Laser treatment of facial hirsutism in women with polycystic ovary syndrome (PCOS): an evaluation of the Monash Health state-wide PCOS service laser therapy outpatient clinic

Hirsutism is defined as excessive terminal hair growth of male-pattern distribution in a woman. Either generalised or localised, it involves hair growth in androgen-dependent areas such as the face, chest, back, upper arms, abdomen and thighs. The prevalence of hirsutism in the general population is estimated to be 4-11% but among women with polycystic ovary syndrome (PCOS), an endocrinopathy characterised by insulin resistance and hyperandrogenaemia, the prevalence increases to beyond 70%. PCOS is also the most common underlying condition of women seeking treatment for hirsutism. Even though not a life-threatening disease, hirsutism causes significant emotional and psychological harm to the affected women. Research has shown that hirsutism is not only associated with lower quality of life but it may have the strongest impact among all other PCOS features. Laser photoepilation is a widely used hair removal method that works on the principal of selective phototermolysis where red or near-infrared wavelengths inflicted preferential thermal damage to the more heavily melanin pigmented hair follicles but sparing the surrounding less pigmented epidermis. It is considered the most effective method of permanent hair reduction even though the evidence supporting the statement is not robust. Study Aim Our aim is to evaluate the laser photoepilation clinic of the PCOS statewide service by using the Monitoring and Evaluation Framework to assess the appropriateness, effectiveness, efficiency, and impact domains. Hypothesis We hypothesise that laser photoepilation is effective in improving hirsutism severity, self-esteem, quality of life, and reducing depression or anxiety in women with PCOS Study objectives 1) Evaluate the appropriateness of laser photoepilation clinic to the women with PCOS and hirsutism by assessing the proportion of women attending the PCOS service being referred to the laser photoepilation clinic and the treatment interval between each woman 2) 3. Evaluate the effectiveness of laser photoepilation in women with PCOS by assessing the changes in subjective and objective hirsutism severity 3) Evaluate the impact of laser photoepilation in women with PCOS by assessing the changes in quality of life, self-esteem, and depression or anxiety scores 4) Assess the adverse effects of laser photoepilation in women with PCOS w Study Design This study will use mixed methods to evaluate the Monash Health PCOS statewide service laser clinic at the Monash Medical Centre, Clayton. The mixed-methods analysis will incorporate semi-structured interviews and an online survey among women with PCOS who have attended the Monash Health PCOS Service, which was established in 2017.