Abstract
Hirsutism, excessive hair growth in women in a male pattern distribution, is the most common endocrine disorder in women and approximately 5 to 15% of the general population of women is reported to be hirsute. It causes profound stress in women. Polycystic ovary syndrome is the most common cause. However a woman could have normal menses, normal androgen levels but be hirsute (idiopathic hirsutism). Ferriman- Gallwey scale (F-G) is used for assessment of hairiness. The maximum score is 36 and a score over 8 is considered as a hirsuid state. As hirsutism is a symptom and not a disease it is important to find the underlying cause and exclude uncommon but serious causes. The aim of the medical treatment is to correct the hormonal imbalance and thereby stop further progress. Oral contraceptives (OCP) are recommended as first line treatment. Spironolactone is the first choice if there is indication for antiandrogen therapy. Antiandrogens should be combined with an OCP in women in child bearing age as antiandrogens are teratogenic. Photo-epilation or electrolysis is mostly needed in order to reduce the amount of hair. Multiple treatments are needed. Hair reduction with each session with photo-epilation is estimated to 15% to 30%. Medical therapy and laser or IPL should be combined for best result.
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