Do you remember being a preteen and spotting those first body hairs? Some of us felt embarrassed, while others were 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, ways you can help your child cope, and strategies for safely managing excess body hair in kids.

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

Symptoms of CAH can look very different from person to person. Not every child will show early signs of puberty, such as pubic or underarm hair, before the usual age. 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 androgens are commonly known as “male” hormones, everyone’s bodies make this hormone. Androgens are needed for normal development and growth. Typically, the amount varies by age and biological sex.

Some children with CAH may have 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 Pediatrics.

Ways To Manage Excess Body Hair

A scientific review published in February 2024 in Pediatric Dermatology shows that all hair-removal methods appear to be safe in children as long as they’re done properly. Let’s take a closer look at some of these options.

1. Epilating

“Epilation” describes 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 (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 done both at home or in a medical office. Some medical professionals, such as dermatologists (skin specialists) or pediatricians, may offer local painkillers — such as creams and sprays — to ease the pain.

2. Creams

If applied correctly, depilatory creams are another option for hair removal. These creams dissolve 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 the product on a small, discrete part of the skin before using it on a larger area. Make sure to follow the instructions carefully.

3. Laser Hair Removal

Laser hair removal limits hair growth by damaging or destroying hair follicles. Lasers, as well as intense pulsed light therapy, are safe for children.

Since laser hair removal requires multiple, continuous treatments by qualified professionals, it can become costly. Short-lived side effects include discomfort, discoloration, and swelling. Blistering, infections, scarring, and skin darkening or lightening may also occur.

4. Electrolysis

Electrolysis destroys the hair root with an electrical current, causing the existing hair to fall out and preventing new growth. It should be done by a trained professional, not at home, to make sure it’s safe and effective.

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

5. Medications

Your child’s healthcare provider may suggest using certain medications to manage excess hair growth. Hydrocortisone, a glucocorticoid, can help lower androgen levels and reduce symptoms like unwanted hair. The dose matters — too little may not control androgen excess, while too much over time can cause side effects. A pediatric endocrinologist (a doctor who specializes in hormone-related conditions in children and teens) will work to find the right balance.

Eflornithine is a cream approved for treating excess facial hair in people aged 12 and older. It temporarily slows 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 the growth of new hair. It can take around six months to see the effects. Antiandrogens, such as spironolactone, may also be prescribed.

A healthcare professional may recommend other drugs, depending on your child’s situation.

Living With Excess Body Hair

Looking different from your peers can be stressful, and adolescents may choose to remove excess hair. Excess hair is linked to lower quality of life and self-esteem and a higher prevalence of anxiety in teenage girls, according to a 2010 study in the Journal of Psychosomatic Obstetrics and Gynaecology.

One of the best steps you can take as a parent or caregiver is to offer your unconditional support. This will help your child build a positive body image for the rest of their life.

Talk With Others Who Understand

On CAHteam, people share their experiences with congenital adrenal hyperplasia, get advice, and find support from others who understand.

How do you support your child with excess body hair? Let others know in the comments below.