Hirsutism is generally treated by pharmacological (by use of drugs) means and mechanical or non pharmacological means. The general principle of management of hirsutism is to use mechanical or non pharmacological means of treatment of hirsutism, either alone or along with pharmacological means or by use of drugs. In other words in all cases of hirsutism mechanical or non pharmacological means should be tried and when it fails, pharmacological means should be used.
Mechanical or non pharmacological methods of treatment of hirsutism include removal of hairs by use of chemicals or simply shaving, removal of hair along with root of the hair follicles (by plucking, waxing, electrolysis and by using laser) and bleaching. These mechanical removal of hairs may be painful but use of laser is painless and gives good results, although the long tern efficacy and long term complication of laser treatment of hirsutism is not yet adequately studied. But laser treatment generally gives long lasting effects and in most cases hair removal is permanent. Even if the hair removal is not permanent, it delays the re-growth of hair for long.
The pharmacological treatment of hirsutism includes use of combined oral contraceptive pills, which contain both estrogen and progestin. The estrogen component used is ethinyl estradiol and progestin component used is norgestimate. The commonly used progestin in combined oral contraceptive pill is norgestrel or levonorgestrel, but these two have androgenic effects and not used in hirsutism. The newer generation progestin norgestimate is used in place of norgestrel or levonorgestrel.
Other drugs which are also used in treatment of hirsutism are spironolactone, cyproterone acetate, flutamide etc.