Combined Oral Contraceptives or Metformin Plus Laser Treatment in Polycystic Ovarian Syndrome Hirsute Patients

TAKE-HOME MESSAGE

• In this study 150 patients with polycystic ovarian syndrome (PCOS) and hirsutism were divided into treatment groups undergoing laser hair removal (LHR) alone, LHR plus metformin, or LHR plus combined oral contraceptives.

• All patients showed improvement in visual analog scale scores and quality of life scores after treatment, but those treated with LHR in combination with oral contraceptives showed significantly more improvement in quality of life than other treatment groups.

–  Caroline K. Crabtree, MD

Abstract 

BACKGROUND

Hirsutism is estimated to affect 10% to 20% of females, provoking significant psychological damage and social embarrassment. Polycystic ovary syndrome is a major cause of hirsutism. 

AIM

Assessing the impact of adding combined oral contraceptives (COCs) or metformin to laser hair removal on the quality of life of polycystic ovarian syndrome (PCOS) patients with hirsutism. 

METHODOLOGY

One-hundred-fifty PCO patients diagnosed with hirsutism were included in this study. Patients were randomized into three groups: group 1 received laser hair removal alone, group 2 received metformin and laser hair removal, and group 3 received COCs and laser hair removal. A diode laser with a wavelength of 810 nm was used for hair removal in all patients according to a protocol of 6 monthly sessions followed by another two sessions after three and six months. Patients were assessed using a visual analog scale (VAS) and Dermatology Life Quality Index (DLQI) and a customized questionnaire (Hirsutism Life Quality Index; HLQI). 

RESULTS

All patients showed a significant improvement in both quality indices (DLQI and HLQI) after treatment relative to pretreatment. Group 3 showed significantly better improvements when compared with group 2 and group 1. At three and six months, group 3 showed non-significantly better DLQI and HLQI as compared with at zero months. On the other hand, group 2 patients displayed significant worsening of both DLQI and HLQI scores at three months, with subsequent improvements again at six. Finally, group 1 patients showed nonsignificant worsening at three months, and significant worsening at 6 months. 

CONCLUSION

Combining hormonal treatment with laser hair removal can achieve greater hair reduction, significant improvements in patients' QOL, and better maintenance as compared with when combining metformin with laser hair removal or conducting alone.

Journal of Drugs in Dermatology

Adding Combined Oral Contraceptives or Metformin to Laser Treatment in Polycystic Ovarian Syndrome Hirsute Patients

J Drugs Dermatol 2021 Mar 01;20(3)302-306, N Dorgham, A Sharobim, H Haggag, M El-Kalioby, D Dorgham 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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