Female Facial Hair

What causes female facial hair?

Excessive facial hair in women usually occurs as a result of hirsutism. Hirsutism arises from either an increased level of male hormones called androgens or by the body being overly sensitive to these hormones. This results in male-pattern hair growth in areas such as the face, neck, chest, stomach, lower back, buttocks, or thighs. 

What counts as female facial hair?

All women have some hair on their face, but it is usually very fine, light in colour and, in many cases, is hardly visible. Facial hair caused by hirsutism is usually coarser and darker. Because hirsutism is associated with an imbalance in sex hormones or the body’s response to these hormones, the growth pattern of unwanted hair resembles that in men.

What is hirsutism?

Hirsutism is defined as excessive hair growth in certain areas of the body in a “male pattern”. It’s typically caused by increased levels of androgen hormones, and typically affects the face, back, chest, neck, buttocks and thighs.

Types of hirsutism

Hirsutism has a number of underlying causes:

• Polycystic ovary syndrome (PCOS) – This is the most common cause of hirsutism, accounting for up to 82% of cases. PCOS is characterised by numerous cysts (fluid-filled sacs) forming on the ovaries. This causes increased levels of androgens (male sex hormones).
• Idiopathic hyperandrogenaemia – this occurs where there are increased levels of the androgen hormones, but no underlying cause can be identified.
• Hyperprolactinaemia – where the body produces too much of the hormone prolactin. Prolactin is involved in the production of milk following pregnancy, but too much prolactin also causes excess androgens.
• Congenital adrenal hyperplasia – a condition present from birth where the adrenal glands produce too much androgen, among other hormones.
• Cushing’s syndrome – this condition occurs due to excess cortisol. Cortisol is an anti-inflammatory hormone that is released in response to physical and psychological stress, but it can also be increased by corticosteroid medications.
• Androgen-secreting tumours e.g. ovarian tumours - these are tumours that release androgen, increasing the levels of androgen in the body.
• Certain medications e.g. steroids, oestrogen antagonists (e.g. clomiphene, tamoxifen), testosterone, cyclosporin, danazol, phenytoin
• Idiopathic hirsutism – occurs where there is excessive male-pattern hair, but hormone levels are normal, and there is no other abnormality detected
• Hypertrichosis – a condition characterised by excessive body hair across the whole body, which does not follow a typical “male pattern”

Hirsutism may be associated with other symptoms aside from excessive facial hair depending on the underlying cause.

Pregnancy and female facial hair

Some women experience excessive growth of facial hair during pregnancy. Although the exact reason behind this is unknown, it is thought to be due to the hormonal fluctuations of pregnancy, specifically an increase in the secretion of male androgen hormones from the ovaries and placenta. Increased hair growth during pregnancy is usually only temporary and tends to go away within 6 months of giving birth.

Menopause and female facial hair

An increase in facial hair is common during menopause, due to the changes in hormonal balance in the body. The level of oestrogen produced by the ovaries decreases during menopause, but testosterone levels may not, which can result in hormonal imbalance and increased facial hair growth.

PCOS and female facial hair

Polycystic ovary syndrome (PCOS) is one of the most common causes of increased androgen secretion, which can lead to excessive hair growth in women. However, the growth of facial hair alone is not an indicator of (PCOS). In order to diagnose PCOS, a doctor will need to review your medical history and confirm the presence of other symptoms, including irregular or absent periods, trouble with weight control, symptoms of diabetes, and other signs of hyperandrogenism such as hair loss and acne.

How is hirsuitism treated?

The most effective treatment for hirsutism may depend on if there is an underlying cause. Aesthetic hirsutism treatments are usually aimed at removing or reducing the appearance of female facial hair. Hair removal methods range from shaving, plucking and waxing, to specialist treatments such as laser hair removal and electrolysis. Oral anti-androgen therapy e.g. co-cyprindiol (Dianette) and oral contraceptives may be effective at reducing hair growth. Topical therapies such as eflornithine cream, also known as Vaniqa cream, are applied directly to the face and chin to help slow down the growth of unwanted hair. 

How to get rid of female facial hair?

Treatment for hirsutism involves methods to remove excess hair, prevent it from coming back, or slowing its growth. Temporary hair removal methods include shaving, plucking or waxing, while more permanent treatments include laser hair removal and electrolysis. Eflornithine cream, sold under the brand name Vaniqa is a prescription topical treatment that can slow down the growth of facial hair when used regularly. 

Electrolysis for female facial hair

Electrolysis is a process that involves passing an electrical current through a hair follicle in order to damage the follicle and prevent new hair growth. To achieve permanent hair removal, several sessions are usually required, carried out by a licensed therapist. Electrolysis is thought of as a safe and effective treatment but can be an expensive option.

Why do some women have facial hair?

The major cause of facial hair in women is due to hormonal imbalance. Even slightly elevated levels of androgens such as testosterone can lead to excessive hair growth. This is commonly due to polycystic ovary syndrome (PCOS), so it is advised to see a doctor if you experience increased facial hair growth. Many women also experience an increase in hair growth during menopause when the body’s hormonal balance is altered. Similarly, some women have a heightened sensitivity to testosterone, rather than higher levels of the hormone itself, which can also lead to excess hair growth.

How much facial hair is excessive in women?

Facial hair in women can range from a few dark hairs here and there, to a thicker covering that resembles a beard. Excessive facial hair is subjective, and even if you have hair on your face, there is no need to remove it if it does not bother you. Often healthcare professionals will ask patients with excessive facial hair to “score” the degree of hair coverage using a visual scale, in order to guide treatment and assess response to therapy. With hirsutism, the hair is often darker and coarser than the thin, fine, short hair that covers most women’s faces.

How are the adrenal glands related to female facial hair?

The adrenal glands are located above the kidneys and are responsible for hormone production. Disorders relating to the adrenal glands can be responsible for excessive hair growth, including adrenal cancer, adrenal tumours, congenital adrenal hyperplasia, and Cushing’s disease. When there is a problem with your adrenal glands, you are likely to experience other symptoms, including high blood pressure, bone and muscle weakness, excess weight in the upper body, headaches, and high or low blood sugar levels. Be sure to see your doctor if you have a combination of these symptoms.

Will the hair get thicker or darker?

Hair caused by hirsutism can be thicker, darker and coarser than the usual facial hair, and this type of hair is referred to as terminal or androgenic hair. It is the type of hair that is normally present on a man’s face, and that develops during puberty. Over time, hair on the face may get thicker or darker or may stay the same.

Should I see a doctor about my facial hair?

Since most cases of excessive facial hair are due to hormone imbalance, it may be advisable to see your doctor for a full assessment. There may be effective therapies available that focus on treating an underlying condition that is leading to your excessive facial hair. You should see your doctor if your facial hair has appeared suddenly, or you are experiencing any other signs or symptoms, as this may point toward a new underlying condition.