This is very important, as self-consciousness about unwanted hair causes much unhappiness. In many instances of simple hirsutism, cosmetic treatment alone may be sufficient, or it may be combined with medical treatment. Several methods are used, either alone or in combination.

Bleaching This makes fine dark hairs less conspicuous. Proprietary creams are available or a home mixture may be made by mixing 30 ml of 6 per cent hydrogen peroxide with 20 drops of ammonia. Bleaches occasionally cause irritation of the skin, but this subsides within a few days of use. These preparations also bleach clothes and towels, so take care when using them. Bleaching is particularly suitable for the upper lip, but it must be repeated when the bleached hair falls out and is replaced by a new dark hair.

Shaving This is easy, cheap and effective, though many women find it distasteful, perhaps because of its association with masculinity. Contrary to popular belief, shaving doesn’t increase the rate of hair growth, but because the hairs regrow with blunt rather than pointed tips, the regrowth feels more stubbly.

Plucking Slow and painful, this is only practical for isolated coarse hairs such as those that sometimes grow around the nipple. Constant plucking around the upper lip and chin may lead to inflammation of the hair follicles, which can result in pigmentation and scarring.

Depilatory creams These dissolve hairs, and are widely used for the armpits and around the bikini line. They occasionally cause skin allergy or irritation. Use them on a small test patch of skin before treating a large area.

Waxing This form of plucking allows a large number of hairs to be removed together. Various forms of cold and hot wax can be used, ranging from a pot of beeswax and resin on the kitchen stove to electrically heated kits that automatically dispense a thin layer of wax when rolled over the skin. There’s always an ‘ouch’ when you yank off the wax, but the hair takes longer to reappear than with other temporary methods. Skin inflammation may sometimes follow waxing, especially if the wax used is too hot.

Abrasive pads Made of sandpaper, these used to be popular for the legs. They have the same effect as shaving or depilatory creams.

Electrolysis and thermolysis These are the only methods that offer any hope of permanent hair removal. A fine needle is inserted into the base of the hair follicle to destroy the growth centre of the hair by electric current or heat. The hair is then removed with forceps. Electrolysis and thermolysis work best for coarse hairs. I would recommend these methods only with a trained operator. Home kits are not advised because of the greater potential for scarring, pigmentation or infection if used by unskilled hands.

Because the hair follicles are not uniformly deep, the best results you can hope for from any treatment session is that about half of the hairs treated will have their growth centres destroyed and will not regrow. A careful operator will avoid scarring by inserting the needle to the depth at which the majority of follicles are, which misses the follicles that lie deeper. The differences in depth are in fractions of a millimeter, which explains why skill and care are so important. The operator will go a bit deeper on the missed hairs at the next session, so that gradually the majority of terminal hair follicles are destroyed.

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