What is Hirsutism? ( It’s Meaning, Causes, Diagnosis, Symptoms & Treatment): Hirsutism is a condition in men or women in which body hair increases to a large extent on those parts of the body where it is normally minimum i.e. androgen dependent areas such as on the chin, neck, upper lips, back, stomach and chest.
It is a hirsute condition which means hairy. Hirsutism may concern to a male pattern of hair growth that may be an indication of a more serious medical condition.
It affects 5-10% of women of reproductive age. 40% of women have some degree of unwanted facial hair. It is a common complain among most of the women.
So if you’re a woman and you have excessive facial hair growing in places where it normally does just for men then it is a state called “Hirsutism”.
Women who have Hirsutism can have dark, thick hair on their face, chest, back and abdomen which is different from the hair that some women have.
Women from certain genetic groups are more likely to develop Hirsutism, which includes women of Middle Eastern, South Asian and Mediterranean descent. It may lead to some serious concern among women.
What is Hirsutism? Its Meaning, Causes, Diagnosis, Symptoms & Treatment 2017
Facial hair or excessive hair on certain areas of face may cost the confidence of modern women. The amount and spot of the hair is measured by a Ferriman-Gallwey score. It is a method of evaluating and quantifying Hirsutism (excessive facial hair) in women.
“Hirsutism” should not be confused with hypertrichosis which is very excessive hair growth anywhere on the body. Hypertrichosis is much less common.
It is medical term and caused by certain genetic condition, malnutrition, drugs or other diseases. So while every one is busy in experimenting for the treatment of excessive hair growth you should first learn about it and than start proper treatment.
Why you should be concern about unwanted hair?
Hirsutism is a major concern and it is considered abnormal in our society. Unwanted excessive hair growth can lead to problems like stress and embarrassment among women. It can cost confidence of women.
Also excessive hair growth in females is not only embarrassing problem but it may also leads to many physical problems.
It is not only a sign of hairiness but also sign of many other diseases like hypertension, obesity, acne, menstrual problems etc.
Most of the women think that it is normal and they can take care about it at home only and do not consult any doctor which leads to other health issues. “Hirsutism” may caused by some medical condition.
Yet many things has to be done for its proper treatment.
This can easily examine by the doctors like endocrinologist, dermatologist or gynaecologist. So there is need to conquer Hirsutism because it affects a woman psychologically.
Hirsutism is commonly an outcome of an underlying endocrine imbalance, which may be adrenal or ovarian. The main symptom of Hirsutism is thick, rough, dark hair that grows on parts of the body abnormally.
For example: The hair will grow more thick and more rough on the chin, face. breast or chest, back, stomach, arms and legs in women.
Another best example of Hirsutism Symptoms may include hair growth in women’s body, chin hair in female, Irregular periods, Virilisation, Acne and deepening voice like men.
The various and most important symptoms of Hirsutism are excessive hair growth on the stomach, back, chest, and on the face just like male hair growth pattern in women.
Hirsutism Symptoms due to Male Hormones:
- Enlarged shoulder muscles
- Oily hair
- Change in feminine body shape
- Signs of masculinity
- Deepening voice
- Irregular periods
- Male pattern baldness
- Enlarged Clitoris
- Enlarged Ovaries
- Decreased breast size
- Greasy skin
Since, these Hirsutism Symptoms arises due to increase in Male Hormone i.e. Androgens. Therefore, it must be properly handle under expert advise.
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How can you distinguish between ‘normal’ hair growth and Hirsutism?
Mostly all the parts of the body are covered with tiny and fine hair except some area like lips, palms of the hands and soles of the feet.
Same type of hair grow in men and women but due to presence of androgen hormone hair thickness vary in men and women.
The hairs are soft and fine and cannot be seen with naked eyes. Normally humans have two kinds of hairs which are as follows:
- Terminal Hairs: This is dark and thick hair found on the scalp, eyebrows, eyelashes, groin and under the arms. These are highly pigmented hair.
- Vellus Hairs: These are very soft and fine hairs normally not colored. This hair can become terminal hairs in the presence of male type hormones.
Most of the women have same number of hair follicles (place where hairs are produced) on their body and face as just men do have. But in women these are very soft and fine and cannot see easily.
Because of presence of male hormones, testosterone makes hair grow darker and thicker on women. This is a condition of Hirsutism. They appear more noticeable on women.
So this condition should be properly handle else it leads to many problems.
Naturally women produce little amount of testosterone and makes terminal hairs appear in the groin and armpits which is more visible to us.
However if there is higher level of testosterone and male hormones in women, terminal can appear on the chin, shoulders, back etc. The terminal hair can grow thicker and more with the age in women.
Some women genetically have terminal hairs on their body although they do not produce any extra hormones.
1. Blood Test to check Excess Adrogens:
In initial state of Hirsutism, when you see thin, soft hair appearing every where on your body. That is the time for you to consult a doctor and have a blood test in order to test the Androgen level of the body. There is less chance of Hirsutism if blood test is conducted every next 6 month.
- Firstly of all, you need to give your blood sample to test it for excess androgen level.
- If the blood test report shows normal androgen level then you don’t need for any more test.
- But, in that case when you find little increase in Androgen level then you must go for ultrasound scan of ovaries.
- In that situation, when the level of testosterone is high then should consult a good doctor for “Catheter treatment“.
2. Facial and Body hair growth scoring – The Ferriman-Gallwey Score
This scale can be used to decide how acute Hirsutism is. Each area is given a number from 1 to 4. If there is only a little extra hair growth, the area is given a score of 1, rising to a score of 4 for areas with a lot of excess hair growth.
A patient can discuss how to use this scale with her doctor; she could use it to show him/her where she feels her excess hair growth is, and how severe it is.
Also, the scale can be used to monitor the success of treatment, by scoring at regular intervals. A doctor will advise how to use the scale in the best way for each patient.
This method is firstly invented and designed for anthropological research. It is designed by Ferriman DM and Gallwey JD for clinical checking of how severe the growth of the hair among various women.
This method represents the hair growth on androgen sensitive area like a male pattern in woman. It helps to show the hair growth in almost four different stages in 11 different body areas such as chin, breast, stomach, back, thighs, legs, chest etc.
Ferriman Gallwey device is a system which is used to evaluate or score the excess hair pattern in women and checked by the doctors. The score of the patient on their hair location starts from 0 which also means no extra hair or no terminal hair growth on the body to 4 which is basically a excessive or very excessive hair growth of terminal hair on the body and the number keeps on increasing till 36 on the scale.
A person who is suffering from hirsutism is diagnose at the number 8 or more and the severity of hair growth has been checked by the doctors on the scale.
Furthermore Hirsutism Diagnosis is considered very important, as a result every women should not try to avoid this.
Causes of Hirsutism
As we know now Hirsutism is medical term and it is concern with the excessive hairiness among various women in the world. It is commonly associated with the acne and oily skin.
It results in the social embarrassment and also a sign of systemic disease. So we should able to know the main cause of this complaint and how to deal with it.
People have habit to do exactly opposite what they are told not to do. Due to which at last they suffer a lot. So you should know the real cause of it and than start its treatment properly.
Polycystic Ovarian Syndrome (PCOS)
First of all excessive hair growth in females is mainly due to PCOS.
Most of the doctors have evaluated the common cause of “Hirsutism” in women is Polycystic Ovarian Syndrome (PCOS) which we will discuss in detail further.
Before heading towards the main causes, we should consider some various important aspects of Hirsutism which can lead to some important assumptions and conclusions.
Hirsutism is mainly of two types:
- Extreme Hirsute: Some women who are suffering from hairiness problem come into this category. They usually have normal level of male hormones and are also called Idiopathic Hirsutism.
- Light Hirsute: The women having very less hairs on their body falls into this category which is very common among most of the women.
Main Causes of Hirsutism
1. Polycystic Ovary Syndrome/PCOS
Polycystic Ovary Syndrome is the most common cause of “Hirsutism”. It is defined as a hyperandrogenism in association with irregular menstruation. PCOS may begin shortly after the puberty age then teen and early age of adulthood.
In this women hormone becomes imbalance and causes unwanted changes into their appearance. Facial hair is the symptom of this hormone change.
As a result of PCOS hormones start imbalance which causes Hirsutism in women.
It is often associates with the obesity and acne. If it is not treated timely then it can also cause diseases like diabetes and heart disease. PCOS women are at particular risk for hypertension, hyperlipidemia, diabetes, and possibly coronary artery disease.
Other than HirsutismPCOS can also cause:
- Weight gain/obesity
- Thinning hair on the head.
- Mood changes
- Pelvic pain
- Sleep problems
2. Defects in the enzymes:
Enzymes are very essential element of human life. It is this which is responsible for all the activities that happen in our body. The enzymatic defect produced by adrenal glands causes the more male sex hormones (testosterone) are produced in girls/women.
Women start gaining the various characteristics of male hormones. One of the most common enzyme defects in adrenal disorders is Congenital Adrenal Hyperplasia.
As a result of defects in enzymes women starts gaining excessive hair growth on face and body.
3. Ovarian and Adrenal tumor:
In contrast to PCOS, the rare group of ovarian and adrenal tumours function independently LH and FSH levels are often suppressed to or below the lower limit of normal.
While circulating androgen levels may be twice the upper limit of normal or higher. Onset of hirsutism or virilization is often unexpected and substantial.
4. Cushing’s syndrome:
Cushing syndrome is a sign of very long exposure of cortisol. Cortisol is a steroid hormone. It liberate in counter of high level of stress and low blood glucose concentration.
It basically falls in the glucocorticoid class of hormones. Cushing syndrome may include high blood pressure. Some of signs are abdominal obesity having big stomach but thin arms and legs.
Women may have more facial hair and irregular menstruation. Sometimes mood swings, headaches, and a chronic persistent feeling of tiredness.
While many women know Cushing’s syndrome at very late stage, at a result gains excessive hair growth.
5. Idiopathic Hirsutism
Hirsutism found in association with regular menses and normal serum androgen levels is known as Idiopathic Hirsutism. Idiopathic Hirsutismmay be due to increased sensitivity to androgens in the pilosebaceous unit.
Due to increased sensitivity to androgen hormone many women have this problem of “Idiopathic Hirsutism”.
A genetic increase in 5α-reductase activity leads to increased synthesis of the potent intracellular androgen di-hydrotestosterone.
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Treatment of Hirsutism
After considering all curable causes of the Hirsutism, there is a need of effective treatment to be applied to disease in order to conquer it. The most effective therapy for Hirsutism usually involves a combination of various approaches such as:
- Lifestyle modifications
- Medical therapy
- Mechanical hair removal/cosmetic removal
1. Lifestyle Changes:
You must follow a healthy lifestyle to fight with excessive hair growth. Therefore, many doctor always suggest to have a healthy lifestyle to prevent hirsutism.
Lifestyle changes that include:
- Healthy eating habits.
- Moderate daily exercise and weight loss.
- Meditation and Yoga.
- Production of sex hormone binding globulin (SHBG) increases, causing a further reduction in free androgen levels.
- Having adequate amount of water intake.
- Being happy.
- Doing power yoga or other exercise.
- Having green tea.
- Avoid refined and processed foods.
We should take great care of our health in order to chase Hirsutism. If we use temporary methods and changing our lifestyle then this disease will not be eradicate from its root.
As a result of changing our lifestyle many diseases also be treated along with Hirsutism.
2. Medical therapy:
Medical therapy involves Androgen Suppression or Androgen Receptor Blockade.
Given the lifespan of terminal hair, at least six months of medical therapy are required before slower and finer regrowth of hair is noted.
Although some permanent destruction of hair follicles can be achieved with electrolysis or laser, hair growth tends to recur after cessation of medical therapy.
3. Eflornithine cream:
It is a prescription cream applied twice per day to slow the growth of unwanted facial hair. The result can be usually being seen after 8 weeks of treatment.
In the beginning, it should ideally be combined with another form of therapy such as laser, waxing etc.
Either Eflornithine cream or medical therapy is commonly used by most women.
4. Ethinyl Estradiol:
These combinations contain oestrogen (a female hormone) and a little dose of other hormones which have an anti-male hormone action. These hormones may not suit everyone, especially women over the age of 40 years.
Side effects include bleeding between periods, tender breasts, nausea (feeling sick) and headaches.
The hormones should not be given to women who are overweight, smoke, or have lifestyle in which they sit down a lot. This is because the medicine can increase the risk of a blood clot in people with these factors. As a result of which many problems arises.
5. Cyproterone acetate or Drospirenone (Anti-Androgens):
Anti-androgens work against male hormones. Women should not become pregnant during and for up to 3 months following treatment with anti-androgens as they can interfere with a baby’s development.
Cyproterone acetate is also available in doses that are larger and more effective than the dose found in the combination product.
The main disadvantage is that higher doses are more likely to produce side effects including weight gain, depression, and loss of libido (sex drive).
Higher doses should therefore only be given to women with moderate or severe Hirsutism and always with a safe contraceptive method, in women of childbearing age.
Spironolactone is a weak diuretic (water tablet) that has some anti-androgen activity.
Like cyproterone, safe contraception should be practiced to avoid pregnancy. Side effects include tender breasts and irregular periods.
This drug is normally used in the treatment of diabetes. In recent years it has been shown to be beneficial to women with PCOS .
The main side effects of metformin are nausea, abdominal cramps, flatulence (wind), diarrhoea and constipation.
In addition to these side effects women also gets hormonal disorder if you take metformin without consulting any dermatologist.
7. Androgen Suppression:
It was designed Suppressive therapy and is used to decrease androgen production of the hormones, especially from the ovaries.
It is most useful and powerful method for treatment of hyperandrogenic Hirsutism, but may also play a role in idiopathic Hirsutism.
8. Oral Contraceptives:
For curing Hirsutism which affects large areas of the body, you may prescribe oral contraceptives or co-cyprindiol (Dianette).
Co-cyprindiol is a type of combined contraceptive pill that can cure unwanted hair growth by blocking and restricting the effects of male hormones (androgens) in the body.
It is only suitable for premenopausal women with Hirsutism. Following is the way to use it:
- The pills should be taken once a day in cycles lasting 21 days.
- This is then again followed by a seven-day break before you start the next cycle.
- It may take around six or more months to see the result.
- Once your unwanted hair growth has been removed, you’ll be advised to stop taking the pills for three to four months because continuous long-term treatment increases the risk of developing a blood clot.
Some common side effects can be caused by co-cyprindiol includes: obesity ,tender breast, irritability ,mood swings, feeling sick, tummy pain etc.
Although glucocorticoids can be used to suppress adrenal androgen production, androgen receptor blockers are more effective in the treatment of Hirsutism, even when due to late onset congenital adrenal hyperplasia.
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In Conclusion – What is Hirsutism? It’s Meaning, Causes, Diagnosis, Symptoms & Treatment
Hence, Hirsutism is a female body disorder in which excessive body hair growth occurs. Also, to cure this disease you have to adopt proper medical therapy and healthy lifestyle. It may require time but it is a curable disease.
Finally i must thanks for reading this article, if you affected by Hisrutism you must ASK A DERMATOLOGIST or contact us! We will help you by free consultant 24X7 online by top +3000 Dermatologist in our listed web site.
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