A9. Excess hair: physical and pharmacological treatments

Abstract

The growth of unwanted hair can be aesthetically distressing and may psychologically affect both women and men. For centuries, numerous techniques have been employed for this indication.1 Modern medicine has developed effective physical and pharmacological methods for the removal of unwanted hair. Laser technology and the principle of selective photothermolysis offers a new approach.2 Pigmented hair bulbs selectively absorb pulsed laser light of wavelenghts ranging from visible red light to low infrared. Light converts to heat and thermally damages the pigmented hair bulb without affecting the surrounding tissue. The follicular epithelium regenerates slowly and regrowth may occur. Nevertheless, the new hair will be thinner and softer. Depending on the anagen/telogen ratio of various body sites, two or more treatment sessions are required. Pharmacological hair reduction can be achieved by long-term treatment with antiandrogens or may be based on blocking of the mitotic activity of the follicular epithelium. Eflornithine, in a 13.9% cream preparation thinly applied twice daily, blocks ornithine decarboxylase, an enzyme needed for the synthesis of polyamines, the main source of the hair shaft.3 Following an average of 2 treatment sessions with the diode laser, sufficient reduction of pigmented hair can be achieved for a mean period of 8 months. Applied topically, Eflornithine is able to reduce the growth of pigmented or unpigmented hair to an extent of at least 50% when applied over a longer period. Compared with conventional mechanical, chemical, and other physical epilatory procedures, modern hair reduction – either laser assisted or pharmacologically-based – represents highly effective treatment options for the reduction of unwanted hair growth.