It is common and normal for women to have facial hair, including hair on the upper lip and chin. This growth is a natural biological process driven by the same hormones that govern hair growth in all people. While the presence of facial hair is not inherently a medical concern, hair that becomes noticeably thick, dark, and coarse may signal an underlying change. This article explains the biological reasons for female facial hair and clarifies when this growth indicates a medical condition that needs attention.
The Biological Basis of Female Facial Hair
All human beings have hair follicles covering almost every part of their body, producing two main forms of hair. Vellus hair, often called “peach fuzz,” is fine, short, and nearly colorless, providing light coverage. Terminal hair is the long, thick, and pigmented hair found on the scalp, eyebrows, and, in males, the beard area.
The conversion of vellus hair to terminal hair is primarily controlled by hormones known as androgens. Although often labeled as “male hormones,” androgens are naturally produced by the ovaries and adrenal glands in women, though at much lower levels than in men. When a hair follicle is sensitive to these androgens, the vellus hair transforms into thicker, darker terminal hair. While facial hair follicles in women are generally less sensitive to androgens than those in men, they still possess the capacity for this transformation.
When Hair Growth Becomes Excessive
When a woman experiences the growth of coarse, dark, terminal hair in areas where men typically grow hair (such as the upper lip, chin, chest, or back), it is medically defined as hirsutism. Hirsutism is a specific condition indicating excessive hair growth dependent on androgens. This is distinct from hypertrichosis, which is a generalized increase in hair growth anywhere on the body, regardless of pattern or androgen levels.
Clinicians evaluate the degree of hirsutism using the modified Ferriman-Gallwey (mFG) scale. This standardized tool assesses terminal hair growth across nine specific body areas, including the upper lip and chin. It assigns a score from 0 (no terminal hair) to 4 (extensive growth) for each location. A total score of 8 or higher is generally considered indicative of clinically significant hirsutism in Caucasian women, though the cutoff score varies by ethnic background. Quantifying the hair growth helps determine if the issue is a normal variation or a symptom of an underlying medical condition.
Common Underlying Causes of Increased Facial Hair
The most frequent reason for hirsutism is Polycystic Ovary Syndrome (PCOS), a common endocrine disorder affecting between 5 and 10 percent of women. PCOS often causes the ovaries to produce higher-than-normal levels of androgens, directly stimulating terminal hair growth on the face and body. This elevated androgen level is frequently associated with other symptoms, such as irregular menstrual cycles, acne, and difficulty getting pregnant.
Beyond hormonal disorders, genetic background and ethnicity can predispose a woman to increased facial hair, often called idiopathic hirsutism when no underlying cause is found. Women of Mediterranean, Middle Eastern, and South Asian descent are naturally more likely to have hair follicles more sensitive to normal androgen levels. Certain medications, including some anti-epileptic drugs and anabolic steroids, can also induce hirsutism by affecting hormone balance or hair follicle activity.
Rarely, a sudden and rapid increase in facial hair, especially when accompanied by signs like a deepening voice or increased muscle mass, may point to a more serious endocrine disorder. Possible but uncommon causes include Cushing’s syndrome (excessive cortisol production) or tumors that secrete androgens. Consult a healthcare provider if you notice a sudden onset of coarse, dark hair or if the growth is accompanied by other symptoms like severe acne or irregular periods.
Management and Removal Options
For women with unwanted facial hair, numerous options are available to manage the appearance of terminal hair, grouped into temporary and longer-term solutions. Temporary methods are accessible and non-prescription, including shaving, which cuts the hair at the skin surface, and depilatory creams, which use chemicals to dissolve the hair shaft. Other common temporary approaches are plucking, waxing, and threading, which remove the hair from the root, providing results that last for several weeks.
For more lasting reduction, professional treatments such as laser hair removal and electrolysis are available. Laser therapy uses concentrated light to target and damage the hair follicle, slowing future growth. Electrolysis uses a fine probe to destroy the hair root completely. A prescription-only topical cream, eflornithine 13.9% cream, can also be applied to the face to slow the rate of hair growth by inhibiting an enzyme involved in the process. Hair removal methods address the symptom, but only medical treatments, such as oral contraceptives or anti-androgen medications, can address the hormonal imbalance causing the excessive growth.