What non-drug, cosmetic approaches can be employed in the treatment of hirsutism and review the utility of these approaches in conjunction with drug therapies.

HIRSUTISMADD IMAGES IF POSSIBLE Paper details:A 26 year old Caucasian female presents to your clinic with complaints of unwanted hair growth and oligomenorrhea (with menstrual cycles every 45 days). On evaluation, her modified Ferriman–Gallwey score is 10. She also has acanthosis nigricans on the back of her neck. On questioning, she complains of steady weight gain since the time of her menarche which was at the age of 14 years. At present, she is obese with a BMI of 34 kg/m2. She has a strong family history of type 2 diabetes mellitus and dyslipidemia. She has done some private tests and the suggested diagnosis is polycystic ovarian syndrome. Her testosterone concentration is 1.5 nmol/l (NR female <2.5), androstenedione 14.5 nmol/l (2-10) with oestradiol 352 pmol/l (>130). The private physician who saw her recommended metformin 500mg bd which she is taking. ADD IMAGES IF POSSIBLE QUESTION In brief, what is polycystic ovarian syndrome (PCOS) and what are its diagnostic features? SCENARIO 2 Increasingly in aesthetic practice, we see women attending concerned about their hirsutism but also transgender patients. The following reveals such a case A 27-year-old trans female attends clinic complaining of hirsutism despite the fact that she has unmeasurable testosterone concentrations, underwent surgery, and is being treated with estrogens. She transitioned over 3 years ago. QUESTION ADD IMAGES IF POSSIBLE What non-drug, cosmetic approaches can be employed in the treatment of hirsutism and review the utility of these approaches in conjunction with drug therapies