What is hirsutism?

Hirsutism is a condition where women have excess hair on their face or body.

Symptoms of hirsutism

The main symptom of hirsutism is unwanted hair growth on a woman’s face, chest, and back. This thick, dark hair is different from the normal, fine “baby” hair on other parts of the body.

Other symptoms of hirsutism may include:

  • Acne.
  • Abnormal menstrual periods.
  • Deepening of the voice.
  • Increased muscle mass.
  • Decreased breast size.

What causes hirsutism?

There are several main causes of hirsutism. These include:

  • Genetics: The condition can run in families.
  • Ethnicity: Women from certain cultures are more likely to have hirsutism. This includes women of Middle Eastern, South Asian, and Mediterranean descent.
  • High levels of male hormones (called androgens): This is often related to a certain condition, such as:
    • Polycystic ovary syndrome (PCOS): This is an imbalance of hormone levels in a woman’s body. It causes cysts to form in the ovaries, as well as other symptoms.
    • Cushing’s syndrome: This is caused by long-time exposure to the hormone cortisol.
    • Tumors: Tumors in your ovaries or adrenal gland can affect your hormone levels.
  • Medicines: These include hormones, anabolic steroids, and medicines used to treat endometriosis.
  • Hair follicles: Some people have hair follicles that are overly sensitive to male hormones. Doctors do not know the cause of this.

How is hirsutism diagnosed?

Contact your doctor if you have abnormal hair growth or other related symptoms. The doctor may run tests to check your hormone levels. If they are high in androgens, they may do an ultrasound to check your ovaries or a CT scan to check your adrenal gland. These tests can show if you have any tumors.

Can hirsutism be prevented or avoided?

You cannot prevent or avoid hirsutism.

Hirsutism treatment

Medicines can help treat most cases of hirsutism. They can balance out your hormone levels to reduce the amount of androgens.

Below are types of medicines your doctor may prescribe:

  • Anti-androgens: Common ones are spironolactone and finasteride. These block your body from producing male hormones. They also can decrease the amount of new hair growth. However, they cannot get rid of the hair you already have. Anti-androgens take at least 3 to 6 months to work. They can cause birth defects. Do not take them if you are pregnant or trying to get pregnant.
  • Birth control pills: These decrease the androgens in your body. Birth control pills are a good option for women who do not wish to become pregnant in the near future. They can be used in combination with anti-androgen medicines.
  • Topical creams: The most common prescription cream is elfornithine. It slows down the growth of facial hair. You apply it to the areas of unwanted hair on your face and chin. The cream takes about 4 to 8 weeks to start to work. Side effects may include skin irritation, a rash, or a stinging feeling.

Some women choose to permanently remove their hair. There are two types of procedures that do this. Talk to your doctor to see if these procedures would be right for you.

  • Electrolysis: The doctor inserts thin needles into the follicles of your unwanted hair. The needles release electrical charges that destroy the follicles. This procedure can be painful and expensive. It may be needed more than once.
  • Laser therapy: The doctor uses targeted lasers to damage the follicles. This causes your unwanted hair to fall out. You may need several sessions of treatments to fully treat the follicles. The treatments can cause your skin to become red, swollen, or irritated. There is a risk of burning, scarring, and discolored skin. For some women, the hair growth may return.

Living with hirsutism

Treatment can help cure or lessen the effects of hirsutism. There also are things you can do at home to conceal the appearance of hair growth.

  • Shaving: This is the safest and easiest method to remove unwanted hair. It also is inexpensive. However, you may have to shave every day. Otherwise, your hair grows back quickly. Frequent shaving can irritate your skin. You can apply a small amount of 1% hydrocortisone cream.
  • Tweezing and waxing: Tweezing is good for removing a few stray hairs. Waxing is more effective for removing large patches of hair. It can cause brief discomfort and skin irritation.
  • Bleaching: This can lighten the color of your unwanted hair to make it harder to see. Follow the directions on the product label. Bleaching can irritate your skin or cause discoloring.
  • Topical creams, lotions, and gels: These products can break down your hair follicles over time. However, they can take a while to work and may not be successful. You may be allergic to the chemicals in the products. 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 have a reaction to the cream, do not use it. Talk to your doctor about other options.

If you are overweight, try to lose weight and eat a healthy diet. Some women find that this helps to balance their hormones.

Women who have hirsutism may have self-esteem issues. The hair growth can be emotional and hard to deal with. It may help to get counseling or join a support group. You can ask your doctor for a recommendation.

Questions to ask your doctor

  • What is the likely cause of my hirsutism?
  • What is the best treatment option for me?
  • Do I need to take medicine? If so, for how long?
  • What are the side effects of treatment?
  • Are there any lifestyle changes I can make to balance out my hormone levels?
  • I’m embarrassed by the excess hair on my face and body. What can I do about it?
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