IF THE regimental sergeant major at Sandhurst needs to rebuke Prince Harry, as is likely sometime over the next few months, for having hair longer than regulations demand, the RSM is not only enforcing good order and military discipline but also biblical orders. The RSM may not be aware of it, but the Bible tells us that if a man has long hair it is shaming, but if a woman has long hair it is glorious. Most people are not born perfect, but whereas having the right amount of hair in the right places is a help in life, too much in the wrong place, or not enough where it is expected and considered an adornment, can be humiliating and depressing.

According to research published in the British Journal of Dermatology, the effect on women of having too much facial hair, even if it is not enough to rival a fairground bearded or moustached woman, is much greater than is usually supposed. Hirsute women have a great burden of emotional stress to carry through life. It is not surprising that they are easily depressed, lack self-esteem and, in general, have a poorer quality of life than contemporaries whose facial skin is free of hair.

What is unexpectedly revealed by recent research is the extent to which this depression eats into the very soul. The level of anxiety and depression of hirsute women was compared that of women in whom breast cancer or a gynaecological cancer had been diagnosed.

It was found that the psyche of an excessively hairy woman was more battered than that of a patient afflicted with one of these cancers that are so intimately involved in a woman’s sense of feminine identity. In the dermatological clinics it was only those patients who had severe widespread psoriasis who suffered a comparable level of distress.

Having excess facial hair, or unwanted hair on the chest, breasts, abdomen or thighs, also involves women in considerable expenditure of time and worry. Hours a day can be spent plucking and waxing, or even just contemplating their misfortune in the looking glass.

There are several different causes of hirsutism — excess or inappropriate hair growth. The most common is polycystic ovarian syndrome (PCOS). A group of doctors at the Royal Free and Institute of Health Sciences, City University, London, led by Dr William Clayton, has recently published its research into the effect of laser treatment in hirsute women with the syndrome.

PCOS affects 10 per cent of adult premenopausal women. Three quarters of the women who have polycystic ovaries also have excess facial hair, and probably unwanted body hair, as well as acne, obesity and, frequently, greasy and sparse scalp hair. Their periods will often be irregular and scant and this will be reflected in loss of fertility. PCOS is also associated with the metabolic syndrome so that patients with it have to be carefully monitored to exclude raised blood pressure, abnormal insulin resistance (and later diabetes), abdominal fat and a raised cholesterol level.

Because hirsute women are usually overweight and have a greasy, spotted and pitted skin, they frequently consider themselves freakish, dirty and unfeminine.

Unfortunately, the importance of hirsutism is not recognised by the National Health Service. Dr Clayton and his colleagues report that it is difficult to obtain laser hair removal on the NHS, partly because its effect on psychological health has not been recognised widely enough.

Laser treatment is particularly effective for people who have dark hair but is relatively less effective for those whose hair is white, blonde or red. The use of lasers means longer intervals between treatment and the hair, when it regrows, is sparser and finer. Laser treatment needs to be carefully controlled, and its effect on the skin meticulously assessed before it is started.

The researchers found that laser treatment reduced the severity of facial hair and the time women thereafter spent on its removal. But probably the most important finding of the survey was how effective it had been in alleviating depression and anxiety: once the women felt confident about their complexions, their quality of life improved.

Any woman who has PCOS also needs a gynaecological and endocrinological opinion as well as dermatological care so that all its potential effects may be treated.