Removal of unwanted facial hair

Unwanted facial hair is a common problem that is seldom discussed in the primary care setting. Although men occasionally request removal of unwanted facial hair, women most often seek help with this condition. Physicians generally neglect to address the problem if the patient does not first request help. The condition may be caused by androgen overproduction, increased sensitivity to circulating androgens, or other metabolic and endocrine disorders, and should be properly evaluated. Options for hair removal vary in efficacy, degree of discomfort, and cost. Clinical studies on the efficacy of many therapies are lacking. Short of surgical removal of the hair follicle, the only permanent treatment is electrolysis. However, the practice of electrolysis lacks standardization, and regulation of the procedure varies from state to state. Shaving, epilation, and depilation are the most commonly attempted initial options for facial hair removal. Although these methods are less expensive, they are only temporary. Laser hair removal, although better studied than most methods and more strictly regulated, has yet to be proved permanent in all patients. Eflornithine, a topical treatment, is simple to apply and has minimal side effects. By the time most patients consult a physician, they have tried several methods of hair removal. Family physicians can properly educate patients and recommend treatment for this common condition if they are armed with basic knowledge about the treatment options.