Hypertrichosis and Genital Rejuvenation: Cutaneous Adverse Events Associated with Pubic Hair Grooming.

Pubic hair grooming is practiced by women and men who consider themselves to have hypertrichosis of their genitals. Of the several modalities that can be used to remove the excess hair-the nonelectric razor is the most common. In addition to laceration, several other adverse cutaneous events have been observed in individuals who groom their own pubic hair.

Excess hair, hair removal methods, and barriers to care in gender minority patients: A survey study.

BACKGROUND: In gender minority patients, electrolysis and laser hair removal may be necessary to reduce facial and body hair in individuals seeking a more feminine appearance and/or modified gender expression. These procedures may also be required preoperatively for some gender-affirming surgeries. AIMS: To identify (a) the frequency of unwanted facial and body hair, (b) the use of various hair removal methods, and (c) associated barriers to care in gender minority patients. METHODS: An online-based patient survey was distributed via social media on Facebook® , YouTube® , and Instagram® in fall 2018. Respondents were at least 18 years old and self-identified as a gender minority. RESULTS: In total, 991 responses were recorded with a completion rate of 77%. Considering excess hair, 84% of transwomen on feminizing hormone therapy (FHT: estrogen and anti-androgen therapy), 100% of transwomen not on FHT, and 100% of nonbinary individuals on FHT reported excess facial/body hair. Laser hair removal (18%) and electrolysis (17%) had similar rates of use in this cohort and were more commonly reported for nonsurgical gender-affirming purposes than preoperative preparation. Cost was the most frequently cited barrier to care. CONCLUSION: As the majority of transwomen and nonbinary people on feminizing hormone therapy had persistent excess facial/body hair, routine use of gender-affirming hormones is not sufficient to fully eliminate unwanted hair. There remains a critical need to advocate for more comprehensive insurance coverage for laser hair removal and electrolysis in gender minority patients.

Use of Long-Acting Somatostatin Analogue (Lanreotide) in an Adolescent with Diazoxide-Responsive Congenital Hyperinsulinism and Its Psychological Impact.

Congenital hyperinsulinism (CHI) is a common cause of hypoglycaemia due to unregulated insulin secretion from pancreatic ß cells. Medical management includes use of oral diazoxide (a KATP channel agonist) and daily injectable octreotide (somatostatin analogue) therapy. However, diazoxide is associated with severe sideeffects such as coarse facies, hypertrichosis and psychosocial/compliance issues in adolescents. Lanreotide (a long-acting somatostatin analogue) is used in adults with neuroendocrine tumours; however, its role in patients with CHI has not been well described. A 15-year-old girl with diazoxide-responsive CHI had severe hypertrichosis secondary to diazoxide and subsequent compliance/psychosocial issues. She was commenced on 30 mg of lanreotide every 4 weeks as a deep subcutaneous injection, in an attempt to address these issues. She was able to come off diazoxide treatment 2 months after starting lanreotide. Presently, after 2.5 years of lanreotide treatment, her blood glucose control is stable with complete resolution of hypertrichosis. Clinically significant improvements in the self-reported Paediatric Quality of Life (PedsQL) questionnaire and Strengths and Difficulties Questionnaire (SDQ) were reported after 1 year on lanreotide. No side effects were found, and her liver/thyroid function and abdominal ultrasound have been normal. We report the first case on the use of lanreotide in an adolescent girl with diazoxide-responsive CHI with significant improvement of quality of life.

An overview of unwanted female hair.

Unwanted facial hair (UFH) is an important but often overlooked issue, with over 40% of women experiencing some degree of UFH. In the female population a wide spectrum of unwanted hair concerns is represented - from biologically normal but undesirable to excessive unwanted hair with an underlying pathology. While women may seek to manage unwanted hair across their bodies, UFH is a particular concern, due to its negative impact on perceived femininity. There may not always be a direct correlation between degree of severity diagnosed objectively by the physician and level of concern and impact upon the patient. This review discusses the spectrum of facial hair experience and outlines the clinical approach to unwanted hair management including UFH. It highlights the importance of a treatment regimen which should respond to the causation factors and needs of the individual. This will lead to a holistic treatment approach including evaluation of the implementation of emotional coping strategies and on-going support, lifestyle modifications, pharmacological interventions (to address underlying pathologies) and the use of cosmetic hair removal methods as either a stand-alone or adjunct treatment as appropriate to the individual.

Hair removal with the long-pulse alexandrite and long-pulse Nd:YAG lasers is safe and well tolerated in children.

BACKGROUND: Children with excessive hair may have severe psychological consequences. Laser hair removal in adults is known to be safe and well tolerated, but this is less well established in children. OBJECTIVE: To describe our experience with laser hair removal in children, and to investigate the safety and tolerability of this procedure in children. METHODS: The case records of 24 children aged < 16 years, who had received a minimum of three treatments for hair removal were analysed retrospectively. For patients with Fitzpatrick skin phototype II-IV, the lasers used were a long-pulse alexandrite (755 nm) with either continuous chilled-air cooling at fluences of 16-27 J/cm(2) or a long-pulse alexandrite with cryogen cooling at fluences of 16-32 J/cm(2). For patients with Fitzpatrick skin phototype IV-VI, lasers used were a long-pulse Nd:YAG (1064 nm) with a chilled contact sapphire tip at fluences of 20-35 J/cm(2) or a long-pulse Nd:YAG with cryogen cooling at fluences of 16-26 J/cm(2). RESULTS: Mean age at first treatment was 12.3 years. Diagnoses were constitutional hirsutism (14 patients), polycystic ovarian syndrome (five), congenital melanocytic naevus (two), generalized hypertrichosis (two) and naevoid hypertrichosis (one). One patient required a general anaesthetic, eight required topical anaesthetic cream, and 15 did not require any form of anaesthesia. Intolerable discomfort requiring adjustment in fluence was the only recorded side-effect, affecting two cases. There were no incidences of blistering, infection, dyspigmentation or scarring. CONCLUSION: When administered appropriately, laser hair removal is safe and well tolerated in children aged < 16 years.

[Hypertrichosis]. / Hypertrichose.

Hypertrichosis denotes growth of hair on any part of the body in excess of the amount usually present in persons of the same age, race, and sex, excluding androgen-dependent hair growth. Hypertrichosis may be an isolated finding or associated with a syndrome, be associated with additional congenital anomalies or a marker for systemic disease. In order to diagnose it accurately, the age of onset, type, localization and pattern of hair growth, associated disorders, medications and perhaps associated anomalies and family history should be considered. Even though hypertrichosis usually has limited medical significance, it often causes cosmetic embarrassment, often resulting in a significant emotional burden. Treatment options are available, though limited in terms of efficacy and patient satisfaction. No single method of hair removal is appropriate for all body locations and patients, and the one adopted will depend on the type, area, and amount of excessive hair growth, as well as on the age, sex, and personal preference of the patient. Patients with hypertrichosis should be adequately advised of the treatment modalities. These include cosmetic procedures (bleaching, trimming, shaving, plucking, waxing, chemical epilatories, electrosurgical epilation), and hair removal using light sources and lasers.

[How I treat ... hypertrichosis]. / Comment je traite ... une hypertrichose.

Hypertrichosis can result from various origins and exhibit diverse clinical presentations. Any etiological treatment, when available, does not always lead to regression of the excess in pilosity. Most often, hypertrichosis represents a real esthetic burden and affects the patient's self-esteem. Currently the laser epilation technique offers new and promising therapeutic possibilities.

Unwanted intrusive thoughts and the growth of facial hair: a cognitive analysis.

The functional connection between unwanted intrusive hair growth and negative automatic cognitions is described and illustrated by case-material. Treatment by cognitive-behavioural therapy (CBT) is recommended as generally successful except when certain facts are denied.