Do you remember being a preteen and spotting those first body hairs? Some of us felt embarrassed, while others felt proud of being one step closer to the adult world.

However, for some children with congenital adrenal hyperplasia (CAH), body hair may appear long before they even learn about puberty, or they may have hair that grows in excess, causing significant distress that can negatively affect their mental health.

Learn more about why some children with CAH get excess body hair, the ways you can help your little one cope, and strategies for safely managing excess body hair in kids.

CAH and Excess Body Hair: What’s the Connection?

Symptoms of CAH may vary widely, meaning not everybody with it will have excess body hair before puberty. However, in some cases of CAH, a significant imbalance of hormones may lead to unusual hair growth.

This happens because the adrenal glands produce multiple hormones, including androgens. Though they are commonly known as the “male” hormones, all people, regardless of gender or biological sex, make this hormone. They are needed for normal development and growth. Typically, the amount a person has of this hormone varies by age, as well as biological sex.

In some children with CAH, there may be too much androgen, causing early puberty, acne, or premature growth of pubic, facial, and armpit hair. Early puberty can be extremely stressful. Adolescents who experience early puberty — particularly girls — are more likely to experience depression and behavioral problems, according to a research review in Frontiers in Pediatric.

Ways To Manage Excess Body Hair

A scientific review published in February 2024 in Pediatric Dermatology has shown that all hair-removal methods appear to be safe in children as long as they are done properly. Let’s take a closer look at each of them.

1. Shaving

Shaving with a razor or other bladed tool is the most common and accessible method to temporarily remove unwanted hair. If an adult safely shaves a child (or a child shaves under adult supervision), it can be a simple and effective way to tame excess body hair.

While generally painless and inexpensive, shaving can cause nicks, cuts, ingrown hairs, and skin infections. However, there are some ways to avoid these unpleasant side effects:

• Frequently change safety razors to avoid the blades becoming blunt.
• Wash the area to be shaved with warm water and a gentle cleanser prior to shaving.
• Apply shaving cream and allow it to sit for a few minutes before shaving.
• Shave in the direction of hair growth and avoid going over one area several times.
• Wash off the freshly shaved area with cold water.
• Apply a fragrance-free moisturizer afterward.

2. Epilating

“Epilation” is the term used to describe methods that forcibly remove the hair with its root, leading to a more long-lasting effect than shaving. These methods include plucking, threading, waxing, and sugaring (which involves applying a paste of sugar, lemon, and water to remove unwanted hair).

Plucking and threading may be more suitable for areas that require more precision, such as eyebrows, whereas waxing and sugaring are more convenient for larger body areas such as legs.

Epilation can cause temporary pain and discomfort, making it unsuitable for some children. It also poses a risk of skin infections, ingrown hairs, bleeding, irritation, and burns.

These methods can be applied both at home or done in a medical office. Some medical professionals such as dermatologists (skin specialists) or pediatricians may offer local painkillers — such as creams and sprays — to alleviate the pain.

3. Creams

If applied correctly, depilatory creams are another option for hair removal. These creams work by dissolving the hair and are available for at-home use without a prescription.

However, using depilatory creams can lead to skin irritation, discoloration, pain, and burning, so it’s important to try it on a small, discrete part of the skin before using it on a larger area. Make sure to follow the instructions carefully.

4. Laser Hair Removal

Laser hair removal aims to damage or destroy hair follicles in order to limit hair growth. Lasers, as well as intense pulsed light therapy, are safe for children.

Since laser hair removal requires multiple, continuous treatments done by qualified professionals, it can be rather costly. Short-lived side effects of laser hair removal include discomfort, discoloration, and swelling. Sometimes, blistering, infections, scarring, and skin darkening or lightening may occur.

5. Electrolysis

Electrolysis destroys the hair root with an electrical current, causing the existing hair to fall out and preventing new hair from growing. It can be done either at home or by a professional.

Just like with laser and intense pulsed light hair removal, multiple sessions are needed in order to achieve results, meaning this can be expensive. However, unlike laser hair removal, there’s no need for maintenance treatments with electrolysis. The hair removal is permanent.

Your child may experience side effects including scarring, burns, and pain. It’s important to find an experienced, certified dermatologist to perform this procedure.

6. Medications

Sometimes, your child’s healthcare provider may suggest using certain medications in order to manage excess hair growth. Hydrocortisone, a glucocorticoid, may help manage the symptoms of androgen excess, including unwanted hair growth.

Eflornithine (Florexa) is a prescription cream for treating excess facial hair in people over 12. It works by temporarily slowing down hair growth, meaning if the treatment is stopped, the hair will grow like it did before starting the drug. It may take up to eight weeks to notice results.

Doctors may recommend that children who menstruate take birth control or combined oral contraceptives. This treatment won’t help remove existing hair, but it might slow down the growth of new hair. It can take around six months to see the effects. Antiandrogens, such as spironolactone, may also be prescribed.

Other drugs may be recommended by a healthcare professional according to your child’s individual situation.

Accepting Excess Body Hair

While children may choose to remove excess hair, hair is not necessarily a symptom that must be treated. It’s normal for all people to grow body hair. Although people with CAH may have more body hair than those that don’t, that doesn’t mean it has to be changed.

Because body hair is an aesthetic issue, it can be debated whether having more hair is a health problem by itself or just a characteristic that’s different from societal norms.

For some people, excess hair has been associated with lower quality of life and self-esteem and a higher prevalence of anxiety in teenage girls, according to a 2010 study published in the Journal of Psychosomatic Obstetrics and Gynaecology.

One of the most important ways you can support your child is to help them accept their condition and the symptoms it causes. Some children may decide to try out hair removal, while others may opt to keep it.

Looking different from their peers can be stressful enough. The best thing you can do as a parent or caregiver is offer your unconditional support. This will help your child build a positive body image for the rest of their lives.

Talk With Others Who Understand

CAHteam is a social network for parents, caregivers, and those with congenital adrenal hyperplasia. On CAHteam, members come together to ask questions, give advice, and share their stories with others who understand life with CAH.

How do you help your child deal with excess body hair? Share your experience in the comments below, or start a conversation by posting on your Activities page.