Ask the Doctor: Why do I have facial hair like men?

I’m 23 years old and in a relationship. I started developing facial hair when I was about 21. I can’t remember ever spotting hair before that time. The hair is on my chin and a little on my nose. The back of my neck also has a lot of wanted hair. I have been shaving but the results are never permanent. Do I have male hormones or something? My boyfriend doesn’t seem to be repulsed by it but it makes me very uncomfortable. Is there a permanent way to get rid of it? Please help. Andrea Dear Andrea, I can understand your anguish. To have facial hair in a woman is not only aesthetically bad but also a cause for distress. Facial hair and hair on the chin and upper lips is due to the masculinising hormone androgens. Whereas estrogens give the clean, soft look to a woman, androgens give the hairy rough look to a man. Every individual has some amount of these hormones, predominance of which determines the gender specific facial and body characteristics. Each hair on the face grows from a hair follicle. Normally these are stimulated to produce hair due to stimulation by androgens. But with normal androgen levels also at times, these follicles may be stimulated to produce more hair. Use of medications like corticosteroids for a long time can lead to hirsuitism in women, i.e. excess facial or body hair. Some birth control pills also mimic effect of androgens in the body causing excess hair growth in a woman. Drugs used to treat migraine, depression, bipolar disorders like mania and depression lead to hirsuitism as adverse effect. Hormonal disorders like diseases of pituitary gland, adrenal glands can have hirsuitism as one of the manifestations. Disorders of the ovary, like polycystic ovarian syndrome, can also cause extra facial hair in a woman. Apart from all these conditions, mental stress is yet another factor which can contribute to or aggravate hirsuitism in a lady. This happens because stress results in excess production of corticosteroids in the body, which can lead to extra facial hair in a woman. You can consult an endocrinologist and get necessary hormonal tests done. If there is any disorder it can be very well treated by medicines or some surgical intervention, depending on the underlying cause. Beauticians counsel against shaving as a means to remove unwanted hair. Because shaving leads to rapid growth of hair again and the new hair coming are brittle, like in the case of the beard of a man. Plucking the hair or use of depilatory creams would have the same effect as shaving, hence I would not advise to use them on a regular basis. Waxing does help for few weeks and is a better option than shaving. Laser hair removing techniques or electrolysis are superior methods to remove unwanted excess hair. In this, heat is generated within hair follicles by means of laser or electric current thus destroying them. This ensures a hair free smooth state for a long time or even life in few cases where underlying cause has also been treated. One should also learn to remain stress free, thus removing one cause for extra hair. Birth control pills containing estrogens predominantly or anti androgen drugs like spironolactone can be used to neutralise the effects of androgen. But these should be taken under medical supervision. Dr. Rachna Pande is a specialist in Internal Medicine at Ruhengeri Hospital