Brief Answer:
It could be due to medications

Detailed Answer:
Hi XXXXXXX

Welcome to HCM. I have gone through your question and understand your concerns.

Have your doctor evaluated you for the cause of hair loss and facial hair? Has he made the diagnosis of polycyctic ovarian disease (PCOD)? How is your menstrual cycles? Please share the reports of the hormonal tests if done - testosterone, DHEA, 17- hydroxy progesterone, thyroid function tests, prolactin etc are usually done in this type of symptoms.

I will explain the answers to your questions

1. Medicine side effect

The medicines you are taking is minoxidil which increase blood supply to skin to promote hair growth and rest are minerals, proteins and vitamins which improve hair growth.

One side effect of Minoxidil is hair growth in face, arms, back etc. This usually appear few weeks or months after treatment and may require dose reduction or stoppage of medication. The vitamins, minerals and proteins would have helped the hair growth

2. Reason for increasing hair growth in face

The cause can be:

a. PCOD - A combination of irregular menstrual cycles + facial hair growth + polycystic ovaries in ultrasound of abdomen. Any two of the three will make the diagnosis. This is responsible for around 90% cases

b. Other causes

Drugs (like minoxidil), adrenal disorders, elevated prolactin, hypothyroidism, cortisol hormone excess etc has to be rule out in all cases.

3. DHEA

Dehydroepiandrosterone (DHEA) is usually elevated in PCOD and other adrenal disorders (like congenital adrenal hyperplasia - rare cause). So elevated DHEA suggest you probably have PCOD. This will get converted to testosterone (male hormone) and will cause hair growth in face and decreased scalp hair.

Hope it answers all your questions.

My suggestions are:
1. See your dermatologist and decrease or stop Minoxidil.
2. Consult an endocrinologist and get worked up for PCOD. If the diagnosis turns out to be PCOD medications can bring down your excess facial hair and DHEA.

If you have any further questions I will be happy to help

With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.

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Brief Answer:
DHEA is only slightly elevated

Detailed Answer:
Hi XXXXXXX

Gone through the reports. Your doctor has done all blood investigations of PCOD.
No need to worry. Reports are ok.

Hope all the investigations are done in the first week of menstrual cycle.
DHEA is only borderline elevated. No need for further hormone work up.

Now with these investigations there are 3 possibilities I would consider:

1. PCOD - if you have either menstrual irregularities or polycystic pattern in ultrasound scan the most probable diagnosis is PCOD.

Treatment - oral contraceptive pills, metformin, anti androgens

2. Drug induced : if before Minoxidil treatment you didn't have any facial hair, then it could be due to this drug.

Treatment - stop the drug

3. Idiopathic : Without any cause. Your facial skin is sensitive to the low level of testosterone normally seen in females and is growing more hair.

Treatment - anti androgen pills

Hope this will help you.

Regards
Dr Ajish TP

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