Article

PCOS and Hirsutism: why choose electrolysis?

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders in women of reproductive age. One of the most distressing symptoms is excessive hair growth (hirsutism), particularly on the face, chest, abdomen, and back. This can have a significant psychosocial impact and requires an effective, safe, and sustainable treatment strategy. Electrolysis is a proven method of permanent hair removal and can play a valuable role in the multidisciplinary management of PCOS.

This article discusses the pathophysiology of PCOS, the development of hirsutism, and the clinical relevance of electrolysis as a treatment option.

What Is PCOS?

PCOS is an endocrine disorder characterized by a combination of:

• Hyperandrogenism: elevated levels of androgens (such as testosterone).

• Ovulatory dysfunction: irregular or absent menstrual cycles.

• Polycystic ovaries: enlarged ovaries with multiple small follicles visible on ultrasound imaging.

The prevalence is estimated to be approximately 6–15% of women of reproductive age, depending on the diagnostic criteria used (e.g., the Rotterdam criteria).

In addition to reproductive issues, PCOS may be associated with metabolic disturbances such as insulin resistance, weight gain, dyslipidemia, and an increased risk of type 2 diabetes and cardiovascular disease.

PCOS and Excessive Hair Growth (Hirsutism)

Hirsutism develops due to increased sensitivity of hair follicles to androgens or elevated circulating androgen levels. Terminal hairs then appear in areas typically associated with male-pattern hair growth (chin, upper lip, chest, lower abdomen).

Key characteristics include:

• Hair becomes thicker and darker in texture.

• Hair growth is often progressive and chronic.

• Pharmacological treatment may reduce the development of new hair, but existing hair usually does not disappear spontaneously.

For many patients, this leads to embarrassment, reduced quality of life, and psychosocial distress.

What Is Electrolysis?

Electrolysis is a method of permanent hair removal in which each individual hair follicle is treated with a fine sterile probe and an electrical current. This selectively destroys the hair follicle, preventing future hair growth.

There are three main modalities:

Thermolysis (Diathermy)

Uses high-frequency heat to coagulate the hair follicle. It is fast and suitable for larger treatment areas.

Galvanic Electrolysis

Uses direct current to destroy the hair follicle through a chemical reaction. It is highly effective but more time-consuming.

Blend Method

Combines thermolysis and galvanic current for maximum effectiveness, particularly in deep or curved follicles.

Electrolysis is the only technique widely recognized as truly permanent hair removal, regardless of hair color or skin type.

Why electrolysis is suitable for PCOS

1. Permanent Solution for Existing Hair

In PCOS, androgen levels often remain elevated even with medical treatment. Electrolysis permanently removes existing hair, providing both cosmetic and psychological benefits.

2. Effective for All Hair and Skin Types

Unlike laser hair removal, electrolysis is effective for:

• Blonde, gray, and red hair

• Dark or highly pigmented skin

• Fine or isolated hairs (e.g., on the chin or upper lip)

3. Medically Safe When Properly Performed

When carried out by a well-trained professional using sterile techniques, electrolysis is safe and highly controllable. Scarring and pigment changes are rare with proper indication and aftercare.

4. Suitable as Adjunctive Therapy

Electrolysis can be effectively combined with:

• Hormonal therapy (e.g., oral contraceptives, anti-androgens)

• Lifestyle interventions (weight management, improved insulin sensitivity)

• Psychosocial support

Comparison with Other Treatments

Laser Hair Removal

• Targets pigment (melanin) in the hair.

• Less effective for light-colored hair and darker skin tones.

• Often results in hair reduction rather than permanent removal.

• May require ongoing maintenance in hormonal conditions.

Medication

• Anti-androgens and hormonal therapy can reduce new hair growth.

• Existing hair usually remains.

• Potential side effects and contraindications.

Epilation and Depilatory Creams

• Temporary solutions.

• Risk of skin irritation and ingrown hairs.

• No effect on the hair follicle.

Electrolysis stands out because of its permanent results.

Risks and Contraindications

Although electrolysis is generally safe, the following considerations apply:

• Temporary redness, mild swelling, or scab formation.

• Risk of hyperpigmentation with improper aftercare or sun exposure.

• Caution in patients with pacemakers, certain skin conditions, or impaired wound healing.

• Multiple sessions are required due to the hair growth cycle.

A proper medical intake and collaboration between healthcare providers and electrologists are essential.

Recommendations for Medical Professionals

• Consider referral for patients with severe or treatment-resistant hirsutism.

• Provide realistic expectations regarding treatment duration and outcomes.

• Encourage a combined approach: hormonal stabilization plus local hair removal therapy.

• Prefer collaboration with certified skin therapists or medically trained electrologists.

• Monitor psychosocial impact and quality of life.

Conclusion

For individuals with PCOS and hirsutism, electrolysis offers a proven, safe, and permanent solution for unwanted hair growth. When combined with medical management, it can significantly improve both physical comfort and psychological well-being. A multidisciplinary approach, involving collaboration between medical professionals and specialized practitioners, leads to optimal patient outcomes.