Q: I have a 7 year old daughter who has been diagnosed with NCAH recently. She is taking hydrocortisone 10mg/day. I shaved her armpit hair 5 days ago. I noticed her armpit hairs are growing and are dark today. Her doctor said hydrocortise would stop the growth of her armpit hair. How long does it take to stop the growth of her hair? Also, she has hair on the outer nose like a black head. Please let me know a safe way to remove her armpit and facial hair. Thank you.

A: The hydrocortisone will bring down the hormones that are causing the hair growth fairly quickly (usually within a month or so). However, the lifespan of a hair follicle is about 6-9 months, so the hair follicles that are already present will remain for the duration of their life cycle unless you do something like electrolysis or laser, which I would not recommend for your 7 year old. Once the level of androgens (the hormones from CAH that cause the hair growth) have come down, you will start to see less hair growth, but it can take up to one year to really see a difference. In the meantime, you can try Nair (a cream that dissolves the hair) or continue shaving, although shaving may cause chafing. You could also consider waxing, which would pull out the hair from the root, but it may be too painful for your 7 year old. Some people also just trim the hair, which is another option. If your daughter has blackheads or acne on her face, acne will resolve more quickly (1-3 months) once the androgens are lowered. In the meantime, you can use a facial cleanser containing salicylic acid and topical benzoyl peroxide as needed.