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Extra Hair Growth

Treating Extra Hair Growth and Acne

Extra hair growth, also known as Hirsutism, can affect women at any age or stage of life. Some women also experience acne along with darker hair that grows at the upper lip and chin, around the breast, between the umbilicus (belly button) and pubic hair, on the forearms and on the inner thighs. When the hair growth is related to a hormonal imbalance we can use medicines to slow the development of new dark hair. First we must be sure that there is no serious medical problem causing the change in hair growth. The medicines are listed in the order in which we would typically use them.

NONE of the treatments for abnormal hair growth are compatible with pregnancy. Anyone taking these medicines must be sure to actively prevent pregnancy as birth defects, primarily in a male fetus, may result from the use of numbers 2, 3 and 4.

1) Oral Contraceptives: Many women with hirsutism have irregular periods. Oral contraceptives can help regulate periods AND treat the hair growth and acne. OCs change protein levels, which then change active hormone levels. It can sometimes take up to 6 months before a difference is noticeable. [One OC contains drospirenone, should be used with a lower dose of spironolactone and potassium levels should be monitored.]

2) Spironolactone: This medicine is a diuretic, or water pill. This medicine acts by blocking the hormone action to change the characteristic of the growing hair. The best dose is 100 mg twice each day, which then can be reduced to 25 or 50 mg doses. It may also take up to 6 months to notice a difference. You must NOT get pregnant while taking spironolactone.

3) Finasteride (Propecia): This medicine inhibits an enzyme that is triggered by the hormone imbalance. It blocks the “influence” of the circulating hormones which cause hair growth. The dose is 1 mg each day. This MUST be used with effective contraception, as it can cause birth defects if used in pregnancy.

4) Flutamide (Eulexin): Flutamide works at the hormone receptor. Side effect can include dry skin, and it can RARELY cause SEVERE liver problems. The dose is 250 mg daily. This MUST be used with effective contraception, as it can cause birth defects if used in pregnancy.


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