The "sec-hormones" fall into three categories: The male hormones androgen and the female hormones estrogen and progesterone. Androgens include testosterone, fluoxymesterone and methylestosterone. Estrogens include cholortrianisene, conjugated estrogens, esterified estrogens, estradiol, diethylstilbestrol, estrone, estropipate, ethinyl estrodiol and quinestrol. While progesterones include hydroxyprogesterone, medroxyprogesterone, megastrol, norethindrone and norgestrel.
Androgens, also known as male hormones, stimulate hair follicles and the sebaceous glands and are responsible for changing the fine, soft vellus hairs into thick terminal hairs. Remember, vellus hair, commonly called "peach fuzz," are short, fine, light-colored, and barely noticeable hair that develops on most of a person's body from childhood. Each strand of vellus hair is usually less than two millimeters (1/13 inch) long and the follicle is not connected to a sebaceous gland. The terminal hair is longer, thicker and darker than vellus hair. During puberty, vellus hair is replaced with terminal hair due to androgenic hormone activity. Both men and women have terminal hair in the pubic and underarm area called axillary hair, but men develop more terminal hair in areas like facial hair, arm hair, abdominal hair, chest hair and leg/foot hair. Follicles in charge of growing terminal hair have sebaceous glands. When things are working normally in the endocrine system, testosterone in the hair follicle is converted to another hormone dihydrotestosterone by enzyme 5 alpha reductase. If there is any dysfunction in the endocrine system or glands, by raising or lowering androgen production, the result can be a disruption in normal hair growth. Too little testosterone can cause hair loss and too much testosterone can produce too much hair growth.
The androgen drugs are used as replacement therapy for male conditions like impotence and hypogonadism. It is also used for female conditions such as delayed bone healing, senile and idiopathic osteoporosis, menorrhagia (excessive menstral discharge), and sexual dysfunction. Among the side effects of androgen drugs on women are seborrhea, acne, male pattern baldness, hirsutism and virilization, which is the development of adult male physical characteristics in women.
Like androgens, the estrogens (commonly known as "female hormones") are found in both men and women, but the ovaries in women generate the greatest levels. These hormones stimulate estrus (the cyclic period of sexual receptivity, marked by intense sexual urge and coinciding with the time that fertilization can take place) and development of secondary sexual characteristics.
These hormones are used as drug therapy to treat ovary failure or removal in young women, for those menopausal or the postmenopausal atrophy of genital tissue and postmenopausal osteoporosis. They are sometimes used in the treatment of certain breast cancers as well. Adverse side effects of these drugs that replace estrogen may include breast enlargement, charges in menstrual flow and sex drive, weight gain or loss, fluid retention, depression, skin irritation, hyperpigmentation (melasma) and most importantly, the increased risk of cancer of the uterus after three years of continuous use. Other side effects may include excessive hair growth or possible hair loss as is the case with all sex hormones.
Understanding the endocrine system helps the technician understand the needs of the client coming in for hair removal. It is only when the client feels that their normal hair growth is excessive or abnormal does the physician and hair removal specialist come into play, either separately or as a team, in dealing with this condition. The sheer complexity of the endocrine system can cause it to be vulnerable to dysfunction. Tumors can cause the endocrine glands to malfunction and disrupt the normal production of hormones. Multiple cysts on the ovaries can cause the client to exhibit hirsutism or the medication she is taking to control these cysts could lead to this same side effect.
Along with estrogen, the ovaries produce progesterone. The principle progesterone hormone is called progestin. Progesterone hormones prepare the uterus for pregnancy and breasts for lactation. In hormone replacement it is used for weight loss (the hCG diet), the treatment of breast and uterus cancer and conception control. The side effects are similar to those of estrogen and may include weight or appetite changes, breast tenderness or enlargement, menstrual changes, blood clots, depression and hair loss or excessive hair growth.
A word on oral contraceptives which are synthetic blends of estrogen and progesterone. This combination creates in the blood the same chemical reaction that exists during pregnancy which is a highly effective form of birth control. However, there are many as 30 or 40 adverse side effects of these drugs whether delivered via pill, injection, implant or patch. They may include acne, hives, various forms of dermatitis and hyperpigmentation.
Corticosteroids are as important to us as the sex hormones.Corticosteroids are produced in both men and women and are made by the adrenal glands which are situated on top of the kidneys. These adrenals secrete a small amount of sex-hormones but largely produce aldosterone. This causes the kidneys to excrete potassium and retain sodium, cortisol, corticosterone and cortisone. Together they help the body resist stress, control immune response, metabolize food intake and inhibit inflammation.
While over 60 years ago, corticosteroids were heralded as a great advance in treatments for dermatological issues, the number of drugs in this category has vastly increased and of the over 1,000 corticosteroid drugs available today, more than 60 percent of them cause hirsutism as a possible side effect.
Topical hydrocortisone, one of the most widely prescribed corticosteroids, is used to treat a variety of skin conditions such as insect bites, poison oak/ivy, eczema, dermatitis, allergies, rash, itching of the outer female genitals and anal itching. Hydrocortisone reduces the swelling, itching and redness that can occur in these types of conditions. This medication is a mild corticosteroid. This common topical medication carries warning labels that remind the consumer that the drug is absorbed by the skin and can find its way into the blood stream. Side effects from hydrocortisone can include redness, blistering and peeling skin, itching, burning and secondary infections. Long term use of hydrocortisone can cause glandular problems, diabetes, Cushing's syndrome and excessive hair growth.
Excessive hair growth due to drug reaction is called "iatric hirsutism." The word iatric comes from the Greek word pertaining to medicine or to a physician. Today there are well over 1,000 drug brands that cause iatric hirsutism.
Drug interaction or a countless number of health conditions can interfere with the sex-hormones in the endocrine system, the ovaries in women, testes in men and adrenal glands in both men and women. Once the balance of testosterone is interrupted, the result can be excessive hair growth.
The wide uses of the drugs that control hormone balance make it extremely important for the technician to employ the use of client health forms. Not only must we stress listing all of the medications that the client is taking but we need to understand how these drugs work and their possible side effects in order to better determine the most accurate form of treatment for the client's hair growth disorder. Is the condition brought upon by drug interaction? Is it a genetic dysfunction? Is it due to a health disorder? Or is it idiopathic hirsutism (meaning there is no known cause)? The more comprehensive the client history is, the easier it is for the technician to uncover the client's under lying cause of unusual hair growth issue. The more we learn and understand the drugs that effect the endocrine system and both the sex-hormones and adrenal hormones and the role that hormones play, the better we can serve our client's needs.