Congenital Hypertrichosis Lanuginosa Treatment & Management

Updated: Aug 28, 2018
  • Author: Dirk M Elston, MD; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

The use of eflornithine (Vaniqa cream) 13.9% or hair removal by means of repeated shaving, depilatory methods (eg, chemical, electric methods), or bleaching can improve congenital hypertrichosis lanuginosa (CHL) patients’ appearance.

Older techniques of hair removal are mentioned in the literature; these rarely used techniques include diathermy and radiation therapy.

Clinicians should consider the use of antidepressant medications in patients with psychological sequelae, including depression.

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Surgical Care

Laser hair removal has been proposed as a treatment option, although there are conflicting reports regarding the proposed efficacy of lasers in removing the vellus hairs in congenital hypertrichosis lanuginosa.

Littler found a 40-80% reduction in unwanted hair using the Q-switched Nd:YAG laser after the application of a topical carbon-based solution. This therapy may be a well-tolerated method of hair removal in children because the lower fluences required resulted in decreased associated pain during treatment.

Vashi et al suggest that because of the difference in the penetrance of laser light into nonpigmented hair versus pigmented hair, laser therapy may not be effective in unpigmented lanugo or vellus hairs. [22, 45]

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Consultations

Genetic consultation may be indicated for the family members of patients with congenital hypertrichosis or Ambras syndrome. Congenital hypertrichosis lanuginosa and Ambras syndrome may have an autosomal dominant pattern of inheritance; however, an association with a genetic defect has not been demonstrated in all patients. Belengeanu et al describe 2 siblings with purported Ambras syndrome born to normal parents and propose that these patients might represent either an autosomal recessive pattern or germline mosaicism. [46]

Psychiatric evaluation may be indicated in patients in whom the physical findings of the syndrome cause psychological morbidity.

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Complications

Compliance issues are the major complications in patients with congenital hypertrichosis lanuginosa. Inconvenience, cost, and the patient's dissatisfaction with the appearance of the hair, may influence his or her compliance with a hair removal regimen.

Psychological sequelae may occur because of the presence of unwanted hair.

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