Your Health - Hirsutism

Hirsutism

(Excess Hair Growth)

Pronounced: Her-soot-ism

by Rosalyn Carson-DeWitt, MD

Definition

Hirsutism is excess hair growth in women and children.

Whether or not hair growth is abnormal depends on:

A person's idea of "normal"
Family tendencies
Ethnic background

Causes

True hirsutism may be due to:

Polycystic ovary syndrome
Defects in the enzymes made by the adrenal glands
Ovarian tumors
Adrenal tumors
Some forms of Cushing's syndrome
Luteoma of pregnancy
Excess growth hormone
Certain drugs, including:
- Minoxidil
- Cyclosporine
- Phenytoin
- Anabolic steroids
- Diazoxide
- Progestin-containing medications
- Oral contraceptives

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

Family members with hirsutism
Lack of ovulation
Disorders of the adrenal glands
Use of androgens
Older age

Symptoms

Symptoms and signs of some disorders associated with hirsutism may include:

Excess hair growth (on the face, arms, legs, or chest)
Abnormal or absent menstrual periods
Decreased breast size
Male-pattern baldness (in a woman)
Deepened voice
Increased size of clitoris
High blood pressure
Enlarged ovaries
Enlarged adrenal glands
Abnormal cholesterol and glucose intolerance

Adrenal Gland

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

Blood tests—to measure the amounts of certain hormones
Stimulation or suppression tests—to measure how hormone levels in the blood respond to changes
X-ray —a test that uses radiation to take a picture of structures inside the body
Ultrasound—a test that uses sound waves to examine the inside of the body
CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body
MRI scan —a test that uses magnetic waves to make pictures of the inside of the body

Treatment

Treatment is directed at the underlying cause of the hirsutism and may include:

Medications

These may include:

Local Hair Removal

Methods of removing hair include:

Shaving
Chemical treatment (depilatories)
Waxing
Electrolysis
Laser treatment
Bleaching

Combination Treatment

Researchers are also looking into combining treatment options for patients diagnosed with hirsutism. A study published in the Journal of American Academy of Dermatology found that elfornithine 13.9% cream in addition to laser treatments further reduces unwanted facial hair for up to six months.

Treatment of Other Conditions

If you are diagnosed with a condition that may be causing hirsutism, proper treatment may resolve the hirsutism.

Prevention

Hirsutism may be prevented by treating the underlying cause.

RESOURCES:

American Academy of Family Physicians
http://www.aafp.org/

Familydoctor.org
http://www.familydoctor.org/

CANADIAN RESOURCES:

Canadian Dermatology Association
http://www.dermatology.ca/english/

Health Canada
http://www.hc-sc.gc.ca/index-eng.php/

References:

Azziz R. The evaluation and management of hirsutism. Obstet Gynecol. 2003;101:99-108.

Current Medical Diagnosis and Treatment . Lange Medical Books; 2001.

Ferri's Clinical Advisor . Mosby; 2000.

Lustberg ME. Hirsutism. N Engl J Med. 2006;354:1532-1533.

Updated Treatment section on 11/1/2007 according to the following study, as cited by DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Hamzavi I, Tan E, Shapiro J, Lui H. A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women. J Am Acad Dermatol. 2007;57:54-59. Epub 2007 Jan 30.

Last reviewed September 2009 by Ross Zeltser, MD, FAAD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.