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Hirsutism is the presence of excess hair growth in women and is commonly caused by an imbalance of hormones.
Young woman with hirsutism.

A young woman with hirsutism.

Alternative names for hirsutism

Hairiness in a male pattern.

What is hirsutism?

Hirsutism is a condition which affects women. It is the presence of excessive hair growth in a male pattern, ie, on the face, chest and back.

What causes hirsutism?

Different body regions respond differently to the presence of male and female sex hormones (testosterone and oestrogen). It is normal for women to have a small amount of testosterone in their system, but there are some medical conditions, such as polycystic ovary syndrome, which cause an imbalance in the levels of testosterone and, as a consequence, male pattern hair growth can occur.

What are the signs and symptoms of hirsutism?

A change in the normal distribution and texture of hair growth should raise suspicion of hirsutism. The areas affected include the chest, arms, back and face (which can be especially distressing). The hair is often coarser and darker than normal. It is often accompanied by greasy skin, acne and oily hair and potentially, male pattern baldness.

How common is hirsutism?  

Hirsutism is common, but the extent of it can vary significantly. There are racial differences in hair growth. The point at which hair growth becomes defined as hirsutism may vary depending upon the racial type or cultural attitudes.

Is hirsutism inherited?

Genetic factors play a part in how sensitive an individual’s skin is to the sex hormones. Polycystic ovary syndrome accounts for 95% of cases and it is known that in half of these patients, there is a family history.

How is hirsutism diagnosed?  

Hirsutism is diagnosed on the basis of the nature and change of the pattern of hair growth. It also normally involves a physical examination. The search for an underlying cause involves hormonal blood tests which can be performed as an outpatient.

How is hirsutism treated?  

Practical treatment involves cosmetic hair removal. This includes hair-removing (depilatory) creams, shaving, waxing and laser hair removal. Treatment should also address the underlying cause, especially if a hormonal disorder is discovered. Investigation and treatment would normally be carried out as an outpatient.

Are there any side-effects to the treatment?

Hair removal can potentially cause skin irritation and scarring.

For individual hormonal problems, the treatments vary.

If hirsutism is a symptom of polycystic ovary syndrome, weight loss, although difficult, is recommended as this often helps reduce the symptoms. Other medication used includes metformin (which is also often used in diabetes), spironolactone and cyproterone. These work by overcoming the hormonal imbalance.

What are the longer-term implications of hirsutism?  

The cosmetic consequences can often cause psychological problems such as anxiety and depression.


Written: March 2011


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