I have been dealing with hirsutism for 6 years. What is my best treatment option? (Photo)

Thank you for your pictures.  I would recommend medical treatment and control of your PCOS.  Your hair growth can be treated best by laser hair removal.

Since you have the diagnosis of PCOS you need to first have this treated by your dermatologist or endocrinologist with medications such as OC's or Spirinolactone.  Then, once your hormones are under better control you can initiate laser hair treatment and bleaching creams for the hyperpigmentation.  Please consult a board certified dermatologist for the best treatment.

     Polycystic Ovarian Syndrome can be genetic and/or lifestyle induced or exacerbated.  It can be frustrating especially with hair growth, acne, infertility issues and body habitus changes.  With the hair growth, particularly dark hair, the definitive treatment is hair laser.  It appears you have some baseline pigment in your skin, you should make sure the laser you decide on is optimal for you skin type.  You will love the permanency of the results versus the sugar hair removal every 8 days.  You can gently shave those area in-between treatments or continue with the sugar treatments until the hair is gone.  Once the hair is gone you many need to deal with some of the existing discoloration from the hair growth and treatment, but at least you should be preventing new hair follicle discoloration occurring.  I would recommend seeing a dermatologist or endocrinologist for a hormone evaluation.  We have our patients go on a strict paleo diet as blood sugars and blood insulin levels tend to be high with PCOS.  Dietary changes always help with PCOS and for many of our patients that have lifestyle induced PCOS it may actually reverse and "cure" the condition.  An easy way to start with diet is to eliminate gluten and dairy from your diet.  Best wishes is treating this.