Q: Hi I need some advice Dr, Please, I am a female and I have hair growing around my nipples, in my anus, in my vagina (bikini line ,under the vagina lips and in towards the back) also under my chin, I am ashamed of it and wanted to know why is it I have hair in places like these. I also noticed the hair under the vagina lips is causing lumps I don’t know what to do for these lumps. Please advise me. Blessings

A: Hi dear. Thanks for writing in.

What you’ve described sounds like hirsutism which is a situation in which there is excessive hairiness in a woman in places like the face, chest and back. Funny enough, growing up, very hairy ladies were considered pretty special…In a good way 😀

This situation can be caused by any situation that increases the male sex hormones (androgens) or increases the response of hair follicles to androgens. Some conditions that can cause this include Poly Cystic Ovarian Syndrome (PCOS), some drugs, obesity etc It is more likely in people who have a family history of this and in people of Asian, Mediterranean and Middle Eastern origin. This can also be found in women with no risk factors and women where no specific cause can be found.

If specific causes are found eg obesity or PCOS, these should be addressed.

As you may have found out, permanent methods of getting rid of the facial and other unwanted hair like laser treatment (which does not destroy the hair follicles) and electrolysis (which destroys hair follicles but may leave small scars on face) are expensive with laser being more popular and more expensive.

Mild cases of hirsutism can be dealt with by shaving, waxing, plucking or using depilatory creams…much as you would take care of underarm hair.

Birth control pills used over a period of 6 to 12 months may improve this condition by helping reduce the effects of androgens and reducing the production of more sex hormones. Anti-androgen drugs can also be used.

So, make out time to go find a gynaecologist as soon as you can and discuss this. He will carry out a detailed investigation and then confirm treatment options that would work best for you depending on his findings eg whether the contraceptive pills are an option for you etc.

Until you’re able to do that, you may have to keep plucking, waxing or using depilatory creams. As soon as you can afford it, laser treatment should be considered.

Shaving is also an option but it could lead to razor bumps in the groin/vagina like what you have observed. The reason for this is because in Africans, the hair in the groin area is very curly and so it is pretty easy for the hair to curl and grow down instead of growing up and out. These lead to red, raised spots/bumps which could get infected and become pus-filled.

More often than not, an ingrown hair does not require special treatment. They just leave quietly on their own…much like how they came. This of course, presupposes that there is no shaving done during this period to aggravate the situation. In the meantime, do not squeeze the bumps as this may push the bacteria further inside. You could use a soft bristled brush to loosen the hair before shaving or use a sterile needle or tweezers to tease out the ingrown hair(s) if it lies close to the surface.

How to prevent ingrown hairs? Simple! Stop shaving…at least for a while. That’s always an option. There’s always a huge debate about whether things should be kept natural down there! 😀 However, if you choose to shave, try using a scissors to trim, before using a single blade shave stick to shave. Make the hair as wet as possible using shave foam and then shave in the direction of the growth of the hair. And while you may think it’s fun to be completely clean shaven there, try not to shave too close to the skin and rinse the shaver after each stroke 😀 Pat the area gently afterwards…don’t rub vigorously. Remember that re-using razors you have used on the infected parts may lead to further re-infection with bacteria that are on the surface of the razor.

Your doctor will make a definitive diagnosis. He/she may prescribe some anti-biotic ointment or oral antibiotics (taken by mouth) and some other ointments to stop the inflammation. Remember that antibiotics should be taken for the full period prescribed by the doctor and not stopped as soon as you feel better.

Have a great evening, y’all 😀