When Too Much Hair Becomes a Problem -- MEDICA - World Forum for Medicine

When Too Much Hair Becomes a Problem

Before (top) and after (bottom)
an 18-week treatment with
eflornithine; © Charité

Too much hair in the wrong places can be a great burden, especially for women. After all, 30 to 40 percent of all women in Germany suffer from a more or less severe hypertrichosis. The causes of the increased hair growth on the face or the body differ from person to person.

Thus, internal diseases such as tumours as well as side effects of drugs can trigger the condition. If that is the case, physicians can eliminate the cause and normalise hair growth again.

However, if a genetic defect is to blame, which applies for about 10 to 20 percent of the cases, physicians can only treat the patients symptom orientated. “After all, you can’t simply remove such a disposition from the hair follicle”, explains Professor Dr. Ulrike Blume-Peytavi from the Dermatologic Hospital at Charité, Berlin in Germany. Aesthetic dermatology is the only help now. “In these cases, dermatologists particularly rely on the use of laser epilation. Excessive hair can be removed in the long run with the help of better and better laser methods”, says Blume-Peytavi. However, it only works with darker hair and if the skin is not strongly pigmented.

One and a half years ago, an agent became available in Germany, which is used locally as a cream, and is also suitable for lighter hair. Eflornithine is an inhibitor of the enzyme ornithinedecarboxylase, that catalyses the conversion from ornithine into putrescine and other polyamines, which on their part influence cell growth in the hair follicle. If the polyamines’ development is restrained, the hair growth is slowed. “The patient spreads the cream thinly onto the face in the morning and evening, and after four to six weeks the hair growth clearly decreases”, says Blume-Peytavi. However, the cream is only effective as long as it is applied. Basically, the cream could also be used for other body parts, but an extensive use would be very expensive.

Eflornithine proved its effectiveness in two big randomised and placebo-controlled studies, involving a total of 596 women with increased hair growth in the face. About one third of the women responded very well to the agent. They described their condition as “clean”, “almost clean” or as a “noticeable improvement”. A further third of the patients experienced an improvement and with the last third there was no difference or their condition was even worse. Each of the successfully treated women described a substantial improvement in their quality of life.

Hence, combined therapies with eflornithine and laser epilation are often recommended. “The advances we achieved in the last years, with successful laser epilation in combination with eflornithine and an enhanced systemic hormone therapy with diminished side effects, permit a very good treatment of hypertrichosis and hirsutism”, says Blume-Peytavi.