the reg for my bikini area. Sugaring not only removes hair but will also exfoliate the area and does not require heat. Pro Tip: Do not let the hair grow too long or it will be more painful when you get it sugared due to it “pulling” when the esthetician applies the sugar. Additionally, start exfoliating the area that was sugared around 3 days after the treatment to ensure you don’t get any ingrown hairs. For a full breakdown on the art of sugaring, see the article I wrote here (https://successwithpcos.com/sugaring-101/).
Depilatory Creams
Depilatory creams are not my favorite to be perfectly honest. First of all, I can never say the word depilatory correctly - I always want to pronounce it 'delapitory' instead (not really sure why). In addition to my strange inability to say this word correctly, I also can't stand the chemical smell of these products. In my own personal use, I've found that I tend to be super sensitive to these creams and that they don't remove the thicker hairs which are common with PCOS.
[2024 update: still accidentally calling them delapitory creams <sigh>].
Threading
Honestly, again not one of my favorite hair removal methods but it does get the job done. There’s something kind of weird about the threading lady (or man, although have yet to encounter a threading man, to date) telling you to hold your skin in various directions while she takes a dental floss looking thread, sometimes puts it in her mouth, and then uses it to pull unwanted hair off of your face and body. Maybe I’m being dramatic about this, but I just find it kind of weird.
Pros: Usually pretty inexpensive, lasts a decent amount of time, and no heat applied like with waxing which is great for gals with more sensitive skin.
Cons: Kinda hurts, kinda weird.
Laser Hair Removal
Unfortunately, I don't have any personal experience to be able to speak to this, but would love to know if someone else has had it done. Comment below if you’ve tried it!
[2024 update: Laser is my new favorite method - but FYI, it HURTS. It’s also 100% worth all the pain and money. Expect to do multiple treatments. Don’t do your treatments during the summer like I did - start doing them in the fall/winter so you are ready to go by summer. Expect the hair to fall out after 5-14 days - mine fell out in about 8, then grew back thinly until I had the next procedure. You will have areas grow back that were not in the correct phase of hair growth to be picked up by the laser. You also need a specific power of the laser to be most effective - the higher the laser, the more it hurts. Again. worth it! Also, you will need to be mindful of the color of your hair. Technology has gotten better to where lighter hair can be picked up but it’s still better and more effective when the hair is darker. It’s also best when you have short hair - aka trimmed depending on the area - but still enough for the laser to pick up. Follow the directions on the day of the procedure to know whether you can wear lotions/deodorant/oils/etc - most likely you want to show up with clean, bare skin. Also, look for packages and savings as there are so many places offering these procedure today!]
What I have heard from friends who have had the procedure and through my own research is that Laser Hair Removal can be quite costly and require several (4-6) treatments to achieve the desired result. These treatments must be spaced out by several weeks (usually 4-6 weeks) and also require a yearly maintenance session after the desired result has been achieved. That being said, I know we all spend tons of time and effort trying to get rid of PCOS-related hair growth anyways, so this may still be a great option for those that don't mind shelling out the cash up front for the procedure. In my unsolicited opinion - if you're gonna spend tons of money over time looking for answers to this problem, yet you know a solution exists right here, you may as well shell out the money up front (if you can) instead of spending it over years without finding a solution that actually works.
Interestingly, I've actually seen some laser hair removal salons (?) (clinics?) (medspas?) advertising directly to women with PCOS and hirsutism. Check out the place I linked above.
Electrolysis
Again, don’t have any personal experience to be able to attest to this hair-removal method, but would love to know if someone else has had it done. Here's what I've heard about electrolysis: it kinda sucks. Here's why. While electrolysis is a super effective method of removing hair, the way it works is essentially by inserting a very fine needle into the (individual) hair follicle and damaging it by applying an electric current. Hence, electrolysis. Electro - referring to electricity, Lysis - the breaking down or dissolution of (in this case, the hair follicle).
I don't know if it's just me, but even the sound of that seems kinda gnarly. The general consensus on this procedure is that it’s, not surprisingly, pretty painful. Apparently, electrolysis is also quite expensive and generally best suited for small areas. While it can be performed on large areas, it seems this would have to be done over time.
Comment below if you’ve tried Electrolysis and can share your experience!
Medications
Vaniqa: Vaniqa (Eflornithine hydrochloride) is a cream that works to significantly slow the growth of unwanted hair but it does not actually remove it. In my understanding, Vaniqa is typically used for unwanted facial hair and takes several weeks (something like 6-8 weeks) for noticeable results. One thing to be aware of about Vaniqa is that it does not give permanent results. This means that as soon as you stop using it, hair growth will return to how it was before you began use. (1) Also be aware that it can cause redness and sensitivity in some women, so make sure to patch test it on another area before using it on yo' pretty face!
Spironolactone: Spironolactone (Aldactone) is one of the most popular anti-androgens, though there are a few other options for treatment as well. I've included Spiro because I've taken it and know it's effects, therefore am able to speak to them here. Additionally, some anti-androgens - like Finasteride (Propecia, Proscar) and Cyproterone acetate are effective - but are not available in the US. (2) Therefore, I will mostly talk about Spiro here.
Anti-androgens work by either decreasing androgen production or by blocking the body's androgen receptors. (2) The great thing about this is that taking an anti-androgen may help with other androgen-related symptoms like acne. I didn't notice a huge change in my acne, but did notice that my skin did seem clearer overall. Comment below if you noticed a difference in your skin on Spiro (or another anti-androgen)!
Usually, anti-androgens are not prescribed until an oral contraceptive has been taken for 6 months and has not been effective in treating hair growth. If after taking an anti-androgen for a 6-month period, one finds the dosage to be ineffective, the dosage can then be increased.
One BIG thing to not about anti-androgens is that they can cause birth defects, so it is really important to continue to stay on birth control while on them. This is not something I am very familiar with so I will not say much on it, but I have read it in multiple sources. PCOS ladies who are TTC: stay away from this one if you are dealing with hair growth.
In regards to effectiveness and dosage, if after taking an anti-androgen for a 6-month period one finds the dosage to be ineffective, the dosage can then be increased.
A final note about Spiro: Spironolactone is a diuretic and is primarily used to treat high blood pressure (side note: as a potassium-sparing diuretic, it's important to watch out for high potassium). When I first started taking Spiro, I had a lot of dizziness with it - likely from decreased blood pressure. I naturally have lower blood pressure, so I had a lot of dizziness upon standing and just in general. Be aware of this and be careful when you first start taking it so you can prevent any possible fainting spells.
Oral Contraceptives: There are a lot of pros and cons to taking birth control, none of which I will discuss here as we are talking strictly about hair growth. When it comes to PCOS-related hair growth stemming from androgen production, oral contraceptives can be a good option because they can lower the amount of free androgens in the body. (1) This can help symptoms, but for me it hasn't worked 100%. I'd be curious if it has completely reduced hair growth for anyone. Comment below!
Needless to say, oral contraceptives would not be a good option for anyone TTC. ;)
Well there you have it, all the options for getting rid of that annoying hair! I'd love to hear your thoughts and experiences on all of this so drop a comment below, shoot me an email, DM me, or however else you crazy kids are communicating now a days.
xx,
Morgan
Resources:
(1) https://www.verywellhealth.com/hirsutism-in-women-with-pcos-2616644
(2) https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-women-beyond-the-basics
(3) https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941
(4) https://www.verywellhealth.com/androgens-and-pcos-excess-levels-what-it-means-4156771