Hirsutism

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Hirsutism
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Excessive hair growth in areas where men typically grow hair
Complications	Psychological distress, acne, menstrual irregularities
Onset	Puberty
Duration	Long-term
Types	N/A
Causes	Polycystic ovary syndrome, Cushing's syndrome, congenital adrenal hyperplasia, androgen-secreting tumors, medications
Risks	Obesity, family history, ethnicity
Diagnosis	Physical examination, blood tests, imaging studies
Differential diagnosis	Hypertrichosis, androgen insensitivity syndrome
Prevention
Treatment	Lifestyle changes, medications, hair removal techniques
Medication	Oral contraceptives, anti-androgens, insulin sensitizers
Prognosis	Varies depending on cause
Frequency	Common
Deaths	N/A

Hirsutism is a condition characterized by excessive hair growth in women in locations where hair is typically more common in men, such as the face, chest, and back. It arises due to an increase in the level of androgens, or male hormones, or an increased sensitivity of hair follicles to these hormones.

Causes

• Hirsutism is commonly associated with the following conditions:
• Polycystic ovary syndrome (PCOS): A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.
• Cushing's syndrome: A condition caused by prolonged exposure to cortisol, the body's primary stress hormone.
• Congenital adrenal hyperplasia: A group of inherited conditions affecting the adrenal glands.
• Androgen-secreting tumors: Rare tumors in the ovaries or adrenal glands that produce androgens.
• Some medications such as Minoxidil and Danazol can also cause hirsutism.

Clinical Presentation

• In addition to excessive hair growth, symptoms of hirsutism can include:
• Irregular or absent menstrual periods
• Deepening of the voice
• Balding
• Acne
• Increased muscle mass

Diagnosis

• Diagnosis of hirsutism involves a detailed medical history, physical examination, and possibly laboratory tests. The Ferriman-Gallwey score is often used to quantify the extent of hair growth.
• Lab tests may include measurements of blood androgen levels and other hormones. Imaging studies like ultrasound or MRI might be used if an androgen-secreting tumor is suspected.

Treatment

• Treatment of hirsutism aims to manage the underlying cause, reduce hair growth, and address cosmetic concerns. This may include:
• Medications: These may include oral contraceptives, anti-androgens like spironolactone, and Metformin.
• Hair removal methods: These can range from shaving and waxing to more permanent methods like electrolysis and laser hair removal.
• Lifestyle changes: Weight loss and healthy diet may be recommended, especially for women with PCOS.

Prognosis

With appropriate treatment and management, most women with hirsutism can achieve good control of their symptoms. However, the condition is typically chronic, and ongoing treatment may be needed to manage hair growth and other symptoms.

See Also

• Polycystic ovary syndrome
• Hyperandrogenism
• Hormonal imbalance

References

• American Academy of Dermatology. (2023). Hirsutism. Retrieved from https://www.aad.org/public/diseases/hair-loss/types/hirsutism
• Mayo Clinic. (2023). Hirsutism. Retrieved from https://www.mayoclinic.org/diseases-conditions/hirsutism/symptoms-causes/syc-20354935
• National Health Service (UK). (2023). Hirsutism. Retrieved from https://www.nhs.uk/conditions/hirsutism/

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