Hirsutism is Excess Hair Growth in Women
I’ve been on somewhat of a hair kick lately, and today I want to talk about a medical condition that affects women. Hirsutism is excessive hair growth on the face and other parts of the body occurring in women. You may be thinking of the classic bearded lady. Basically, women with hirsutism grow hair in a male-like pattern. This is usually due to an underlying medical condition. Some of the most common medical conditions that can result in hirsutism include: polycystic ovarian syndrome, cushing’s syndrome, congenital adrenal hyperplasia, drug induced hirsutism, and androgen secreting tumors. Then there are the cases of idiopathic hirsutism (no known cause) and familial hirsutism (which is inherited).
How common is hirsutism?
Hirsutism affects many women. It’s more common than you may think. Up to 11% of women will suffer from this condition. It usually occurs during the reproductive years when hormone levels are fluctuating and at their highest.
Mild hirsutism won’t manifest as a full beard. It may just be the bothersome appearance of a few thick, fast growing hairs on the chin or upper lip.
Hirsute women often present to their dermatologist first because they notice the increased hair growth and more acne than usual. Endocrinologists are doctors who specialize in diseases affecting the hormonal balance of the body. They will be the ones best suited to treat the underlying cause of hirsutism.
Why do some women develop hirsutism?
In hirsutism, there is an excess of androgens in the body. Androgens are the male hormones of testosterone and dihydrotestosterone. Androgens act on the hair follicles of the scalp, chest, lower abdomen, thighs, chin, face, and other areas to stimulate hair growth. They also act on the sebaceous glands to become more active. This causes your sebaceous glands to produce more oil which can lead to acne.
How is hirsutism diagnosed?
There are clinical scales available that can help your physician diagnose hirsutism. In order to quantify whether the hair growth is excesive, your doctor may use a tool called the Ferriman-Gallwey score. This method rates the amount of hair in 9 different body areas from 0 (no excessive terminal hair) to 4 (extensive terminal hair growth). The max score is 36, and traditionally white women with a score greater than 8 can be considered hirsute. Other ethnic groups have different amounts of baseline body hair that are considered “normal.”
The most obvious way to treat excessive hair growth is to remove the hairs. This can be done with waxing, plucking, shaving, chemical depilation, laser hair removal, or electrolysis. I urge you to read my previous article on the methods of hair removal.
However, this will not treat the cause of the condition. The hair will continue to grow. As women who suffer from hirsutism know, the hairs come back thick, and they come back fast.
The best method involves taking medications that treat the underlying medical condition. A recent study found that oral contraceptive pills are an effective treatment for mild hirsutism. For moderate to severe hirsutism, medications such as flutamide and spironolactone have been shown to help. Additionally, they found that finasteride, gonadotropin releasing analogues such as Lupron, and metformin had inconsistent or no benefits in treating hirsutism.
Oral contraceptives regulate the body’s hormone levels and are the best treatment for hirsutism. This is especially true among women with polycystic ovarian syndrome.
Have you ever had to deal with unwanted and possibly misplaced body hair? I’d love to hear about your experience in the comments below!
- van Zuuren, Esther J., and Zbys Fedorowicz. “Interventions for Hirsutism.” JAMA17 (2015): 1863-1864.