What Is Hirsutism?

Hirsutism—also known as excessive hair growth—is a condition that occurs in 5 to 10% of females.1 It causes unwanted hair growth on the face and body in females. The hair tends to grow in areas typically seen in males. Several conditions can cause hirsutism, and treatments aim to reduce or eliminate unwanted hair.

This article will discuss hirsutism symptoms, causes, and treatment. It will also cover diagnosis and the outlook for those with the condition.

What Are Hirsutism Symptoms?

The primary symptom of hirsutism is the excessive growth of coarse dark hair in areas of the body that are sensitive to androgens (sex hormones like testosterone produced in higher amounts in the testes than in the ovaries). These areas are:2

• The upper lip
• Chin and jawline
• Back
• Chest and abdomen
• Inner thigh

Hirsutism vs. Hypertrichosis

Hypertrichosishair growth

What Causes Hirsutism?

About half the time, hirsutism results from increased androgen levels. About the other half of the time, hirsutism occurs in females with normal androgen levels. Androgens are sex hormones normally found in low levels in females and higher levels in males. When the body makes too many androgen hormones, it can cause hirsutism in females.

Polycystic ovary syndrome (PCOS) is the most common cause of hirsutism.3 PCOS causes three out of every four cases. People with PCOS may have other symptoms, including:2

• Acne
• Diabetes
• Irregular menstrual periods
• Difficulty losing weight

For some people, their hirsutism's cause is never found.2

Can I Have Hirsutism Without PCOS?

While PCOS is the most common cause of hirsutism, other potential causes exist.

Some of the other—rarer—causes of increased hair growth are:2

• Adrenal gland tumor or cancer
• Ovarian tumor or cancer
• Cushing's syndrome
• Congenital adrenal hyperplasia
• Hyperthecosis

Medications can also cause unwanted hair growth. Medications known to cause hair growth are:2

• Testosterone
• Anabolic steroids
• Glucocorticoids
• Danazol

How Is Hirsutism Diagnosed?

A healthcare provider will begin by performing a physical examination to check for excessive hair growth and asking questions. The provider may order one or more of the following tests, which they can use to diagnose hirsutism. They are:2

• Blood test: Testosterone test, DHEA sulfate test, and 17-hydroxyprogesterone blood test
• ACTH stimulation test: Measures the adrenal gland response to adrenocorticotropic hormone (ACTH). ACTH stimulates the adrenal glands to release the cortisol hormone.

If someone has virilization—the growth of male characteristics—then a healthcare provider may use a pelvic ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) for diagnosis.2

How Is Hirsutism Treated?

Hirsutism is usually a long-term condition. The choice to remove excessive hair growth is up to each person. If the hair growth does not bother them, they can leave it alone. However, many people choose to remove the hair.4

Hair removal options are outlined below. include:4

Laser Hair Removal

During laser hair removal, a trained dermatologist or nurse applies an intense beam of laser light to an area of hairy skin. You may experience a slight stinging sensation during the procedure and some short-term redness and swelling.

The procedure is not permanent, but hair is removed longer than waxing or depilatories.5

Electrolysis

During electrolysis, a small needle is inserted into a hair follicle to deliver an electrical charge. This charge kills the hair down to its root. You may experience a mild stinging sensation and short-term redness and tenderness.

Any hair that is darker or thicker may require multiple treatments.6

Shaving

Shavingshaving

The problem with daily shaving is that it can develop ingrown facial hairs and razor bumps (pseudofolliculitis barbae).4

Waxing

Waxing involves applying a thin layer of heated wax to the surface of hairy skin, which is then yanked off using a cloth. This process pulls the hair entirely out of the shaft.

This typically only needs to be done every three weeks.

Similar to shaving, ingrown hairs can occur.

Medications

Medications can treat hair growth related to hirsutism. They can decrease the amount of hair or stop new hair growth. Most medications must be taken for six months before noticeable improvement begins. Medication options include:4

• Birth control pills: Lowers androgen levels (60–100% of females will see improvement with this medication)
• Anti-androgens: Decrease androgen production (spironolactone is the most commonly taken medicine in this class)

High Testosterone Levels in Women

What Is the Prognosis for Hirsutism?

Hirsutism is typically a long-term condition. Though there may be no way to cure it, the prognosis is good due to several treatment options available to those who have it. There are ways to stop excessive hair growth or remove hair with medicines or external treatments.

It's important to know that hair follicles grow for six months before they fall out. This means that medicines can take six months before hair growth decreases.2

How to Cope With Hirsutism

For someone with hirsutism, dealing with their condition can be hard to cope with and stressful. Finding a healthcare provider who understands your concerns and is open to finding the right treatment can help. A support group with people who suffer from the same condition can also provide comfort to those with hirsutism.

Summary

Hirsutism is unwanted hair growth in females. It can occur as a result of increased androgen hormones, PCOS, or other causes.

A healthcare provider can diagnose it through a physical exam and diagnostic testing. Treatment aims to reduce androgen hormones and remove unwanted hair. Those with hirsutism may find that joining a support group or connecting with other people with the condition can also provide emotional assistance.

6 Sources

By Patty Weasler, RN, BSN
Weasler is a Wisconsin-based registered nurse with over a decade of experience in pediatric critical care.