Hair removal or depilation

What is excessive hair removal?

Hair removal can be used for patients with excess hair (hirsuitism) in a normal distribution pattern, or for abnormally placed hair. It is usually achieved permanently by electrolysis or laser therapy. Excess hair (or hair not in a usual pattern or place) essentially means that an individual, usually a female patient, grows too much body or facial hair in a male pattern.

Although it sometimes occurs in males, it is more difficult to detect because of the wide range of normal hair growth in men. Excess hair affects approximately 10% of women in Western societies and is commoner in those of Mediterranean or Middle-Eastern descent.

It is usually caused by high levels of male hormones and additional symptoms may be irregular periods, acne, deepening of voice and baldness. The British Association of Dermatologists advises that there are a range of treatment options:

  • Medical treatments: prescription hair removal cream (eflornithine) cream, or a range of hormone altering medication (anti-androgens)
  • Self-care: shaving, waxing, hair removal creams and bleaching creams
  • Physical treatments: electrolysis, or laser and intense pulsed light (IPL) treatments.

Patient eligibility criteria:

The patient's local NHS commissioning organisations will only fund this treatment if the patient meets any of the following criteria:

  • If the patient has undergone reconstructive surgery leading to abnormally located hair-bearing skin. For example, if reconstructive surgery has led to hair growing in places it would not normally do so such as in the mouth, or a skin graft that has caused visible excess hair growth
  • If the patient is undergoing treatment for small hole or tunnel in the skin, usually caused by loose hair piercing through the skin in the cleft of the buttocks, where the buttocks separate (pilonidal sinuses).

The clinician in charge of the care of the patient’s specific condition, usually a hospital doctor, can assist the application, if there is exceptional clinical need for the treatment to be funded. The patient’s clinician must evidence clinical exceptionality and must be supported by the patient’s local NHS commissioning organisation. See separate leaflet for more information on Individual Funding Requests (IFRs).

Advice and further guidance:

  • For more information, search for ‘hirsuitism’ and ‘laser hair removal’ at
  • Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.

Treatment policy for patients covered by NHS Birmingham and Solihull CCG

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