Hirsutism is a condition in which a woman has excessive growth of coarse hair in a male-like pattern. The hair growth is seen on the face, chest, back and upper thighs. Hirsutism runs in some families and tribes, with no identifiable cause or harmful consequences.
This condition is caused by excessive production of male hormone – androgens. Therefore, it can also be associated with other signs of virilization such as:
Decreased breast size
Increased muscle mass
Enlargement of the clitoris
Causes of hirsutism include:
1. Polycystic ovary syndrome (PCOS). This is a condition which is characterized by an imbalance of sex hormones. It results in multiple cysts in the ovaries, irregular periods, infertility as well as hirsutism. A lot of cases are associated with obesity.
2. Cushing syndrome. This occurs when your body is exposed to high levels of the hormone cortisol. over a long period.
3.Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands.
4. Tumors. Rarely, an androgen-secreting tumor in the ovaries or adrenal glands can cause hirsutism.
5. Medications. Some medications can cause hirsutism. These include minoxidil and danazol. If your partner uses topical products containing androgens, you can be affected as well, through skin-to-skin contact.
Diagnosis and treatment
Hirsutism can be emotionally distressing. Some women feel self-conscious about having unwanted hair while some may develop depression. Since hirsutism can be due to an underlying condition, it is important to see a doctor for proper evaluation and treatment.
Your doctor will need to examine you from head to toe and request for some laboratory tests to check your hormone levels. An ultrasound is required to diagnose PCOS and tumours that might be producing excess androgens. More advanced tests, such as a CT scan may also be required in some cases.
Where a cause is identified, treatment of the cause usually stops or slows the hair growth, but existing hair may not go away completely.
Self-care measures can be used to remove the excess hair from time to time. This includes shaving, plucking, depilation and waxing. In obese women with PCOS, weight loss is a very effective way to control hirsutism.
Further treatment is aimed at reducing the level of androgens and minimising the hair growth. Options include:
Oral contraceptives. Birth control pills which contain estrogen and progestin with anti-androgen properties can be used to treat hirsutism in women who do not desire to get pregnant anytime soon.
Anti-androgens. These drugs block the action of androgens in the body. They’re sometimes prescribed after six months on oral contraceptives if the oral contraceptives aren’t effective enough. The results take at least six months to be noticeable. Possible side effects include menstrual irregularity. Because these drugs can cause birth defects, it’s important to avoid getting pregnant while taking them.
Topical cream. This is applied directly to the affected area of your face. It helps slow new hair growth but doesn’t get rid of existing hair. It can be used with laser therapy to enhance the response.
Laser therapy. A beam of highly concentrated light (laser) is passed over your skin to damage hair follicles and prevent hair from growing (photoepilation). You might need multiple treatments. People with dark skin are at increased risk of side effects from certain lasers, including a darkening or lightening of their usual skin tones, blistering, and inflammation.
Electrolysis. This treatment involves inserting a tiny needle into each hair follicle. The needle emits a pulse of electric current to damage and eventually destroy the follicle. You might need multiple treatments.
Electrolysis is effective but can be painful. A numbing cream spread on your skin before treatment might reduce discomfort.