Having thicker, longer hair is a sign of beauty. Along with acting as an insulation against cold and conserving heat, hair serves the purpose of camouflage and sexual attraction. But hair growth in humans in unwanted areas of the body is regarded as a disfigurement and frowned upon.
Termed ‘Hirsutism‘ scientifically, it is more common in women of a particular ethnicity and present in variable growth patterns. Hirsutism can significantly impact the psychological wellbeing and cause social problems for the subject. For understanding it better we need to first understand hair growth cycle.
Pathophysiology of Hair Growth
The hair of a human being consists of 3 parts – the follicle, the root and the hair shaft.
- Follicle – A sac like structure from in the skin from where hair grows
- Root– Soft thickened bulb at the base of the hair
- Hair shaft – The visible part of hair that protrudes out of the skin surface
The follicles are formed as a part of a cellular proliferation and differentiation process as a result of activation of several molecular pathways, growth factors, proteins and genes. The initial hair cycles occur very early on after which hair grows in a mosaic pattern. Except the palms, soles, external genitalia and lips, nearly all parts of the body are covered with hairs.
Referred to as vellous hairs, these are thin and colorless and hardly visible to anyone. The eyebrow, eyelashes and scalp are covered with thicker, longer and pigmented hair and referred to as terminal hairs.
In most women, vellous hairs cover the face, chest and back and give the impression of hairless skin. Men have terminal hair covering their body and faces. Terminal hair grows in the scalp, under the armpits and in genital areas of both men and women and is not classified under hirsutism. Similarly a mixture of vellous and terminal hair is present in the lower arms and legs of both sexes and is not a part of the condition.
Hair Growth Occurs in 4 main Phases
- Anagen phase or active growth phase when the follicles are enlarged and hair fibers are produced.
- Catagen phase or apoptotic phase which marks the beginning of telogen phase
- Telogen phase or shedding phase in which the old hair is shed and new hair prepared for the next anagen phase.
- Exogen phase or active shedding phase independent of either anagen or telogen phase.
These phases don’t depend on vascularization or other extra follicular components but work on the directions of the ‘hair cycle clock’ which in turn is controlled by signals from follicular epithelium or through rhythmic alterations in the expressions of corresponding receptors.
Hair Growth on Chin
Hair growth on the chin when in vellous form is normal. The androgen hormones are said to be the main regulator of human hair follicles. It is the effect of the androgens that results in changing of vellous hair follicles into larger, intermediate or terminal follicles and subsequent growth of coarse dark hair.
During puberty, there is an increase in the production of androgen hormone, resulting in coarser, darker hair. The androgen hormones are significantly more men than in women because of which bears, moustache are common during puberty in men. The increase in androgenetic hormones in women results in hirsutism and subsequently hair growth over the chin.
Though how Hirsutism appears is still under research, it has been observed by researchers that the androgen hormones are bound to specific plasma proteins. A decrease in the concentration of these plasma proteins results in elevation of androgen hormones promoting hirsutism. Hair growth depends on the reduction of testosterone to dihydrotestosterone that is mediated by the 5-alpha reductase enzyme. During hirsutism there is significant increase in the conversion rate of Testosterone to DHT almost reaching male levels. This results in formation of uncommon hair growth in other parts of the body and the chin.
Effects of these androgens can increase sebum production giving rise to oily or acne prone skin. Their excess production can affect the menstrual cycle and in turn the ovulation process. Male like balding, enlargement of clitoris, deepening of the voice are some other after effects of androgen increase.
Factors Triggering Hirsutism and Hair on Chin
- PCOS or Polycystic Ovary Syndrome present in 5-10% women. It is a common cause of Hirsutism.
- Cushing syndrome or overproduction of cortisol by adrenal glands can be genetic or a result of chronic steroid therapy.
- NCAH which is a group of genetic conditions restricting hormone production in the adrenal glands.
- AST indicates tumors in ovaries or adrenal glands can lead to abnormally high androgen levels and accelerate hirsutism conditions
- Effects of medications such as anabolic steroids, medications used for increased hair growth and supplements like androstenedione are medication related causes of hirsutism.
Psychological Effects associated with a Hairy Chin
Unwanted hair on the chin or any part of the face has been known to impact women psychologically. In studies conducted to understand the psychological effects of the problem, 80% of the women reported discomfort in social situations because of the condition. The overall bother crossed an alarming 89%.
Tablets, capsules or other pill forms are used in medical treatment methods to bring the hormone levels down. Some of the most common medications used for chin hair reduction and other hirsutism symptoms are
- Oral birth control– A small amount of androgen is produced by the ovaries during ovulation. This insignificant in itself becomes accelerated in hirsutism patients.
- Antiandrogenic medications block androgen receptors along with blocking the conversion of testosterone into active hydrogens
- GnrH analogs suppress ovarian androgens to achieve hypoandreism
- Steroid medications work on the overactive adrenal glands
The issue with Medications
In the process of reducing the androgen levels, medications cause a lot of side-effects that can be problematic in the long run. Steroidal medications for example are initially effective but can result in abnormal weight gain, thinning of bones and even blindness when used long term. Additionally these medications can lead to irreversible damage to the liver or serious drug interactions if misused or used concomitantly without supervision.
The need for safer ways of dealing with the problem has resulted in the introduction of other methods of dealing with the condition. Topical creams and hair removal methods are 2 such options.
Hair Removal Methods
Dermatologists often advise temporary and permanent hair removal methods to stop hair growth on the chin. Temporary hair removal methods use treatment measures like waxing, depilatories, bleaching creams and as a last resort shaving.
Permanent methods consist of mildly invasive methods in the form of laser and electrolysis methods. In laser treatment, the surgeon uses concentrated beams of light to destroy the hair follicles while in electrolysis, they use electric current through a needle for the same purpose. Mostly centred on the external hair shafts and follicles, hair removal methods are safer in the long run than medications.
But there is a catch
Hair removal through any method can be irritating for the skin. Especially in the chin region which is already sensitive due to the effects of hirsutism. In androgen sensitive areas, waxing which normally is a painful procedure further irritates the skin. Depilatories use chemicals to dissolve the hair shaft that may not be favourable for an acne prone skin. Similarly excessive bleaching can make the skin look unnatural and further irritate it.
Laser and electrolysis though effective in their own way are painful. Home electrolysis can be unpredictable. Performed by licensed practitioners, they can be expensive along with leading to variable outcomes.
A safer, better option
The need for a painless yet effective manner of removing chin hair has resulted in the demand for skin friendly, safe and economical solutions or simply put Topical solutions . Till date there is only one topical cream that has been approved for Hirsutism cases and hair removal from chin.
Let’s talk about Vaniqa
Vaniqa Cream or Eflornithine cream is a topical cream based solution for removal of chin hair that is being actively recommended by dermatologists these days. In Clinical trials conducted on Eflornithine Hydrochloride, 60% of subjects with unwanted hair showed improved results in 4-8 weeks. Actively working as an ODC inhibitor, Vaniqa use results in slowing down of the anagen phase of hair growth. Once the anagen phase has been inhibited, the telogen phase kicks in. This
Vaniqa is skin friendly. Studies conducted to test the dermal safety of the cream have proved as such. In a repeated insult patch conducted on 280 subjects with unwanted facial hair, it was proved that Eflornithine Hydrochloride 13.9%, the active ingredient of Vaniqa does not have photo contact allergy, contact sensitizing or phototoxic properties. This makes it safe to use in females of all skin types.
Apart from the physiological benefits, the psychological aspects of the cream have been favorable. Vaniqa use has seen statistically significant results in the mental outlook of patients using the cream. Patients have reported and preferred using Vaniqa than other methods for treating or concealing facial hair.
Combination treatments use the modified technologies of either method to further improve the results. Vaniqa has also been successfully used in some clinical trials as a combination mechanism. It has been observed that using it with shaving or plucking produces better results than its use as an individual cream. Similarly laser treatments combined with use of Vaniqa have reported significantly improved outcomes in studies. Even micro needling treatment has shown good potential when combined with Eflornithine cream.
Overall Vaniqa has proved itself a reliable option for safe and efficient removal of hair on chin without dermatologically affecting the skin. Whether or not the effects are permanent depends on the intensity of application and grade of Hirsutism.
Can Chin hair be permanently removed in this method?
The permanence of the results using Vaniqa is as of under research. As of now its results are not permanent. You will need to use regularly for the hair growth to decrease in intensity. Combining it with other methods can delay the reversal process. But discontinuing the product will gradually result in activation of the anagen phase of hair growth again. Additionally Vaniqa use has been observed to be more active in Caucasian women. It’s results have been slightly less effective in non-Caucasian and obese women.
Safety is a Must
Vaniqa in spite of its safety is not suitable for all skin conditions. It cannot be used in a skin with inflammatory eruptions or burns. The use of the medication in an already acne prone skin can exacerbate the condition. Animal studies have shown reproductive toxicity on being treated with Eflornithine cream. In another human study about the safety of Vaniqa, reliable information could not be obtained regarding Vaniqa safety during pregnancy.
Additionally the risk of allergy exists in the use of Vaniqa. However safe it might be, if you have an allergic reaction towards any of its ingredients, then it is best to avoid it and switch to other safe options.
Take Home Factor
Chin hair in women though a safe phenomenon can greatly impact their self-esteem and overall sense of wellbeing. Early diagnosis of the underlying problem and subsequent treatment can help in dealing with the complications that come with the problem. Vaniqa has been recommended by the British Association of Dermatologists as a treatment for chin hair in women.
It is a safer, painless and recommended method of reducing unwanted hair. But understanding about your underlying problem and getting the required treatment for it is equally important. Additionally neither Vaniqa nor other treatment options have as of now provided a permanent hair loss solution. Treatments no matter how effective provide reversible hair reduction. It is important to use them regularly for best results.
Health care experts need to understand the psychological aspect of the problem and find a holistic approach for dealing with it. Most importantly awareness about the problem should be spread to reduce the stigma associated with it