Hirsutism: An Embarrassing Condition

The extent of normal hair growth differs between people, families, and races. It is somewhat extensive in the Mediterranean and some Asian subcontinent populations. Too much facial or body hair growth in a woman is known as hirsutism. There is no absolute margin between the normal hair growth and hirsutism.

Usually, sex hormones affect the hair growth in the moustache, beard, breast, chest, armpit, the midline of the abdomen, genital area, and the thighs. A type of soft hair (vellus hair), which is normally present all over the body, is not affected by the sex hormones. If a woman has excess hair growth over the regions, which contain the sex-hormone dependent hair, it shows increased male hormone (androgen) production in the ovaries and adrenal glands. This process commonly occurs due to polycystic ovary syndrome (PCOS) but occasionally other rarer conditions. Other conditions include an abnormal growth of adrenal glands (congenital adrenal hyperplasia), Cushing’s syndrome, and tumours of the ovary and the adrenal gland.

Androgens are normally known as male hormones. However, both males and females produce androgens. Men produce androgens in larger amounts compared to women. There are few male hormones, of which testosterone is the well-known one. Hirsutism can occur due to increased levels of androgens or raised sensitivity of the hair follicles to normal male hormone levels.

A few women with hirsutism produce excessive androgens. Sometimes, this is because of a medical condition like polycystic ovarian syndrome or other rare diseases. Additionally, some medications like progestogen containing contraceptive pills, some hormones, danazol, phenytoin, minoxidil, diazoxide, ciclosporin, and anabolic steroids can lead to hirsutism. Actually, most females with hirsutism have no underlying disease or hormone imbalance. It may occur due to raised sensitivity of the hair follicles to normal levels of androgens.

Most females develop more body or facial hair progressively as they become older, especially after their menopause. At least 25 % of middle-aged females remove unwanted hair on the face. Usually, females have different hair distributions according to their ethnicity. Therefore, it may be natural to have some hair on the abdomen, face, and nipples.

Sometimes, hirsutism seems to run in certain families and is not related to an excess male hormones. Hirsutism is also normal in some people with Middle Eastern or Mediterranean origins.

Symptoms of hirsutism

Abnormal excessive hair distribution, which can be very embarrassing and result in distress, is the main symptom. Too much thick, usually dark, hair can be found on the chest, face, upper back, limbs, and abdomen.

Diagnosis of hirsutism

Females with regular menstrual cycles and mild hirsutism rarely have an underlying disease. If your doctor suspects that you may have some underlying condition, he or she will ask some questions and then, if required, perform some blood tests.

If you have at least one of the following features, consult your doctor.

• Severe hirsutism
• Hirsutism and menstrual problems
• Hirsutism before puberty
• Hirsutism is developing rapidly (over 1-2 years)
• Hirsutism and diabetes mellitus
• Hirsutism and obesity
• Hirsutism and features indicating a rise in male hormones like deepening of the voice, baldness, or thinning of the scalp hair

Management

Usually, hirsutism is not a curable condition. However, laser treatment or electrolysis can clear the areas of excess hair growth. Frequent bleaching, plucking, depilatory cream, shaving, or waxing can be used. Such removal neither improves nor worsens the condition. Management of underlying conditions, like drugs, and ovarian or adrenal tumours, may help resolve hirsutism. Some medications are used to manage hirsutism but are normally less satisfactory because the condition frequently reappears, if the treatment stops. They always need a year or more of treatment for the maximum benefit, and long-term treatment is often required.




Related Links:

Male Pattern Baldness (Androgenic Alopecia)
Alopecia Areata: Another Type of Hair Loss
20 Secrets for Healthy Hair