Dear Doctor,

I am a 29 year old woman and I recently noticed at least four tiny beards growing on my chin. I cut them and the hair grew again. What could be the cause and how can I stop it from growing?

Berna, Gacuriro

Dear Berna,

I understand your agony because facial hair, particularly a beard in women, is a source of great discomfort. This is due to the general concept that men have beards and women are supposed to have clean, smooth faces. But every individual has some amount of masculine and feminine hormones, quantity being predominant as per the gender of the person.

It is due to the effect of a small quantity of masculinizing hormones that women have hair over the limbs and the face. The quantity of hair usually varies in each individual. 

Usually around menopause, the level of estrogen (feminizing hormone) reduces and other hormones like testosterone and androgens increase, causing the boost in facial hair. Mental and or physical stress can also lead to the increase in levels of androgens in the body, resulting in hair over the face or even chin of women. Similarly, women who participate actively in athletics or physical sports can have an increase in facial hair. 

Hormonal disorders like thyroid problems, disorders of adrenal glands, pituitary gland problems and others are also responsible for beards in women. Polycystic ovarian syndrome is also a very common cause for the increase in level of male hormones in women leading to a male pattern of hair growth including a beard. Because of causing hormonal disturbances, ovarian tumors can lead to facial hair.  Obesity and resultant insulin resistance is another factor responsible for abnormal facial hair in women.

The use of anabolic steroids to improve performance or other medical reasons like long term use of corticosteroids for some chronic medical condition, leads to hirsuitism in women like the condition of the masculine pattern of hair growth.

You have not mentioned the pattern of your menstrual cycles and this is because irregular menstrual cycles are indicator of hormonal disorders. As such, for your age you should get yourself investigated and treated for the new onset of hair. Tests for hormonal disorders are available in Kigali. Learn to avoid stress and be relaxed completely both physically and mentally. If you are taking corticosteroids for some ailment like arthritis or bronchial asthma, avoid them.

Drugs like spironolactone and metformin can help control this problem but the side effects caused will outweigh the benefits. Beauty treatment like waxing and epilation are some of the methods used to remove unwanted hair. But these do not lead to the permanent cure of the problem. If you pull out the hair mechanically, it will re-grow and thicker too! Mechanism remains the same as for the growth of male beards after shaving.

Dr. Rachna is a specialist in Internal Medicine at Ruhengeri Hospital.