Is your facial hair the sign of a medical issue?

Health

Facial hair is never welcome (and could signal a medical problem).

For years, Cindy Moro (a pseudonym) couldn't pass by a mirror in full daylight without wincing. She was acutely self-conscious of the dark hairs sprouting up in the most unwanted of places: her upper lip, chin and sideburn area. After experimenting with many methods of hair removal without success, she used electrolysis to rid herself of the hair.

"I would come home from a treatment and just cry, it hurt so much," Moro recounts, "but it was worth all the pain." After a year's worth of expensive monthly treatments, most of the excess hair has disappeared. Excess facial hair can either be an occasional bother or a long-term nuisance. Sometimes it can even be a symptom of a serious medical condition. Here's why many women grow unwanted facial hair--and when it might also be a problem.

It's in the genes The amount of hair on your body is primarily dependent on your genetic heritage. If the maternal side of your family tended toward hairlessness, chances are you will too. In general, Scandinavians, native North Americans and East Asians tend to have very little body hair, whereas Mediterraneans, Hispanics and some Africans are inclined to be hairier. And because women in these cultural groups tend to have dark hair, their facial growth is prominent and visible.

The hormone connection The hair on your face is caused by androgens, your body's male hormones, and some families and ethnic groups are hyper-sensitive to androgens, says Dr. Diane Quintal, an Ottawa dermatologist and director of the hair clinic at Ottawa General Hospital.

Or your body may be overproducing androgens, especially if you are ap-proaching menopause, when female hormones like estrogen plummet while male hormones like testosterone remain stable. So, even the fairest-haired wo-men can expect the occasional hairy growth spurt at that time. And as we age, our hair tends to thin on our heads and sprout on our chins, explains Dr. Elizabeth Salamon, an endocrinologist at St. Boniface Hospital in Winnipeg. Hormone replacement therapy evens out the hormones, which in turn reduces hair growth, she says.

Excess weight can also play havoc with the body's hormone levels. An enzyme found in body fat can convert estrogen into testosterone, so obese women have a tendency to grow unwanted facial hair.

The disease link When an obese woman with facial hair experiences abnormal periods, infertility, deepening of the voice or balding, she may have a serious hormonal disorder called polycystic ovarian syndrome, which affects up to five per cent of women of reproductive age. Polycystic ovarian syndrome is treatable with anti-androgen medications. These drugs, however, cause menstrual irregularities and may harm fetuses. That's why doctors often prescribe birth control pills together with the anti-androgens to avoid potential complications.

Anti-androgens can also help wo-men who have a genetic predisposition to facial hair. Dr. Quintal has had success with women in that category, but explains that the therapy is long term. Stop the medication, and the hair growth eventually recurs.

What's right for you? Not all women with excess hair will choose medication. In the absence of a serious hormonal disorder, what you do about facial hair is a very personal decision (see Hair begone! ). But no hair-removal method can guarantee a permanent solution. If you're genetically inclined to be hairy or your hormones are out of balance, those hairs may rise yet again.

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