When Is Hair Growth a Sign of a Hormonal Imbalance? Doctors Weigh in

Contrary to popular belief, it's quite common—and completely normal—for those assigned female at birth to have facial hair commonly referred to as "peach fuzz," whether along the jaw, above the lip, or on the chin. What can be a sign of something amiss health-wise, though, is experiencing thick, rapid hair growth across your face and body. In fact, new, sudden changes in hair growth can actually be one of the frontward presenting signs of a hormonal imbalance.

To get to the bottom of what type of hair growth signals a hormonal balance (or any other serious condition), we tapped expert OBGYN Shweta Desai, MD, and board-certified dermatologist Michelle Green, MD, for everything there is to know about the intersection of hair growth and hormones.

Ahead, with their help, discover whether your facial hair is nothing to worry about or if it’s time to ring your doctor for some direct medical advice. 

What Causes of Facial Hair in Females?

Facial hair growth in women is totally normal, so long as it’s in small amounts—think peach fuzz or a few darker strands here and there. “The appearance of peach fuzz or a stray dark, coarse strand of hair every once in a while [say, on your chin] shouldn’t be a reason to sound the alarms,” adds Green.

While some facial hair is par for the course, Desai says that if the hair grows thick and coarse, there’s a chance that hirsutism (or excessive male-pattern hair growth) is at play. “Hirsutism affects between five and 10 percent of females of reproductive age,” she explains, noting that it’s caused by an uptick in androgens (aka male hormones like testosterone). 

When diagnosing hirsutism, Desai says that multiple factors play a role, including age, race, and family history. “Providers will examine areas that are known to be most sensitive to androgens, including the upper lip, chin, chest, abdomen, pubic region, arms, thighs, and back,” she adds.

If your doctor finds that your excessive growth patterns are occurring in areas of androgen sensitivity, then it’s likely that your hair growth is a sign of hormonal imbalance. As for the cause of the imbalance? Desai says that PCOS (Polycystic Ovary Syndrome, which begins at puberty and causes an imbalance of sex hormones), androgen-secreting tumors, and congenital adrenal hyperplasia could be at play.

When Is Facial Hair Growth a Sign of Hormonal Imbalance?

When it comes to excessive growth, most times, it is a sign of a hormonal imbalance. However, according to Green, genetics and metabolism influence hair growth patterns. So, while PCOS and adrenal gland disorders might be the cause, it’s also possible that pregnancy and menopause—two completely normal cycles of life that cause intense changes in hormones—could play a role. Additionally, she points out that unwanted facial hair growth can also be related to using certain medications like Minoxidil (Rogaine), Androgel (testosterone), or dehydroepiandrosterone (DHEA).

Additionally, Desai mentions that, while extremely rare, excessive facial hair growth can be due to hypertrichosis. “Hypertrichosis is the excessive growth of androgen-independent hair that is soft and in non-androgen sensitive areas,” she explains. “This type of hair growth is most commonly due to family history but can also be related to hypothyroidism, anorexia, or oral medications.”

When Is Facial Hair a Red Flag?

When you notice a sudden change in the density, pattern, or overall appearance of your facial hair, Green says you should be concerned and see your physician for evaluation. “These things may be a sign that other changes are happening in the body,” she explains. “Other signs of hyperandrogenism, besides hair growth, are acne, high blood pressure, irregular periods, deepening of your voice, weight gain, and increased muscle mass.” 

A stray hair here or there isn’t a big deal. Neither is peach fuzz on your lips or cheeks.

When to Consult a Doctor

If you are concerned about any excessive hair growth, it’s important to raise questions on the matter to your doctor of choice. That way, you’ll be able to approach your hair growth with medical expertise and even rule out disorders that need medical management.

Since so many factors could be at play, Green recommends an appointment with a board-certified dermatologist to review your concerns. Additionally, you can also make an appointment with an OBGYN, as they specialize in disorders like PCOS, which could be at play. 

How to Remove Unwanted Facial Hair

Depending on the cause of your facial hair growth, your hair removal options will vary. If your hair growth is due to a hormonal imbalance, Green says that testosterone-reducing oral medications like Spironolactone (which also helps treat acne) can help, as can oral contraceptives which also help regulate hormonal imbalance. And, whether your hair growth is the result of hormone imbalance or genetics, there’s always the option to tweeze, bleach, wax, and laser it away if it bothers you.

“The most effective method for treating unwanted hair growth is laser hair removal,” Green says. “Other methods of hair removal can be painful, time-consuming, costly, and messy.” Conversely, laser hair removal like GentleLase and GentleYAG can target hair growth in a few sessions to permanently stop it without damaging the skin. 

The Takeaway

Facial hair growth is normal regardless of your assigned sex. Even when it grows in excess and is linked to hormonal imbalances, it’s linked to conditions that many people before and after you have and will experience. While some of the triggers for rapid facial hair growth can feel scary, knowing how to approach, monitor, and overcome them is helpful. Fortunately, there are OBGYNs and dermatologists to help with just that.