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SUMMARY
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Body hairs can be involved in non scarring and scarring alopecias.
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Excessive body hairs are a clue for diagnosis of systemic diseases.
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Body hair examination is important in the evaluation of all patients with hair disorders
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TIPS FOR DIAGNOSIS
In case of pubic and axillary alopecia, hormonal status should be evaluated with age taken into consideration.
Dermoscopy can help differentiate types of leg alopecia including anterolateral leg, friction alopecia, and alopecia areata
Lanugo hair hypertrichosis and hair loss in an underweight patient suggest an underlying eating disorder, as the psychiatric disorder often is not the chief complaint.
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TIPS FOR TREATMENT
There is no approved treatment for body hair loss.
Reassurance might be enough for treatment in most cases of body hair loss.
Alopecia of the axillary and pubic areas might cause embarrassment and require minoxidil and topical/intralesional steroids.
Topical eflornithine is approved for treatment of excessive facial hair and can be prescribed in both hypertrichosis and hirsutism.
Antiandrogens and 5-alpha reductase inhibitors are often utilized off label in the treatment of hirsutism.
Choice of method of hair removal should be discussed with patients keeping in mind type and color of hair, costs, and expected results.
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DON’T FORGET
Trichotillomania can involve pubic hair.
Weight loss should be encouraged in overweight and obese hirsute women, because it reduces insulin resistance and androgen production.
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PITFALLS AND CAUTIONS
When pregnancy is desired, all pharmacological treatments for hirsutism must be discontinued. Antiandrogens, in particular, are contraindicated in women trying to conceive because of potential adverse effects on male sexual development.
There are several alarm signs that may indicate the need for an immediate medical evaluation, such as virilization, rapid excessive hair growth within weeks to months, and detection of an abdominal or pelvic mass.
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PATIENT EDUCATION POINTS
Laser hair removal is more effective in subjects with fair skin and dark hair.
Thin, fine hairs are not removed well with lasers.
Lasers don’t really provide permanent hair removal: multiple repeated treatments can reduce hair as much as 90%, with results persisting for up to 1 year.
Axillae respond better than legs and arms.
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When people hear the term hair loss, they often think of the scalp hair, but hair loss and alopecia can occur on any part of the body including eyebrows, eyelashes, face, beard, chest, abdomen, axilla, arms, legs, and pubic hair. Alopecia can be permanent or temporary. In this chapter, we will be discussing body hair loss, excluding the scalp and face.
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Since the beginning of recorded history, men and women have searched for cures for hair growth disorders. In ancient Greece, Hippocrates, the Father of Modern Medicine, tried to describe hair loss as he observed it and attempted many medical solutions.1 Although currently associated with the werewolf myth, hypertrichosis ...