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2023 Aug 5;402(10400):472-483.

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Key Takeaways Facial hair follicles are the most androgen-sensitive in the body, which is why the face shows PCOS changes early and visibly Free testosterone and SHBG together tell a more accurate story than total testosterone alone Addressing the hormonal driver (insulin resistance, adrenal androgens, or inflammation) is the foundation of treatment Spearmint tea twice daily has clinical trial support for reducing free testosterone and facial hair growth rate Eflornithine cream (Eflora) is the only topical prescription specifically designed for facial hirsutism and reduces growth rate by 50-60% For Indian skin tones, Nd:YAG laser is the safest and most effective laser type for facial hair reduction Treatment takes 6-9 months minimum

doi: 10.1007/s00125-015-3660-2 16 WolvertonDBlairMM