Laser hair removal for PCOS and hormonal hair

Hirsutism or hypertrichosis?

Hirsutism is excess coarse, dark hair in a typically male pattern, such as the chin, jawline, upper lip, chest or abdomen. It's driven by androgens (male-type hormones) or by how sensitive the follicles are to them.

Hypertrichosis is excess hair that isn't androgen-driven. It can appear anywhere on the body and doesn't follow a male pattern.

The difference matters. Hormone-driven hair keeps responding to the hormones behind it, which shapes the results you can promise. Using the right word also keeps your records accurate.

How common is PCOS?

According to the NHS, PCOS affects about 1 in 10 women in the UK, and the 2023 international PCOS guideline puts it at 10 to 13% worldwide. PCOS and idiopathic hyperandrogenism (raised androgens with no other cause found) together account for more than 85% of hirsutism.

PCOS is diagnosed by a doctor, not in the treatment room. For adults, the international guideline uses two of three features: irregular or absent ovulation, signs or blood tests showing raised androgens, and polycystic ovaries on an ultrasound scan or a raised AMH blood test. Excess hair on its own doesn't mean a client has PCOS.

Record what you see, not a diagnosis

Your notes should describe observations, such as "coarse dark hair on chin and jawline", not conclusions such as "hirsutism due to PCOS" or "likely hormonal imbalance". Diagnosing, or suggesting medication, is outside a technician's scope. If a client tells you they've been diagnosed, record it as something the client reported.

Red flags that mean refer

Most hormonal hair develops gradually. Hair that appears rapidly, over a few months, or that comes with signs of virilisation such as a deepening voice, needs prompt medical assessment, because in rare cases it can point to an androgen-secreting tumour. Advise the client to see their GP promptly, ideally that week, and record that you did.

How you raise it matters as much as what you say:

• Lead with the treatment. You can treat, and there's one thing you'd like the client to get checked alongside it.
• Say what you don't know. You can't say what's causing the hair growth; that's a question for their GP.
• Never imply blame.
• Write it down: what you advised, and when.

What laser can and can't achieve

Laser can reduce hormonal hair and improve how clients feel. A 2024 systematic review carried out for the international PCOS guideline found that laser and light-based treatments reduced the severity of hirsutism and improved psychological wellbeing and quality of life. It also suggested these clients may need more sessions than people with idiopathic hirsutism.

Results still need honest framing. In a 2024 study of 172 women with PCOS-related facial hirsutism, quality of life improved over 24 weeks of laser treatment, but hair regrowth at six months pointed to a limited long-term effect.

The hormonal driver keeps running, so new follicles can convert to coarse hair over time. That's why maintenance sessions are often needed, and why it's better to say so at the first consultation than at the last.

Some clients use a prescription cream, eflornithine, alongside laser. In a 2007 trial on the upper lip, about nine in ten sides treated with the cream plus laser reached complete or almost complete hair removal, compared with about two in three treated with laser alone. Whether a client uses it is a decision for their GP or prescriber, not the technician.

Paradoxical growth

Paradoxical hypertrichosis means new, thicker or darker hair in or near the treated area after laser. It's uncommon and reported mostly on the face and neck. Some studies have linked hormonal conditions such as PCOS to a higher risk, although a large Japanese study found no link. Explain the risk before facial treatment, and record that you did.

Learn it properly: PCOS and Hormonal Hair

PCOS and Hormonal Hair is a 16-minute online masterclass for laser technicians and for clinics training their teams. It covers the difference between hirsutism and hypertrichosis, the main causes, the red flags that mean refer and how to raise them without alarming the client, what the evidence says laser can achieve, maintenance, paradoxical growth, and working alongside a client's GP without diagnosing or advising on medication.

• 16-minute video masterclass
• Short quiz at the end
• Certificate of completion for every learner who passes
• £25