Understanding What Medications Cause Facial Hair Growth?

According to the National Institutes of Health, numerous medications can cause excessive hair growth, a condition known as hirsutism or hypertrichosis. Understanding what medications cause facial hair growth is crucial for patients experiencing this challenging side effect, helping them seek appropriate management and medical advice.

Quick Summary

Several drug classes, including hormonal, immunosuppressive, and antihypertensive agents, can cause increased facial hair growth. This can occur through androgen-dependent hirsutism or androgen-independent hypertrichosis, often reversing after discontinuing the medication under a doctor's supervision.

Key Points

• Hirsutism vs. Hypertrichosis: Understand the difference between androgen-dependent hirsutism (male pattern hair) and androgen-independent hypertrichosis (generalized excess hair).

• Androgenic Medications: Anabolic steroids, testosterone, danazol, and DHEA are known to cause hirsutism by mimicking or increasing male hormones.

• Non-Androgenic Medications: Drugs like minoxidil, cyclosporine, and phenytoin cause hypertrichosis through non-hormonal pathways, such as vasodilation or direct stimulation of hair follicles.

• Consultation is Key: Always speak with a doctor before changing or discontinuing a medication to address hair growth, as abrupt changes can cause serious health issues.

• Reversibility Varies: Hair growth often reverses upon stopping the medication, but it can take several months or more, and some effects, especially from high-dose androgens, may be permanent.

• Management Options: Treatment strategies range from medication adjustments and topical creams (like eflornithine) to cosmetic procedures like laser hair removal or electrolysis.

Experiencing unexpected facial hair growth can be distressing, and for many, the cause can be a medication they are taking. This phenomenon, known as drug-induced hirsutism or hypertrichosis, is a known side effect of a variety of prescription and non-prescription drugs. Understanding the different types of drug-induced hair growth and the specific medications involved is the first step toward finding a solution.

The Two Types of Drug-Induced Hair Growth

Drug-induced excessive hair growth can be categorized into two primary types based on its mechanism and pattern:

• Hirsutism: This is the growth of coarse, dark hair in areas where men typically grow hair, such as the upper lip, chin, and sideburns. In women, hirsutism is almost always caused by an overabundance of androgens (male hormones) or an increased sensitivity of hair follicles to normal androgen levels.
• Hypertrichosis: This involves excessive hair growth in any area of the body, and it is not dependent on androgens. It can affect both men and women and can be caused by mechanisms other than hormonal changes, such as increased blood flow to hair follicles or prolonged hair growth cycles.

Medications with Androgenic Effects (Causing Hirsutism)

Some medications mimic or increase the levels of androgens in the body, leading to androgen-dependent hirsutism.

• Testosterone and Anabolic Steroids: These are among the most common culprits, especially when used for hormonal therapy or illegally for muscle enhancement. Testosterone Replacement Therapy (TRT) can lead to increased facial hair growth, and abuse of anabolic steroids by athletes or bodybuilders has known androgenic side effects, including hirsutism.
• Danazol: This synthetic steroid is used to treat endometriosis and fibrocystic breast disease. It has significant androgenic effects, and increased hair growth on the face, chest, and back is a well-documented side effect.
• DHEA (Dehydroepiandrosterone): Marketed as an anti-aging supplement, DHEA can increase androgen levels, leading to hirsutism.
• Certain Synthetic Progestins: Some older versions of synthetic progestins found in oral contraceptives can have androgenic properties, although most modern birth control pills are formulated to reduce androgenic effects.
• Valproic Acid: This anticonvulsant has been linked to hyperandrogenism and polycystic ovary syndrome (PCOS)-like conditions in some women on long-term treatment.

Medications with Non-Androgenic Effects (Causing Hypertrichosis)

Other medications can promote hair growth through mechanisms unrelated to androgens, leading to hypertrichosis.

• Minoxidil: Originally an oral medication for high blood pressure, minoxidil's most famous side effect is hair growth. It is now widely used topically to treat pattern baldness. Both oral and topical forms can cause systemic absorption and unwanted hair growth on the face and other parts of the body. Its mechanism involves vasodilation and the prolongation of the hair growth phase (anagen).
• Cyclosporine: This potent immunosuppressant, used to prevent organ transplant rejection and treat certain autoimmune conditions, can cause excessive hair growth, especially on the face, arms, and back. The mechanism is thought to involve the stimulation of hair follicle cells.
• Phenytoin: An antiepileptic drug, phenytoin has been associated with hypertrichosis since its introduction. The excessive hair growth often appears on the limbs and face and can occur within the first few months of therapy.
• Diazoxide: This antihypertensive and blood sugar-raising drug can also cause hypertrichosis.
• Glucocorticoids: While sometimes used to treat hair loss, chronic, long-term use of glucocorticoids like prednisone can lead to increased hair growth as part of exogenous Cushing's syndrome.

Comparison of Hair Growth-Causing Medications

Medication Class	Example(s)	Mechanism of Hair Growth	Typical Hair Growth Pattern	Reversibility
Androgenic Hormones	Testosterone, Anabolic Steroids, DHEA	Mimic or increase androgens	Hirsutism (male pattern)	Often reversible, but can cause permanent changes
Synthetic Steroids	Danazol	Androgenic properties	Hirsutism	Reversible, dose-dependent
Antihypertensives	Minoxidil, Diazoxide	Vasodilation, prolongs anagen phase	Hypertrichosis (non-androgen-dependent)	Reversible upon discontinuation
Immunosuppressants	Cyclosporine	Stimulates hair follicle epithelial cells	Hypertrichosis (generalized)	Reversible, but can take time
Anticonvulsants	Phenytoin, Valproic Acid	Unclear (possibly androgen-dependent)	Hirsutism (facial and body), hypertrichosis	Reversible, but can take time; Valproic acid linked to PCOS
Corticosteroids	Prednisone (long-term)	Part of exogenous Cushing's syndrome	Hypertrichosis, hirsutism	Reversible after discontinuation
Antipsychotics	Risperidone	Increases prolactin, altering androgen-estrogen balance	Hirsutism, acne	Reversible with dose adjustment or switching

Addressing Medication-Induced Facial Hair Growth

Managing unwanted hair growth requires a conversation with a healthcare provider. It is vital not to stop a prescribed medication without medical guidance, as doing so could have serious health consequences.

1. Consult Your Doctor: Inform your physician about the side effect. They can evaluate whether the hair growth is caused by your medication or another underlying condition.
2. Adjust the Medication: Your doctor might suggest adjusting the dosage, switching to an alternative drug within the same class, or choosing a different class of medication entirely. For example, some newer oral contraceptives have less androgenic activity.
3. Use Prescription Topical Creams: For facial hirsutism in women, a topical cream containing eflornithine hydrochloride can be prescribed. This cream works directly on the skin to slow hair growth and may show results within two months.
4. Explore Cosmetic Hair Removal: While waiting for the medication to be adjusted or for hair growth to subside, cosmetic options can help manage the symptoms. These include:
   • Bleaching: Lightens hair, making it less noticeable.
   • Waxing, Shaving, or Depilatory Creams: Provide temporary removal.
   • Electrolysis: A permanent hair removal method that uses an electric current to destroy hair roots.
   • Laser Hair Removal: Heats and destroys hair follicles to reduce hair growth long-term.
5. Consider Anti-Androgen Medications: In some cases, and particularly for hirsutism, your doctor may prescribe an anti-androgen medication like spironolactone. This blocks the effects of androgens and can help reduce unwanted hair growth over several months.

Is Medication-Induced Hair Growth Reversible?

The reversibility of drug-induced hair growth depends heavily on the specific medication, the dosage, the duration of use, and individual factors. In most cases, hair growth is reversible and will begin to recede after the offending medication is discontinued. However, the process is not immediate. The time it takes for hair to return to its previous state depends on the hair's natural growth cycle and can take several months to over a year. For some individuals, particularly with prolonged use of high-dose androgenic drugs, certain changes may be irreversible. Open and consistent communication with your healthcare provider is key to managing this process safely and effectively.

Conclusion

Excess facial hair as a medication side effect is a well-documented issue stemming from various pharmacological mechanisms. Whether it's androgen-dependent hirsutism caused by drugs like testosterone and danazol or androgen-independent hypertrichosis from agents like minoxidil or cyclosporine, the underlying cause is manageable. By working closely with your healthcare provider to identify the culprit medication, you can determine the best course of action, which may involve adjusting your prescription, utilizing anti-androgen therapies, or employing cosmetic removal techniques. This integrated approach ensures both your primary health condition and your quality of life are effectively addressed. For more information, see this resource from the National Institutes of Health: Excessive or unwanted hair in women - MedlinePlus.

Frequently Asked Questions

Are medication-induced facial hair growth and normal facial hair growth the same?

No, medication-induced hair growth is often a side effect and can differ significantly from natural facial hair. It might appear in new or unexpected areas, be coarser, or grow more rapidly than normal hair due to the drug's effect on hormones or hair follicle processes.

How long does it take for hair to stop growing after discontinuing a medication?

If the hair growth is reversible, it typically takes several months to a year for noticeable changes to occur after discontinuing the medication. This is because hair follicles operate on a cycle, and it takes time for the body to return to normal functioning.

Can topical minoxidil cause facial hair growth?

Yes, topical minoxidil, commonly used for scalp hair loss, can lead to unwanted facial hair growth. This can happen from inadvertent spread of the product or from systemic absorption, and it is a well-documented side effect.

Is there any medication to counteract hair growth caused by another drug?

Yes, depending on the cause. For androgen-dependent hirsutism, anti-androgen medications like spironolactone can be prescribed alongside or after other medication adjustments. Topical creams like eflornithine can also inhibit hair growth directly on the skin.

Do all oral contraceptives cause facial hair growth?

No, most modern oral contraceptives are formulated to have minimal androgenic effects. However, older or specific types containing certain synthetic progestins (e.g., older second-generation) may have some androgenic activity and could potentially cause or worsen hirsutism in sensitive individuals.

What is the difference between drug-induced hirsutism and hypertrichosis?

Hirsutism is androgen-dependent, meaning it is caused by male hormones and results in coarse hair growth in male-pattern areas. Hypertrichosis is androgen-independent and involves excessive hair growth anywhere on the body, affecting both sexes.

What cosmetic options are available for managing medication-induced facial hair?

Cosmetic options range from temporary solutions like shaving, waxing, and depilatory creams to longer-term or permanent methods such as electrolysis and laser hair removal.