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.

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]}

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.

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.

Medication

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Media Gallery

Family of Petrus Gonzales, who lived in the 16th century.
Patients in well-documented cases of Ambras syndrome. (A) Daughter of Petrus Gonzales. (B) Grandson of Schwe Maong. (C) Adrrian Jepticheff. (D) Fedor.

of 2

Author

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American College of Rheumatology

Disclosure: Received income in an amount equal to or greater than $250 from: Biogen US (Adjudicator for study entry cutaneous lupus erythematosus); Priovant (Adjudicator for entry into a dermatomyositis study); IQVIA (Serono - adjudicator for a study of cutaneous LE) <br/>Received honoraria from UpToDate for author/editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for these trust accounts for: Stocks held in various trust accounts: Allergen; Amgen; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble;; Celgene; Gilead; CVS; Walgreens; Bristol-Myers Squibb.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Leonard Sperling, MD Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Sarah K Taylor, MD Staff Physician, Eisenhower Army Medical Center Dermatology, Ft Gordon

Disclosure: Nothing to disclose.

Kenneth J Galeckas, MD Assistant Professor, Department of Dermatology, Uniformed Services University of the Health Sciences; Staff Dermatologist, Director, Laser and Cosmetic Clinic, Intern and Medical Student Coordinator, Department of Dermatology, National Naval Medical Center

Kenneth J Galeckas, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for Dermatologic Surgery, Association of Military Dermatologists

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Abby S. Van Voorhees, MD, and Analisa Halpern Vincent, MD to the development and writing of this article.

Sections Congenital Hypertrichosis Lanuginosa
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Treatment
Medication
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Congenital Hypertrichosis Lanuginosa Treatment & Management

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