A condition in which excessive hair growth happens on certain parts of the body is called hirsutism. This health condition usually affects females or people assigned female at birth (AFAB). However, it is not known the exact cause of this disease but it can be another disease symptom (including polycystic ovary syndrome). Healthcare providers treat this condition with weight loss programs, medicines, and hair removal options.
What is Hirsutism?
People who experience this condition often develop coarse and dark hair on the upper lip, chin, chest, abdomen, or back. The abnormal hair growth can provoke distress but it is a treatable condition.
Who Does Impact Hirsutism?
This condition primarily affects females and AFAB. It also can happen in males and people assigned to males at birth (AMAB). However, it isn’t easy to make the difference between hirsutism and typical hair growth.
If you have a family history of polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia, and obesity you are at higher risk of developing hirsutism. Additionally, those who are Mediterranean, Hispanic, South Asian, or Middle Eastern are more likely to develop this health condition.
Children also may experience hirsutism but rarely.
How Does Hirsutism Affect My Body?
While hirsutism does not impact your physical health, it may cause psychosocially (emotional) and psychological (behavior and thoughts about yourself) problems for example anxiety, depression, stress, and others.
Symptoms
Usually, one of the most common hirsutism symptoms is dark hair growth. Virilization is another symptom that is considered a health condition in a person who develops secondary sex characteristics of men and people AMAB. Check below some secondary sex characteristics that may occur due to virilization:
- Deepening of the voice
- Reduced breast size
- Increased muscle development
- Clitoromegaly (enlargement of the clitoris)
- Elevated sex drive
- Acne
If you experience any of the previous symptoms, immediately visit a healthcare professional.
Causes
This condition does not have a known cause. However, check below some conditions that can provoke hirsutism:
- The natural production of androgens
- Polycystic ovary syndrome (PCOS)
- Postmenopause
- Cushing’s syndrome
- Other conditions (including adrenal hyperplasia, tumors on the adrenal glands or ovaries, and others)
- Medicines (such as anabolic steroids, Testosterone, Cyclosporine, Minoxidil, Danazol, Phenytoin, and others)
Does Hirsutism Always Mean PCOS?
While approximately 70-80% of people who experience polycystic ovary syndrome develop hirsutism, it is not the only cause of this health condition.
Furthermore, hirsutism is not a contagious condition. It means that it cannot be transmitted from one person to another.
Diagnosis
Physicians will perform a physical examination to identify the extent of the uncommon hair growth. In addition, they also will notice any other symptoms including acne. Usually, healthcare professionals use the Ferriman-Gallwey scale to grade the hirsutism severity. This scale examines nine areas of the body such as the upper lip, chest, upper and lower abdomen, upper arms, thighs, upper and lower back, and buttocks (butt). Therefore, the previous areas receive a 0-4 score which means the severity of hirsutism. Thereafter, your doctor will add the scores together and if you are black or white a total score less than 8 is common. However, a normal score is considered less than 9 or 10 if you are Mediterranean, Hispanic, or Middle Eastern. A score of less than 2 is common in Asian people.
Additionally, your doctor may order you to do some tests including blood tests (to check hormone levels), ultrasound, and X-rays (to examine ovaries, uterus, and adrenal glands).
Treatment
The treatment includes different medicines, weight loss programs, hair removal procedures, home remedies, and others. The way how your doctor prescribes the treatment depends on the severity of the condition, other existing health conditions, your age, weight, and others.
Weight Loss
In most cases, hirsutism treatment begins with weight loss because losing 5% of the body weight is enough to decrease androgen production and excessive hair growth.
Medicines
- Eflornithine Skin Cream – It is a special cream prescribed by doctors to decrease the growth of the hair. However, it does not remove it. To notice some overcomes, it may take 6-8 weeks. Do not stop using this product until your doctor directs you to do so because the hair will begin to grow the same as before using this cream. Allergic reactions, hair bumps, discoloration, stinging, or burning of the skin may occur as side effects of this medicine.
- Gonadotropin-releasing Hormone (GnRH) Agonists – Your physician will give some injections (which can be expensive) to decrease the androgen production by the ovaries. Adverse reactions include reduced libido (hypogonadism), fluid retention, hot flashes, weight gain, and others. However, if your body adjusts to the active ingredient of this medicine, you may not experience any of the negative effects listed above.
- Insulin-lowering Medicines – You can receive Pioglitazone and Metformin to decrease insulin and androgen levels in the blood. Do not use these drugs as a primary line of treatment because they can cause serious side effects. For example trouble breathing, irregular heartbeat, bloody urine, decreased blood sugar (hypoglycemia), allergic reactions, and others. Consult with your doctor for more details.
- Low-dose Steroid Medicines – These type of medicines is usually used when you have hirsutism due to overactive adrenal glands. You may also notice some side effects while using steroid medications. Examples include increased appetite, weight gain, mood swings, blurred vision, and others.
- Androgen-suppressing Medicines – Spironolactone, Finasteride, and Flutamide are some effective medications in the treatment of mild hirsutism. These drugs work by reducing the androgen production. Dry skin, heartburn, dizziness, fatigue, and liver damage are some negative effects that may occur during treatment with these medications.
- Birth Control Pills (Oral Contraceptives) – This category of medicines is one of the most common drugs used in hirsutism treatment. Birth control pills help to regulate menstrual cycle, prevent pregnancy, and reduce androgen levels. The common adverse reactions are breast swelling or tenderness, headaches, moodiness, irritability, abnormal menstruation, and others.
Hair Removal Options
- Electrolysis (This procedure involves a tiny needle and mild electrical zap, which destroy hair roots one by one).
- Laser Hair Removal (Dark hair has a lot of pigment and this procedure involves a laser that destroys cells that contain a lot of pigment).
Home Remedies
- Shaving (it is one of the most common of removing hair methods)
- Bleaching (some products may lighten the hair in unwanted body parts)
- Waxing and plucking (tweezing)
Frequently Asked Questions
How common is hirsutism?
This condition affects about 5% to 10% of children around child-bearing age and approximately 40% of women and AFAB at a certain point in their life.
How soon will I feel better after treatment?
The duration of the treatment is prescribed by your doctor and it depends on the hirsutism severity you experience. It may take weeks or months to notice some changes. Discuss with your physician for more details.
Is it possible to prevent hirsutism?
Decreasing the risk of hirsutism depends on the cause for example if you have PCOS, weight loss, a healthy diet, and regular exercise can lessen the symptoms.
However, if you are on treatment with medications that cause hirsutism, discuss it with your healthcare professional.
