Cosmetic treatment is usually undertaken, particularly for congenital hypertrichosis, where, unlike in many acquired hypertrichosis cases, the underlying problems cannot be cured. There is no single treatment for all hypertrichoses and patients. The site, nature and amount of growth, and the patients and their preferences are taken into account when deciding the most appropriate treatment method.
The common treatments are shaving, plucking, epilation, depilation, electrolysis and laser removal. Laser and electrolysis treatment approaches hold the promise of being permanent hair removal approaches. Other treatments are temporary and have to be repeated.
Cosmetic Hair Removal Treatment:
In most cases, excess hair growth caused by hypertrichosis is not due to any underlying medical problems. However, they produce severe emotional problems where cosmetic treatment is the only viable therapy. Where there is an underlying problem, it is a necessary part of the overall treatment regimen.
Several treatment options are available which differ in their efficacy, comfort levels and cost. The treatment mode depends on the site, nature of growth and the patient. In most cases, more than one treatment is needed.
Cosmetic treatment methods:
Shaving is the simplest and cheapest but leaves hair roots intact and therefore hair growth unaffected. Side effects are minimal but in some ethnic groups, folliculitis may occur. Women are averse to it because of its masculine nature.
Plucking and epilation involves removing the hair shaft and bulb. It is done singly by tweezers in plucking. In epilation, waxing is used to uproot a large number of hairs in one operation. This treatment is one of the least expensive and the cosmetic effect lasts for 4 to 8 weeks, but it is slow and not practical for large areas. Plucking is done in the anagen phase because if done in other phases it encourages further hair growth.
Side effects are sometimes caused by the waxing material and include burns due to hot wax, folliculitis, hyperpigmentation and scarring. Children have poor tolerance to plucking and epilation since degree of comfort is low.
Depilation uses variants of thioglycolates, used in perming, to dissolve the hair shaft, sparing the hair bulb. The cosmetic effect produced is excellent and lasts for about two weeks.
The thioglycolate variants are used in an alkali solution to get a pH concentration, which dissolves the hair without damaging the skin. For removing coarser terminal hairs, sulfides of strontium, barium and calcium are used. The bad odor of hydrogen sulfide gas, produced by sulfides is masked by fragrances.
Side effects include irritant dermatitis in 1% to 5% cases. Occasionally sulfides cause an allergic dermatitis. To prevent systemic absorption, depilatories for children should be used in only small localized areas.
Laser Hair Removal Treatment:
Excessive hair disorders are a great embarrassment and a source of emotional stress to affected individuals. Cosmetic treatment, which improves the appearance, is essential to lessen the pains of these unfortunate people.
Laser hair removal systems are currently widely used for long-term hair removal. The need to have a fast and non-invasive treatment method led to the development of this treatment.
All laser treatment systems use the principle of selective photothermolysis where a selected chromophore is targeted by the laser to produce the heat that destroys the follicle. Therefore deep penetrating wavelengths in the range of 600 – 1100 nano meters (nm) are used. Care is taken to limit skin damage by restricting damage to the target area. This is done by ensuring enough laser absorption by the target and using a pulse rate shorter than the thermal relaxation time of the target.
The systems differ in the parameters like wavelength, pulse duration, fluence, spot size and repetition rate and in the cooling system used. The cooling device reduces heat conduction limiting skin damage and pain. The selection of these parameters is important for getting the ideal laser for an individual.
All laser treatment systems are more or less equally effective attaining on an average 20% long-term hair reduction with every treatment in 80% of cases. This shows that multiple treatments give better results. Likelihood of long-term hair reduction bears a strong correlation to hair color. Dark hair on fair skin responds better to treatment than blond, red or white hair. The re-growing hair is sometimes thinner and lighter improving the overall appearance.
Electrolysis – Hair Removal Treatment:
Excessive hair disorder, such as, hypertrichosis and hirsutism are a source of great embarrassment and emotional stress to the affected individuals. Cosmetic treatment, which improves the appearance, is essential to lessen the pains of these unfortunate people.
Of all the cosmetic treatment techniques available today, electrolysis is the only cosmetic treatment, which has the potential to become a permanent hair remover. It is a kind of electrosurgical depilation where the hairs are electrochemically destroyed using electric current. Electrolysis treatment is carried out with a very sophisticated machine, called the depilator, which is operated by highly skilled personnel. This apparatus is used to send a regulated and controlled electric current to the hair follicle.
Today, by broad consent, the term electrolysis is used to describe the general process of electrochemical destruction of hair. Under this broad term there are three available techniques to carry out the process. These are galvanic electrolysis, thermolysis and a blend method. The aim of all three techniques is to destroy the hair follicle without causing any serious scarring.
Eflornithine Hair Removal Treatment:
Excess hair growth disorders, such as, hypertrichosis are a common problem seldom discussed in primary care setting. Unwanted hairs are a source of great embarrassment and distress to those affected and can badly disturb their social life. Hair removal treatments are therefore an important part of the total treatment regimen.
There are several treatment options all varying in their efficacy, degree of discomfort and cost. They are shaving, plucking, depilation, epilation, electrolysis and laser treatment. A single treatment will not work on all body sites and patients. The treatment selected depends on the body site, nature of hair growth, the patients and cost. In most cases, more than one method of treatment is needed.
Side effects:
Side effects are mainly local and include acne, stinging, burning and erythema. They are more common in patients treated with eflornithine than in those given placebo treatment. Percutaneous absorption of eflornithine, which causes these side effects, is 4 percent. But it is less than 1 percent when the 15 percent eflornthine cream is applied twice a day on a shaved 50 sq.cm. area of skin under the chin. The no-effect dose is presently not known. However, these side effects generally resolve without treatment or discontinuation of eflornithine.
The use of eflornithine in the generalized forms of hypertrichosis is limited because no data is available regarding the maximum area it can be applied on. Safety and efficacy of eflornithine (vaniqa) for various types of hypertrichosis and on a wider patient population, especially children, has not been established. Eflornithine is a pregnancy category C medication, and it is not known whether it is excreted in human breast milk.
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