Hirsutism
Condition
(Excess Male-Pattern Hair Growth)
Definition
Hirsutism is excess male-pattern hair growth in women. The coarse, dark hair can grow in areas such as the face, chest, and back.
Causes
Hirsutism is often due to an increased level of a male sex hormone called androgen. Some common causes are:
- Polycystic ovary syndrome (most common cause)
- Congenital adrenal hyperplasia
- Ovarian tumors
- Adrenal tumors
Sometimes the cause is not known.
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Risk Factors
This problem is more common in women of reproductive age.
Symptoms
The most common problem is excess hair growth on the face, arms, back, armpits, groin, or chest. Severe problems may be:
- A deep voice
- Male-pattern baldness
- Acne
- Decreased breast size
- Increased muscle mass
- Increased size of clitoris
- Abnormal or absent menstrual periods
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on areas of hair growth. This is often enough to make the diagnosis.
Blood tests may be done to check hormone levels.
Other tests may be done to look for a cause.
Treatment
Any underlying causes will need to be treated. This may stop hair growth in some women.
The hair does not need to be removed, but some women may choose to do so. Options are:
- Hair removal with:
- Shaving
- Bleaching
- Chemical treatment (depilatories)
- Waxing
- Electrolysis
- Laser treatment
- Intense pulsed light (IPL)
Medicine may be given to lower the level of male hormones. Some examples are:
- Oral contraceptives
- Spironolactone
- Finasteride
- Flutamide
- Metformin
Eflornithine may also be given. It blocks a substance needed for hair growth.
Prevention
There are no current guidelines to prevent this health problem.
American Osteopathic College of Dermatology
Family Doctor—American Academy of Family Physicians
CANADIAN RESOURCES:
Canadian Dermatology Association
Health Canada
American Osteopathic College of Dermatology
Family Doctor—American Academy of Family Physicians
CANADIAN RESOURCES:
Canadian Dermatology Association
Health Canada
References
- Hirsutism. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=Hirsutism.
- Hirsutism. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/hirsutism.
- Hirsutism. UCLA Health website. Available at: http://obgyn.ucla.edu/hirsutism.
- Hirsutism and virilization. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hirsutism-and-virilization.
- Martin KA, Anderson RR, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(4):1233-1257.
Contributors
- Daniel A. Ostrovsky, MD
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