Hirsutism

Overview

What is hirsutism?

Hirsutism (say: "her-soot-ism") is a condition that causes too much hair to grow on a woman’s face or body.

Symptoms

What are the symptoms of hirsutism?

Women who have hirsutism can have dark, thick hair on their face, chest, abdomen and back. This thick, dark hair is different from the hair that some women have on their upper lip, chin, breasts or stomach, or the fine "baby" hair all over their body.

Women from certain ethnic groups are more likely to develop hirsutism, including women of Middle Eastern, South Asian and Mediterranean descent.

Other symptoms of hirsutism may include:

  • Acne

  • Irregular menstrual periods

  • Deepening of the voice

  • Increased muscle mass

  • Decreased breast size

Causes & Risk Factors

What causes hirsutism?

Hirsutism can be caused by abnormally high levels of male hormones (called androgens). The following are some of the conditions that may increase a woman’s normally low levels of male hormones:

Hirsutism can also be caused by hair follicles that are overly sensitive to male hormones. Doctors don’t know why this occurs.

Some medicines can cause hirsutism. These medicines include hormones, anabolic steroids and a medicine used to treat women who have endometriosis (called danazol).

Hirsutism also seems to be hereditary (which means it runs in families).

If you have hirsutism, your family doctor may want to do some tests to find out what is causing it.

  • Polycystic ovary syndrome, which occurs when an imbalance of hormone levels in a woman’s body causes cysts (say: "sists") to form in the ovaries

  • Cushing’s syndrome, which occurs when your body is exposed to high levels of the hormone cortisol for a long period of time

  • Tumors in the ovaries or adrenal gland, formed when abnormal cells grow out of control and clump together

Diagnosis & Tests

When should I see my doctor about hirsutism?

See your doctor if you have a sudden increase in facial or body hair, if your periods have become irregular or if your voice has become deeper.

Treatment

What can I do to get rid of the excess hair?

You should lose weight if you’re overweight. Losing weight reduces the amount of hormones in your body that cause increased hair growth. Other ways to eliminate or hide excess facial and body hair include the following:

Shaving is the safest and easiest method of removing hair. However, you will have stubble unless you shave every day. Your skin may become irritated with frequent shaving. If your skin becomes irritated, apply a small amount of 1% hydrocortisone cream.

Depilatories, or creams that remove hair, can be used. They leave no stubble. However, these creams may irritate your skin. To test how sensitive your skin is, apply a small amount of cream to the inside of your wrist. Wait one day before applying the cream to other parts of your body. If you don’t have a bad reaction to the cream on your wrist, it’s probably okay to use it.

Bleaching paste may also be used. Use this product according to the directions on the label. Bleaching products may irritate your skin.

Tweezing and waxing are effective ways of removing unwanted hair. Tweezing is good for removing small stray hairs and waxing is more effective for removing larger patches of hair. Skin irritation can occur, especially with waxing.

Electrolysis gets rid of hair permanently by delivering a small electrical current through a needle placed into the hair follicle. Electrolysis can be expensive and time-consuming. If you choose to have electrolysis, make sure the operator is qualified and licensed. Talk to your doctor before trying a home electrolysis product.

Laser hair removal uses a laser light to damage hair follicles so unwanted hair falls out. This also prevents the hair from growing back. You’ll probably need multiple laser treatments over a number of weeks, and the results may not be permanent. Laser hair removal is expensive and can only be done by a licensed practitioner. Side effects of the procedure may include redness, scarring and darkening or lightening of the skin.

Are there medicines to treat hirsutism?

There are several medicines available to treat hirsutism. Your doctor may prescribe a medicine called an anti-androgen to help block the male hormones associated with hirsutism from being produced in your body. Common anti-androgen medicines include spironolactone and finasteride. Anti-androgens usually take at least 3 to 6 months to work. They can decrease the amount of new hair growth, but they are less likely to change the amount of hair you already have. Anti-androgens can cause birth defects, so you should use a form of birth control while taking these medicines.

Your doctor may also prescribe birth control pills, which can help decrease androgens in the body. This treatment option is especially helpful for women who do not wish to become pregnant in the near future. Birth control can be prescribed in combination with anti-androgen medicines.

There is also a medicine made specifically to slow down the growth of facial hair. It is called eflornithine and it is a prescription cream that you apply to the affected skin on your face and chin. This medicine may start to work as soon as 4 to 8 weeks after you begin treatment. Side effects include skin irritation, rash and a stinging sensation.

Questions to Ask Your Doctor

  • What is the likely cause of my hirsutism?

  • What is the best treatment? Do I need medicine?

  • What are the risks and benefits to taking a medicine to treat hirsutism?

  • How can I help balance out my hormones? Should I make any lifestyle changes?

  • I’m embarrassed by the excess hair on my face or body. What can I do about it?